{
  "abstract": "Background and Importance Myopia is increasing among children, with 22% of 5th graders and 22% of 10–14-year-olds affected in Estonia. Myopia raises the risk of serious eye diseases such as myopic macular degeneration, retinal detachment, glaucoma, and cataracts. Low-dose atropine is used off-label to slow myopia progression, with the strongest evidence from Asian populations. In Europe, and especially in Estonia, the effect is still being determined. Currently, there is no approved medication treatment for myopia in Estonia.Aim and Objectives To develop a protocol for preparing 0.05% atropine eye drops in a hospital pharmacy cleanroom as the first medical treatment option for myopia in Estonia. Additional objectives were to create affordable unit-dose eye drops, analyse their efficacy and tolerability in Estonian children, obtain health insurance funding, and enhance cooperation between hospital pharmacies nationwide.Materials and Methods A 12-month prospective study of 34 myopic children (median age 11.8 years; median SER –5.0 D) was conducted. Patients were treated with 0.05% atropine unit-dose eye drops prepared weekly under class A cleanroom conditions. Refraction was measured at baseline and at 3, 6, 9 and 12 months. Side effects were monitored at each visit.Results and Impact The protocol for preparing 7-day unit-dose eye drops was successfully implemented. After 12 months, mean SER change was only –0.10 D. Since January 2025, treatment has been reimbursed by the Health Insurance Fund, and prescriptions have increased by over 26% annually. Since June 2025, Pärnu Hospital Pharmacy also prepares atropine drops, currently treating three patients. All children continue treatment due to excellent outcomes.What’s Next Conduct stability studies to extend shelf life beyond 1 week, scale up preparation to reach more patients, and expand production to other hospitals in Estonia. The long-term goal is to ensure wider European availability of 0.05% atropine eye drops.",
  "authors": [
    {
      "affiliations": [
        "East Tallinn Central Hospital, Ravi 18, 10138, Tallinn, Estonia"
      ],
      "name": "Susanna Ojamäe"
    },
    {
      "affiliations": [
        "East Tallinn Central Hospital, Ravi 18, 10138, Tallinn, Estonia"
      ],
      "name": "Ülle Helena Meren"
    },
    {
      "affiliations": [
        "East Tallinn Central Hospital, Ravi 18, 10138, Tallinn, Estonia"
      ],
      "name": "Kadi Palumaa"
    }
  ],
  "title": "NP-001 0.05% atropine for myopia treatment for children in Estonia: development of a protocol to prepare eye drops and the effect and tolerability in a 12-month treatment in East Tallinn Central Hospital",
  "uid": "f76d1628-2355-546c-bd6b-4b1d387d4d94"
}