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Volume 15
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10.3390/jcm15187108
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

A Comparative Study of Atropine, Orthokeratology, and Combination Therapy for Axial Elongation in Children with Myopia

by
Ji Ho Park
1,2,
Chan-Ho Cho
3,
Jaehan Joo
4,
Moon Won Hwang
5,
Dongwon Yi
6,
Do Hee Jung
1,2,
Jung Hyo Ahn
1,2,
Seung Min Lee
1,2,
Sangwoo Moon
1,2,
Cheng-Ye Che
7,
Su-Jin Kim
1,2,* and
Ji Eun Lee
1,2,*
1
Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea
2
Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
3
Department of Ophthalmology, College of Medicine, Yeungnam University, Daegu 42415, Republic of Korea
4
Research Institute of Electronics and Information Communication, College of Information Technology and Convergence, Pukyong National University, Busan 48547, Republic of Korea
5
Department of Ophthalmology, College of Medicine, Inje University Busan Paik Hospital, Inje University, Busan 48547, Republic of Korea
6
Division of Endocrinology and Metabolism, Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea
7
Department of Ophthalmology, Affiliated Hospital of Medical College, Qingdao University, Qingdao 266071, China
*
Authors to whom correspondence should be addressed.
J. Clin. Med. 2026, 15(18), 7108; https://doi.org/10.3390/jcm15187108 (registering DOI)
Submission received: 3 August 2026 / Revised: 8 September 2026 / Accepted: 11 September 2026 / Published: 13 September 2026
(This article belongs to the Section Ophthalmology)
Versions Notes

Abstract

Background/Objectives: Atropine and orthokeratology (OK) are used for childhood myopia control, but comparisons of atropine monotherapy, OK monotherapy, and combination therapy remain limited. This study compared 12-month axial length changes and the proportions of fast, intermediate, and slow progressors among these treatments. Methods: This retrospective study included 154 children followed for at least 12 months: 70 received atropine monotherapy, 64 received OK monotherapy, and 20 received combination therapy. Axial length changes at 6 and 12 months were analyzed using a linear mixed-effects model adjusted for age at treatment initiation, sex, baseline axial length and baseline spherical equivalent refractive error. Based on 12-month axial elongation, progression was classified as fast (≥0.30 mm), intermediate (0.15 to <0.30 mm), or slow (<0.15 mm). Results: At 12 months, mean axial elongation was 0.294 ± 0.209 mm, 0.238 ± 0.228 mm, and 0.160 ± 0.109 mm in the atropine, OK, and combination groups, respectively. The group-by-time interaction was significant (p = 0.006). No significant pairwise differences were observed at 6 months. At 12 months, axial elongation was significantly smaller in the combination group than in the atropine and OK groups (adjusted mean differences, 0.161 and 0.115 mm; 95% CI, 0.078–0.245 and 0.024–0.207; Holm-adjusted p < 0.001 and 0.027, respectively). There was no significant difference between the atropine and OK groups (p = 0.155). The pattern of progression differed among groups (p = 0.017), with fast progressors least frequent in the combination group (5.0% vs. 32.9% and 32.8%). Conclusions: In this observational cohort, combination therapy was associated with less axial elongation and fewer fast progressors than either monotherapy.
Keywords: atropine; axial length; combination therapy; myopia control; orthokeratology atropine; axial length; combination therapy; myopia control; orthokeratology

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MDPI and ACS Style

Park, J.H.; Cho, C.-H.; Joo, J.; Hwang, M.W.; Yi, D.; Jung, D.H.; Ahn, J.H.; Lee, S.M.; Moon, S.; Che, C.-Y.; et al. A Comparative Study of Atropine, Orthokeratology, and Combination Therapy for Axial Elongation in Children with Myopia. J. Clin. Med. 2026, 15, 7108. https://doi.org/10.3390/jcm15187108

AMA Style

Park JH, Cho C-H, Joo J, Hwang MW, Yi D, Jung DH, Ahn JH, Lee SM, Moon S, Che C-Y, et al. A Comparative Study of Atropine, Orthokeratology, and Combination Therapy for Axial Elongation in Children with Myopia. Journal of Clinical Medicine. 2026; 15(18):7108. https://doi.org/10.3390/jcm15187108

Chicago/Turabian Style

Park, Ji Ho, Chan-Ho Cho, Jaehan Joo, Moon Won Hwang, Dongwon Yi, Do Hee Jung, Jung Hyo Ahn, Seung Min Lee, Sangwoo Moon, Cheng-Ye Che, and et al. 2026. "A Comparative Study of Atropine, Orthokeratology, and Combination Therapy for Axial Elongation in Children with Myopia" Journal of Clinical Medicine 15, no. 18: 7108. https://doi.org/10.3390/jcm15187108

APA Style

Park, J. H., Cho, C.-H., Joo, J., Hwang, M. W., Yi, D., Jung, D. H., Ahn, J. H., Lee, S. M., Moon, S., Che, C.-Y., Kim, S.-J., & Lee, J. E. (2026). A Comparative Study of Atropine, Orthokeratology, and Combination Therapy for Axial Elongation in Children with Myopia. Journal of Clinical Medicine, 15(18), 7108. https://doi.org/10.3390/jcm15187108

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