Timing of Height Growth Peaks and Axial Elongation in Atropine-Treated Myopic Children

Purpose To investigate the association between systemic height growth rate and ocular axial elongation rate in atropine-treated children with myopia, and to explore whether the timing of height growth may serve as a prognostic factor for treatment response. Methods Children with myopia (< 15 years) who underwent serial ocular biometry and anthropometric measurements over ≥ 3 visits spanning > 1 year were included. Participants were classified into a control group (no atropine) and an atropine group (0.05% nightly, initiated for axial elongation ≥ 0.4 mm/year). Axial elongation and height growth rates were calculated for each inter-visit interval. Peak growth ages were defined as those with the greatest inter-visit changes. Subgroup analyses in the atropine group were based on the median peak height growth age (10.45 years) and median annual axial elongation rate (0.23 mm/year). Results A total of 139 eyes from 70 children were analyzed (56 control, 83 atropine-treated). Height growth rate and axial elongation rate were not significantly correlated in either group. In the atropine group, peak height growth age showed marginal bimodality (P = 0.051) and correlated strongly with peak axial elongation age (r = 0.86, P < 0.01). Children with earlier height growth peaks had greater annual axial elongation (0.27 ± 0.17 vs. 0.15 ± 0.12 mm/year; P < 0.01) despite identical dosing. Conclusions Among atropine-treated children, earlier systemic growth peaks were associated with faster axial elongation. Monitoring height growth timing may help identify rapid ocular growth periods and optimize treatment strategies.