Atropine Sulfate Can Slow Progression of Mild to Moderate Myopia

Doctor putting eye drops into girls eye
Doctor putting eye drops into young girls eye.
Efficacy and safety of 3 different doses of atropine sulfate (DE-127) ophthalmic solution at slowing myopia progression.

This article is part of Ophthalmology Advisor’s conference coverage from the 2021 meeting of the American Academy of Ophthalmology, held in New Orleans from November 12 to 15, 2021. The team at Ophthalmology Advisor will be reporting on a variety of the research presented by the ophthalmology experts at the AAO. Check back for more from the AAO 2021 Meeting.


Atropine sulfate (DE-127) can effectively reduce myopia progression, according to research presented at the American Academy of Ophthalmology 2021 annual meeting in New Orleans, held November 12-15. Investigators demonstrated that the drug worked to slow progression at both 0.005% and 0.01% doses.

The investigation reviewed the cases of 99 patients between the ages of 6 and 11 who had mild to moderate myopia and were enrolled in the double-blind APPLE study. Participants were randomly selected to receive either DE-127 0.0025% (n=24), 0.005% (n=24), 0.01% (n=25) or a placebo (n=26). Participants were asked to add 1 drop of the medication into each eye once daily. 

After 1 year, change from baseline of spherical equivalent (SE) and axial length (AL) from each of the study groups was measured against the placebo group. The mean changes to the SE and AL in the DE-127 0.0025% group were  -0.49 (0.06) and 0.30 (0.03), respectively. In the DE-127 0.005% group, SE and AL had mean changes of −0.37 (0.06) and 0.27 (0.03), respectively. In the DE-127 0.0025% SE and AL had a mean change of -0.35 (0.06), and 0.25 (0.03). 

The placebo group had a mean change in SE and AL of −0.60 (0.06) and 0.36 (0.02). A small number of patients in each dose group experienced adverse events that included eye pruritus and blurry vision. 

All atropine doses proved safe and tolerable; however, doses 0.005% and 0.01% demonstrated the most success at slowing myopia progression

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Chia A, Inoue H, Tan D. Efficacy and safety of DE-127 vs placebo in mild or moderate myopia: the APPLE study. Poster presented at: The American Academy of Ophthalmology 2021 Annual Meeting; November 12-15, 2021; New Orleans. Abstract PO241.