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Purpose <p>To investigate the effect of nightly 0.01% atropine eye drops on choroidal thickness (ChT) in pre-myopic children (at risk of myopia).</p> Methods <p>In a 12-month randomised, double-blind, placebo-controlled trial, 54 children aged 5–12 received nightly 0.01% atropine or placebo in both eyes. ChT was measured in 15 macular sectors using swept-source OCT at baseline and every 3 months. Longitudinal mixed-effects models (LMM) compared ChT changes between groups, and an unsupervised clustering analysis of individual ChT trajectories was performed.</p> Results <p>Both groups showed progressive choroidal thinning. At 12 months, atropine-treated eyes showed a trend towards less choroidal thinning than placebo, especially in the central, inferior and temporal macular areas, but between-group differences did not reach statistical significance after multiple comparison correction. Clustering of ChT trajectories revealed two exploratory clusters: a “Thinning-dominant” pattern with pronounced mid-year thinning (6–9 months) followed by partial recovery by month 12 and a “Stable ChT” pattern with minimal change. Eyes in the Thinning-dominant group had faster axial elongation than the Stable group, suggesting an association between ΔChT clusters and ocular growth.</p> Conclusions <p>Nightly low-dose atropine in pre-myopic children showed a non-significant trend toward reduced macular choroidal thinning. Clustering and early-change analyses revealed heterogeneity in ChT responses and exploratory associations with ocular growth. These findings require external validation and do not support early ΔChT as a clinically actionable treatment–response marker.</p>

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Effect of 0.01% Atropine on Choroidal Thickness and Ocular Growth in Pre-myopic Children

  • 期刊论文

  • 发表日期：

    2026年4月8日

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  • Meinan He,
  • Luqiang Wang,
  • Shuwei Zhang,
  • Lei Wang,
  • Ziyu Zhang,
  • Ruihua Wei,
  • Hong Nian,
  • Bei Du

摘要

Purpose

To investigate the effect of nightly 0.01% atropine eye drops on choroidal thickness (ChT) in pre-myopic children (at risk of myopia).

Methods

In a 12-month randomised, double-blind, placebo-controlled trial, 54 children aged 5–12 received nightly 0.01% atropine or placebo in both eyes. ChT was measured in 15 macular sectors using swept-source OCT at baseline and every 3 months. Longitudinal mixed-effects models (LMM) compared ChT changes between groups, and an unsupervised clustering analysis of individual ChT trajectories was performed.

Results

Both groups showed progressive choroidal thinning. At 12 months, atropine-treated eyes showed a trend towards less choroidal thinning than placebo, especially in the central, inferior and temporal macular areas, but between-group differences did not reach statistical significance after multiple comparison correction. Clustering of ChT trajectories revealed two exploratory clusters: a “Thinning-dominant” pattern with pronounced mid-year thinning (6–9 months) followed by partial recovery by month 12 and a “Stable ChT” pattern with minimal change. Eyes in the Thinning-dominant group had faster axial elongation than the Stable group, suggesting an association between ΔChT clusters and ocular growth.

Conclusions

Nightly low-dose atropine in pre-myopic children showed a non-significant trend toward reduced macular choroidal thinning. Clustering and early-change analyses revealed heterogeneity in ChT responses and exploratory associations with ocular growth. These findings require external validation and do not support early ΔChT as a clinically actionable treatment–response marker.