Ophthalmic Physiol Opt. 2026 Apr 8. doi: 10.1007/s44402-026-00058-8. Online ahead of print.
ABSTRACT
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.
PMID:41949791 | DOI:10.1007/s44402-026-00058-8
