Introduction: To explore the short-term effects of atropine 0.01% on the structure and vasculature of the choroid and retina in myopic Chinese children. Methods: This study was a single-center randomized clinical trial. A total of 40 subjects with myopia \ -6.0 D were enrolled and randomized to receive atropine 0.01% once nightly with regular single-vision lenses or to simply wear regular single-vision lenses at an allocation ratio of 1:1. Follow-up visits were planned at 1 month and 3 months. Choroidal thickness (ChT) was obtained by optical coherence tomography (OCT). Retinal vessel density (RVD), retinal thickness (RT), foveal avascular zone (FAZ) and choriocapillaris flow (CCF) were measured by optical coherence tomography angiography (OCTA). The RVD and RT were measured at fovea, parafovea and perifovea area and four quadrants.Results: Twenty-one subjects were allocated into the atropine group and 19 subjects into the control group. Over 3 months, the control group showed greater progression of myopia than those in the atropine group. ChT in the atropine group increased 11.12 ± 13.96 lm, which was not significant compared with that of the control group. None of the retinal sectors in atropine-treated eyes showed significant changes of RT and RVD compared with the control group. Besides, FAZ and CCF of the atropine group were not affected by atropine use over time, and there was no difference between the two groups. Conclusion: Administration of atropine 0.01% eye drops demonstrated no effect on RVD, FAZ and CCF over 3 months, while a modest increase of ChT was observed in atropine-treated eyes. Trial Registration Number: ChiCTR1800017154.

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