Int J Med Sci 2020; 17(2):176-181. doi:10.7150/ijms.39365 This issue

Research Paper

Efficacy and Safety of 1% Atropine on Retardation of Moderate Myopia Progression in Chinese School Children

Qin Zhu1*, Yang Tang1*, Liyun Guo1*, Sean Tighe2, Yuan Zhou1, Xiaofan Zhang1, Jieying Zhang1, Yingting Zhu2✉, Min Hu1✉

1. Department of Ophthalmology, The Second People's Hospital of Yunnan Province (Fourth Affiliated Hospital of Kunming Medical University); Yunnan Eye Institute; Key Laboratory of Yunnan Province for the Prevention and Treatment of ophthalmology (2017DG008); Provincial Innovation Team for Cataract and Ocular Fundus Disease (2017HC010); Expert Workstation of Yao Ke (2017IC064), Kunming 650021, China
2. Tissue Tech, Inc., Ocular Surface Center, and Ocular Surface Research & Education Foundation, Miami, FL, 33126 USA
* The first three authors contribute equally to this work.

This is an open access article distributed under the terms of the Creative Commons Attribution License ( See for full terms and conditions.
Zhu Q, Tang Y, Guo L, Tighe S, Zhou Y, Zhang X, Zhang J, Zhu Y, Hu M. Efficacy and Safety of 1% Atropine on Retardation of Moderate Myopia Progression in Chinese School Children. Int J Med Sci 2020; 17(2):176-181. doi:10.7150/ijms.39365. Available from

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Background: To evaluate the long-term efficacy and safety of topical 1% atropine for retarding moderate myopia.

Methods: A randomized, controlled study evaluating atropine and placebo in 660 Chinese children. Patients received drops q1month for 24 months, then q2month for 12 months, followed by no drops for 12 months. Spherical equivalent, axial length, intraocular pressure and atropine-related side effects were examined at 6, 12, 24, 36 and 48 months for all children.

Results: Spherical equivalent, myopic progression, axial length augmentation, and progression rate were significantly reduced in the atropine group than those in the placebo group (all P<0.05), indicating that 1% atropine effectively retarded myopia. Moreover, myopic rebound and adverse effects of 1% atropine were eliminated by gradual withdrawal and elimination of 1% atropine. Furthermore, pupil size, near visual acuity, and amplitude of accommodation returned to pretreatment levels after withdrawal of atropine.

Conclusion: Topical 1% atropine periodically and alternatively in phase I with gradual reduction in phase II and final withdrawal in phase III may effectively improve atropine efficacy, retard moderate myopia, reduce atropine side effects, minimize myopic rebound, and increase compliance of children simultaneously.

Keywords: atropine, myopia, therapeutic effect, Chinese children