Atropine and Spectacle lens Combination Treatment (ASPECT): 12-month results of a randomised controlled trial for myopia control using a combination of Defocus Incorporated Multiple Segments (DIMS) lenses and 0.025% atropine

Br J Ophthalmol. 2025 Aug 20;109(9):1074-1080. doi: 10.1136/bjo-2024-326852.

Abstract

Aim: To evaluate and compare the efficacy of combination treatment using 0.025% atropine and Defocus Incorporated Multiple Segments (DIMS) spectacle lenses to 0.025% atropine and single vision (SV) spectacle lenses in slowing myopia progression in children with myopia.

Methods: Randomised controlled trial conducted on children aged 4-16 years with myopia between -1.00D and -6.00D and astigmatism ≤2.00D. Children were randomly allocated into two groups: 0.025% atropine and SV spectacle lenses treatment group (group A), and 0.025% atropine and DIMS spectacle lenses treatment group (group B). Cycloplegic spherical equivalent refraction (SER) and axial length were measured at baseline, 6 and 12 months.

Results: 102 patients completed the 12-month follow-up: n=49 in group A, mean age 9.50±2.78 years and n=53 in group B, mean age 9.90±2.47 years. At 12 months, the mean AL±SD change was 0.18±0.16 mm in group A and 0.07±0.16 mm in group B (mean difference: 0.11, 95% CI: 0.05 to 0.17; p≤0.001). Mean SER±SD progression at 12 months was -0.19±0.42D and -0.09±0.35D in groups A and B, respectively (p=0.13). 39.6% of children in group B had no axial elongation over 12 months compared with 12.2% of the children in group A (p=0.002).

Conclusions: Combination treatment with 0.025% atropine and DIMS spectacle lenses is more effective in controlling axial elongation than 0.025% atropine with SV lenses. Although not significant, SER differences between groups were lower in group B. These findings support a potential additive effect of the two treatments.

Keywords: Child health (paediatrics); Clinical Trial; Treatment other.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Atropine* / administration & dosage
  • Axial Length, Eye
  • Child
  • Child, Preschool
  • Disease Progression
  • Eyeglasses*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Mydriatics* / administration & dosage
  • Myopia* / physiopathology
  • Myopia* / therapy
  • Ophthalmic Solutions
  • Refraction, Ocular / physiology
  • Treatment Outcome
  • Visual Acuity / physiology

Substances

  • Atropine
  • Mydriatics
  • Ophthalmic Solutions