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Cohort studyJapanese journal of ophthalmology · 2026

Beyond mild myopia: a pilot randomized trial of 0.01% atropine in school-aged children with myopia ≤ -4.50 D.

Eizo Tanaka, Yuki Morizane, Seiko Fujii … Satoshi Hasebe

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OphthalmologyCohort study

0.01% atropine slowed myopia progression in children with high myopia.

Beyond mild myopia: a pilot randomized trial of 0.01% atropine in school-aged children with myopia ≤ -4.50 D.

Eizo Tanaka … Satoshi Hasebe

Japanese journal of ophthalmology · 2026

Purpose

To conduct an exploratory randomized trial evaluating the efficacy of 0.01% atropine in schoolchildren with myopia ≤ -4.50 D.

Methods

In this 24-month trial, 19 children were assigned to atropine/control (n = 9) or control/atropine (n=10) sequences, with crossover at 12 months.

n = 19 children

Results

less nearsightedness worsening with atropine than without treatment

D/year 0.26 (95% CI 0.08 to 0.45)

CI excludes the null - significant

More results

Baseline spherical equivalent refraction ranged from -11.02 to -4.50 D.

Mean axial length elongation was +0.40 ± 0.18 mm/year under control and +0.34 ± 0.18 mm/year under atropine, with an adjusted difference of -0.05 mm/year (95% CI, -0.11 to +0.00; p = 0.065; 14% inhibition).

More results

Treatment-by-period interactions were not significant for either spherical equivalent refraction or axial length, but rebound could not be excluded given the small sample size.

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Conclusion · 1 of 2

In the present cohort, 0.01% atropine suppressed myopia progression over 12 months, with inhibition ratios similar to previous trials involving mild to moderate myopia.

Conclusion · 2 of 2

These findings support the feasibility of low-dose atropine for advanced myopia and justify full-scale trials.

Post

Beyond mild myopia: a pilot randomized trial of 0.01% atropine in school-aged children with myopia ≤ -4.50 D.

0.01% atropine slowed myopia progression in children with high myopia.

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