Three-year results of 0.01% and 0.1% loading dose atropine treatment including washout in Danish children with myopia: a placebo-controlled, randomised clinical trial
Reviewed by Jonathan Chan

This was a placebo-controlled, double-blind, randomised clinical trial of 97 children to examine the safety and efficacy of low-dose atropine (0.1% and 0.01% loading dose) after 2-year treatment and 1-year washout in 6–12-year-old Danish children with myopia. Ninety-one children were randomised to receive either 0.01% low-dose atropine for 24 months or 0.1% for 6 months, then 0.01% for 18 months (0.1% loading dose) or placebo, followed by 1-year washout. The primary outcome was myopia progression (axial length (AL)) and spherical equivalent refraction (SER). The secondary outcomes were adverse events, ocular biometrical measurements and treatment responder eyes (myopia progression of less than -0.5 dioptres (D)). At 3 years, the mean AL was -0.06mm and -0.09mm less compared with placebo in the 0.1% loading dose and 0.01% groups. Mean SER was -0.02D less and 0.17D more compared to the placebo group in the 0.1% loading dose group and the 0.01% group. There was no significant group difference in the responder eyes. The authors concluded that there was no difference in myopia progression between groups following washout. A 6-month 0.1% loading dose did not improve efficacy compared with 0.01%. The 0.1% loading dose showed a rebound effect after dose switching.

3-year results of 0.01% and 0.1% loading dose atropine treatment including washout in Danish children with myopia: a placebo-controlled, randomised clinical trial.
Hansen N, Hvid-Hansen A, Møller F, et al. 
BRITISH JOURNAL OF OPHTHALMOLOGY
2025;109(9):1056–63.