Does Iris Color Affect Atropine?

Meta-analysis examines whether iris color influences atropine 0.01% and 0.05% efficacy in myopia

To investigate whether iris color influences the efficacy of low-dose atropine in myopia management.

Safety-related ocular effects of low-dose atropine appear consistent across different iris colors.
At 24 months, children with non-brown irides showed significantly less myopia progression with atropine 0.01% compared to placebo.
No significant treatment effect was observed in children with brown irides treated with atropine 0.01%.
Differences in efficacy were not observed with atropine 0.05%.
Pharmacokinetics may explain the differences, as atropine binds to melanin in the iris.

The analysis was post-hoc and not powered to detect subgroup differences.
Variability between trials, including formulation differences, may have influenced results.
Previous studies in predominantly Asian populations have shown efficacy with 0.01% atropine, indicating iris color alone may not explain treatment response.