March 1, 2024
By Dwight Akerman, OD, MBA, FAAO, FBCLA, FIACLE
Photo Credit: Lightfield Studios, Dreamstime Photos
The prevalence of myopia has been increasing globally, and it is estimated that by the year 2050, nearly half of the world’s population will be affected by this condition. This has led to growing interest in developing effective treatments for controlling myopia progression, particularly in children and adolescents.
However, little attention has been paid to the potential rebound effect of these treatments after their discontinuation. The rebound effect is defined as the increase in myopia progression that occurs after the cessation of a treatment that had previously slowed its progression. This effect is a concern because it could offset the benefits of the treatment and lead to a worsening of myopia. Therefore, it is essential to understand the rebound effect of different myopia control treatments to effectively plan for continued treatment and choose the most suitable treatment option.
In this systematic review, Sánchez‐Tena et al. aimed to assess the rebound phenomenon in different myopia control treatments. They searched two databases, PubMed and Web of Science, for full-length randomized controlled studies (RCTs) and post-hoc analyses of RCTs reporting new findings on myopia control treatment rebound effect. The review included 11 studies, and the Cochrane risk of bias tool was used to analyze the quality of the selected studies.
The authors found that all myopia control treatments produced a rebound effect after their cessation, with the mean rebound effect for axial length (AL) and spherical equivalent refraction (SER) being 0.10 ± 0.07 mm [−0.02 to 0.22] and −0.27 ± 0.2 D [−0.71 to −0.03], respectively, after 10.2 ± 7.4 months of washout. The rebound effect was more significant for pharmacological or light therapies than optical treatments. Specifically, spectacles with highly aspherical lenslets or defocus incorporated multiple segments technology, soft multifocal contact lenses, and orthokeratology showed lower rebound effects compared with atropine and low-level light therapy, with a mean rebound effect for AL and SER of 0.04 ± 0.04 mm [0 to 0.08] and −0.13 ± 0.07 D [−0.05 to −0.2], respectively.
These findings suggest that optical treatments produce less rebound effect than pharmacological or light therapies. However, optical treatments may not achieve the same level of myopia control as pharmacological or light therapies. Therefore, health care professionals and patients must consider both the rebound effect and the level of myopia control achieved by different treatments when choosing the most suitable treatment option.
The authors also noted that more studies are required to confirm these results, particularly studies that compare the long-term efficacy and rebound effect of different myopia control treatments. Additionally, future research should explore the mechanisms underlying the rebound effect and ways to mitigate its impact.
In conclusion, this systematic review highlights the importance of considering the rebound effect of myopia control treatments when planning for continued myopia treatment effectively. The findings suggest that optical treatments produce less rebound effect than pharmacological or light therapies. However, more studies are required to confirm these results, and health care professionals and patients need to consider both the rebound effect and the level of myopia control achieved by different treatments when choosing the most suitable treatment option.
Key Points
- A rebound effect can be observed after the discontinuation of different myopia control treatments.
- Optical treatments seem to produce less rebound effect than pharmacological or light therapies. However, the latter treatments seem to achieve better control of myopia progression.
- Awareness of the rebound effect of myopia control treatments could help health care professionals and patients effectively plan for continued myopia treatment and choose the most suitable treatment option.
Abstract
Assessing the Rebound Phenomenon in Different Myopia Control Treatments: A Systematic Review
Miguel Ángel Sánchez-Tena, Antonio Ballesteros-Sánchez, Clara Martinez-Perez, Cristina Alvarez-Peregrina, Concepción De-Hita-Cantalejo, María Carmen Sánchez-González, José-María Sánchez-González
Purpose: To review the rebound effect after cessation of different myopia control treatments.
Methods: A systematic review that included full-length randomized controlled studies (RCTs), as well as post-hoc analyses of RCTs reporting new findings on myopia control treatments rebound effect in two databases, PubMed and Web of Science, was performed according to the PRISMA statement. The search period was between 15 June 2023 and 30 June 2023. The Cochrane risk of bias tool was used to analyze the quality of the selected studies.
Results: A total of 11 studies were included in this systematic review. Unifying the rebound effects of all myopia control treatments, the mean rebound effect for axial length (AL) and spherical equivalent refraction (SER) were 0.10 ± 0.07 mm [−0.02 to 0.22] and −0.27 ± 0.2 D [−0.71 to −0.03] after 10.2 ± 7.4 months of washout, respectively. In addition, spectacles with highly aspherical lenslets or defocus incorporated multiple segments technology, soft multifocal contact lenses and orthokeratology showed lower rebound effects compared with atropine and low-level light therapy, with a mean rebound effect for AL and SER of 0.04 ± 0.04 mm [0 to 0.08] and −0.13 ± 0.07 D [−0.05 to −0.2], respectively.
Conclusions: It appears that the different treatments for myopia control produce a rebound effect after their cessation. Specifically, optical treatments seem to produce less rebound effect than pharmacological or light therapies. However, more studies are required to confirm these results.
Sánchez‐Tena, M. Á., Ballesteros‐Sánchez, A., Martinez‐Perez, C., Alvarez‐Peregrina, C., De‐Hita‐Cantalejo, C., Sánchez‐González, M. C., & Sánchez‐González, J. M. (2024). Assessing the rebound phenomenon in different myopia control treatments: A systematic review. Ophthalmic and Physiological Optics.
DOI: https://doi.org/10.1111/opo.13277
