PHARMACOLOGICAL INTERVENTIONS FOR CHILDHOOD MYOPIA CONTROL: A SCOPING REVIEW OF EVIDENCE AND GLOBAL PATTERNS
Author(s)
Sui Chee Fai, PhD;
SUNWAY UNIVERSITY, STUDENT, Bandar Sunway, Malaysia
SUNWAY UNIVERSITY, STUDENT, Bandar Sunway, Malaysia
OBJECTIVES: Childhood myopia is a progressive condition projected to affect nearly 40% of children worldwide by 2050. Its early onset increases risks of high myopia and vision-threatening complications later in life. This scoping review maps current pharmacological interventions in children, highlighting study characteristics, gaps, and priorities for future research.
METHODS: We conducted a scoping review of pharmacological interventions for childhood myopia. Literature searches were performed in PubMed, Scopus, Web of Science, and the Cochrane Library. The review followed the Arksey and O’Malley methodological framework and adhered to PRISMA‑ScR reporting guidelines.Eligible studies included children aged 2-18 years and evaluated pharmacological interventions for myopia progression. Data were extracted on study design, country, sample size, intervention type and concentration, duration, and age groups.
RESULTS: A total of 81 studies were included, with 77 focusing on atropine and 4 on non-atropine interventions. Three agents were identified, with atropine accounting for up to 95% of the publications. The volume of publications surged, with 66.7% of the studies published between 2021 and 2025. Geographically, 70.0% of the studies originated from Asia, while 54.4% were conducted in high-income countries.Of the study designs analyzed, 53.1% were randomized controlled trials (RCTs). Atropine interventions varied across 12 concentrations (0.0025% to 1.0%), with 0.01% being the most frequently studied. Efficacy demonstrated a dose-dependent response; 0.05% atropine achieved superior control in Asian populations, resulting in a 67% reduction in spherical equivalent refraction (SER) compared to 27% for 0.01%. Conversely, the 0.01% dose exhibited limited efficacy in non-Asian cohorts.High-dose atropine (≥0.5%) demonstrated short-term efficacy but was associated with significant rebound effects and minimal long-term benefits. Notably, only 35.0% of the studies included preschool children, and 47.5% had a follow-up duration of 12 months or less.
CONCLUSIONS: Atropine is the only pharmacological agent with substantial evidence for myopia control, providing a favorable risk-benefit balance at low-to-medium doses.
METHODS: We conducted a scoping review of pharmacological interventions for childhood myopia. Literature searches were performed in PubMed, Scopus, Web of Science, and the Cochrane Library. The review followed the Arksey and O’Malley methodological framework and adhered to PRISMA‑ScR reporting guidelines.Eligible studies included children aged 2-18 years and evaluated pharmacological interventions for myopia progression. Data were extracted on study design, country, sample size, intervention type and concentration, duration, and age groups.
RESULTS: A total of 81 studies were included, with 77 focusing on atropine and 4 on non-atropine interventions. Three agents were identified, with atropine accounting for up to 95% of the publications. The volume of publications surged, with 66.7% of the studies published between 2021 and 2025. Geographically, 70.0% of the studies originated from Asia, while 54.4% were conducted in high-income countries.Of the study designs analyzed, 53.1% were randomized controlled trials (RCTs). Atropine interventions varied across 12 concentrations (0.0025% to 1.0%), with 0.01% being the most frequently studied. Efficacy demonstrated a dose-dependent response; 0.05% atropine achieved superior control in Asian populations, resulting in a 67% reduction in spherical equivalent refraction (SER) compared to 27% for 0.01%. Conversely, the 0.01% dose exhibited limited efficacy in non-Asian cohorts.High-dose atropine (≥0.5%) demonstrated short-term efficacy but was associated with significant rebound effects and minimal long-term benefits. Notably, only 35.0% of the studies included preschool children, and 47.5% had a follow-up duration of 12 months or less.
CONCLUSIONS: Atropine is the only pharmacological agent with substantial evidence for myopia control, providing a favorable risk-benefit balance at low-to-medium doses.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EPH164
Topic
Epidemiology & Public Health
Disease
SDC: Pediatrics, SDC: Sensory System Disorders (Ear, Eye, Dental, Skin)