Abstract: Myopia management has evolved from traditional physical correction to early pharmacological intervention. In particular, low-concentration (e.g., 0.01%) atropine, a non-selective muscarinic receptor antagonist, has been extensively investigated and widely applied in myopia prevention and control. In addition, endogenous hormones such as insulin/insulin-like growth factor-1 and estrogen are involved in the regulation of scleral extracellular matrix remodeling, while the dopamine/melatonin circadian rhythm modulates retinal dopamine levels, both of which jointly participate in the onset and progression of myopia. This review elaborates on the mechanism of action, key clinical evidence, as well as existing consensus and controversies of the above-mentioned various pharmacological agents for myopia control, aiming to provide evidence-based references for clinical pharmacological treatment strategies of myopia.

Key words: Myopia, Pharmacotherapy, Atropine, Endogenous hormones