Clinical Report: Dual Therapy for Myopia Control

Overview

The ASPECT trial indicates that combining low-dose atropine with DIMS lenses significantly reduces axial elongation in children with myopia compared to atropine alone. Nearly 40% of children in the combination group showed no axial elongation over 12 months, highlighting the potential of multimodal approaches in myopia management.

Background

Myopia prevalence is rising globally, necessitating effective management strategies to mitigate long-term complications. Combination therapies that address multiple pathways of eye growth may enhance treatment outcomes, particularly in pediatric populations. The ASPECT trial provides critical evidence supporting the use of dual therapy in myopia control.

Data Highlights

Key Findings

• Combination therapy with atropine and DIMS lenses resulted in a statistically significant reduction in axial elongation (0.11 mm difference).
• 39.6% of children receiving combination therapy showed no axial elongation compared to 12.2% in the control group.
• Changes in spherical equivalent refraction were directionally favorable but not statistically significant.
• Children in the combination group achieved axial elongation rates comparable to emmetropic peers.
• Both atropine and DIMS lenses are established monotherapies, each reducing myopia progression by approximately 50–60% in previous studies.

Clinical Implications

The findings from the ASPECT trial support a tailored approach to myopia management, particularly for younger patients. Achieving near-physiological axial growth may help reduce the risk of myopia-related complications over a patient's lifetime.

Conclusion

The ASPECT trial adds to the evidence that combination therapies may be more effective in managing myopia than monotherapy alone. Further long-term studies are needed to confirm these findings and optimize treatment strategies.

Related Resources & Content

1. British Journal of Ophthalmology, 2025 -- 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
2. Optometric Management, July 2023 -- CLINICAL: Myopia Management
3. Optometric Management, August 2023 -- Myopia Control Spectacles: Review of the Latest Research
4. Optometric Management, May 2017 -- SERVE UP MYOPIA CONTROL
5. Contact Lens Spectrum — POINT/COUNTERPOINT: MYOPIA MANAGEMENT
6. https://www.hapos.gr/wp-content/uploads/2025/06/Myopia-Consensus-Statement2025_compressed.pdf
7. 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 | British Journal of Ophthalmology
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