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The Association for Research in Vision and Ophthalmology (ARVO) 2025 Annual Meeting is being held in Salt Lake City, Utah, from May 4-8, 2025. Myopia management is one of the most popular research topics at the event, with many leaders in the industry sharing their myopia-related findings. While the meeting featured hundreds of presentations and posters on myopia management, Review of Myopia Management will be highlighting several noteworthy research findings throughout the event.
Here are some of the research highlights from days four and five of ARVO.
Spectacles
Adaptation and Visual Performance of CARE Spectacle Lenses: Findings from the Clinical Evaluation of MyoCare in Europe (CEME) Study
Miguel Angel Sanchez Tena, Cristina Alvarez-Peregrina, Cesar Villa-Collar, Clara Martinez-Perez, Nicole Liu, Padmaja Sankaridurg, Arne Ohlendorf
This study investigates the adaptation, perceived vision and visual performance of cylindrical annular refractive elements (CARE) spectacle lenses designed to slow myopia in children, compared to single vision lenses (SVL). Conducted as part of a two-year, prospective, double-masked, multi-center clinical trial, the research involved 234 European children aged 6-13 years with specific refractive errors. Participants were randomly assigned to receive either CARE (n=115) or SVL (n=119). Adaptation and vision aspects were assessed through a questionnaire at dispensing, one week and three months post-dispensing, using a Likert scale. Visual acuity (VA) was measured at central and peripheral distances at the same intervals. Statistical significance was determined using various tests, with a threshold of p<0.05. Results indicated that children rated adaptation to CARE lenses lower than SVL at one week (7.95±2.00 vs. 9.41±1.15, p<0.001), with 99.1% of SVL users adapting within three days compared to 83.3% of CARE users (p<0.001). Central VA was slightly better with CARE at dispensing (Δ -0.02 logMAR, p<0.001), but not clinically relevant, and no differences were observed at three months. Peripheral VA showed statistically significant differences, with clinical relevance at both visits. While children adapted to CARE lenses, subjective ratings after three months were similar to SVL for most aspects, with peripheral VA reduced by approximately one line.
Myopic control efficacy of myopia children switching from single-vision spectacle lenses to spectacle lenses with aspherical lenslets
XUE LI, Chen-Hsin Sun, Jinhua Bao, Yingying Huang, Hao Chen
The study aimed to evaluate the efficacy of myopia control in children transitioning from single-vision spectacle lenses (SVL) to spectacle lenses with aspherical lenslets (HAL). Conducted over three years with 42 participants, the research focused on axial length (AL) growth as a measure of eye growth and myopia progression. Results indicated that switching to HAL in the third year led to a significant deceleration in eye growth, with an estimated reduction of approximately 59%. This finding aligns with previous studies on myopia control efficacy. Linear regression analysis revealed a slope of 0.41 when using a simplified model, suggesting that HAL effectively slows AL elongation compared to SVL. Additionally, a subgroup of nine eyes showed minimal AL reduction, with a best-fit slope of 0.95, indicating variability in treatment response. The study concludes that the within-eye comparisons of growth before and after HAL treatment can effectively demonstrate intervention efficacy without the need for a parallel control group. For eye care professionals, these findings underscore the potential benefits of HAL lenses in managing myopia progression in children, highlighting the importance of considering lens type in treatment strategies.
Low-dose Atropine
Noemi Guemes-Villahoz, Paula Talavero-Gonzalez, Paloma Porras-Angel, Rafel Bella-Gala, Alicia Ruiz-Pomeda, Beatriz Martin-Gonzalez, Elena Hernandez-Garcia, Carmen Nunila gomez-de-liano, Rakhee Shah, Julian Garcia-Feijoo, Rosario Gomez-de-liano
This randomized controlled trial (RCT) investigates the efficacy of combining 0.025% atropine eye drops with Defocus Incorporated Multiple Segments (DIMS) spectacle lenses compared to 0.025% atropine with single vision (SV) lenses in slowing myopia progression in children. The study recruited children aged 4-16 years with myopia ranging from -1.00D to -6.00D and astigmatism ≤2.00D, randomly assigning them to two groups: group A (atropine and SV lenses) and group B (atropine and DIMS lenses). A total of 102 patients completed the 12-month follow-up, with 49 in group A and 53 in group B. At the 12-month mark, the mean change in axial length (AL) was 0.18±0.16mm for group A and 0.07±0.16mm for group B, showing a significant difference (mean difference: 0.11, p<0.001). The mean spherical equivalent refraction (SER) progression was -0.19±0.42D for group A and -0.09±0.35D for group B (p=0.13). Notably, 39.6% of children in group B experienced no axial elongation over 12 months, compared to 12.2% in group A (p=0.002). The findings highlight the combination of 0.025% atropine and DIMS spectacle lenses is more effective in controlling axial elongation than atropine with SV lenses, suggesting a promising approach for myopia management in children.
Axial Length
Does Prior Progression Predict Future Change in Axial Length among Children with Myopia?
Michael X. Repka, Wesley T. Beaulieu, Stacy L. Pineles, Danielle L. Chandler, Yi Pang, Lori Ann F. Kehler, Catherine Jordan, Katherine Lee, David B. Petersen, Susan A. Cotter, Raymond T. Kraker, Katherine K. Weise, Jonathan M. Holmes
This study investigates whether prior changes in axial length can predict future changes in myopia progression among children aged 5 to under 13 years. A post hoc analysis was conducted on pooled data from participants randomly assigned to receive either 0.01% atropine or placebo eye drops nightly for 24 months. With no significant difference in mean axial length change between the treatment groups, data were combined for analysis. Out of 187 participants, 136 (73%) completed the 12- and 24-month visits with axial length measurements. The results indicated a significant relationship between changes in axial length during the first year and the second year (P<.001). However, the proportion of variation explained was relatively low, with age accounting for 33% and prior axial length change contributing only 6%. The study also evaluated the predictive ability of categorizing participants as fast or slow progressors based on a 0.25 mm change in axial length. Sensitivity and specificity for predicting future progression were 74% and 72%, respectively, but 28% of participants were misclassified between the two years. In conclusion, while age is a significant predictor of axial length progression, prior changes in axial length are not reliable for predicting future changes, limiting their clinical utility for managing myopia in children.
The Limitations of Percentile Growth Curves for Myopia
Mark A. Bullimore, Xu Cheng, Monica Jong, Alex Nixon, Noel A. Brennan
This research revisits the axial length centile growth curves originally published by Hirsch in 1952, assessing their accuracy in representing emmetropic and myopic growth. The study aims to determine the suitability of these curves for evaluating the impact of myopia control therapies. The authors conducted a comprehensive search of PubMed to identify published axial length centile growth curves, ultimately finding six relevant curves: three for European children, two for Chinese children and one for Indian children. They compared axial length values derived from established myopic and emmetropic models against these centile curves. Results indicated that while lower percentiles (shorter axial lengths) generally aligned with emmetropic growth trajectories, the centile curves were flatter for myopic growth, particularly at higher percentiles. Notably, only the centile curves for Chinese children reflected myopic growth patterns, and only for older children at higher percentiles. The study concludes that centile growth curves tend to underestimate the axial elongation rates in myopic children, which may lead to mismanagement of myopia treatment. Eye care professionals should rely on established myopic growth models rather than centile curves to assess treatment efficacy and make informed decisions regarding myopia control strategies.
Light Therapy
Long-Term Efficacy and Safety of Repeated Low-Level Red Light Therapy for Myopia Control: A Real-World Study
Lili Wang, Yanpin Chen, Feng Jiang, Yang Xiao, Junwen Zeng
This prospective, real-world study evaluated the long-term efficacy and safety of repeated low-level red light (RLRL) therapy in controlling myopia progression in children. A total of 1,963 myopic children participated, receiving RLRL therapy via an at-home device emitting red light (650 nm) for three minutes, twice daily, five days a week. The primary outcome was the proportion of participants achieving complete myopia control, defined as axial length (AL) elongation of less than 0.10 mm/year or cycloplegic spherical equivalent refraction (SER) progression of less than 0.25 diopters (D)/year. Among the 896 children aged 6–18 years included in the analysis, 65.5% achieved complete myopia control based on AL elongation, and 68.2% based on SER progression. Factors such as older age, longer baseline A, and more negative baseline SER were associated with better treatment efficacy (P < 0.01). Notably, children aged 6–7 years had lower control rates, but adjusting for physiological growth increased their control rate to 78.1%. Best-corrected visual acuity remained stable in 94.8% of participants, with no severe adverse events reported. These findings indicate that RLRL therapy is a safe and effective intervention for slowing myopia progression in children, with approximately 70% achieving complete myopia control over two years.
MyopiaX-1 12-Month Results: Safety and Effect Outcomes on the Reduction of Myopia Progression in a Multicenter, Randomized, Controlled Trial
Katrin Lorenz, Gareth Lingham, Ian Flitcroft, Nikita A. Wong, Ida Zündorf, Gabriela Burian
The MyopiaX-1 trial evaluates the safety, tolerability and potential efficacy of MyopiaX, an app-based intervention that administers blue light to the optic nerve head to control myopia progression through melanopsin-mediated dopamine release. This randomized, controlled, multicenter clinical trial involved 101 children aged 6 to 12 years with myopia, who were assigned to either MyopiaX or defocus incorporated multiple segments (DIMS) spectacles as the active control. Participants using MyopiaX applied the device twice daily for 12 months, initially as a sole therapy for the first six months and then in conjunction with DIMS for the latter half. Clinical assessments were conducted at multiple intervals, focusing on changes in axial length (AxL) and cycloplegic spherical equivalent refraction (SER). Results showed that 80.2% of participants completed the trial, with no serious ocular adverse events reported. The mean AxL changes at 12 months were 0.18 mm for MyopiaX and 0.14 mm for the control group, while SER changes were -0.25 D and -0.23 D, respectively. Notably, adherence to MyopiaX was associated with reduced AxL change. In conclusion, MyopiaX demonstrated safety and potential efficacy in managing myopia progression, providing eye care professionals with a promising new tool for myopia control.
Contact Lenses
Real-world safety and performance of a novel soft contact lens for myopia management in Chinese children
Xu Cheng, Jie Xu, Alex Nixon, Noel A. Brennan, Weizhong Lan
This study assessed the safety and performance of a soft contact lens designed for myopia control (EE lens) in Chinese children at the Aier Eye Hospital in Hainan, China, over a 12-month period. The research involved a single-site, prospective, single-arm, open-label design, with 70 participants aged 7-12 years fitted with the EE lens. Of these, 64 completed the follow-up. Throughout the study, no participants discontinued due to lens-related issues, and no serious adverse events were reported. At the 12-month mark, the mean changes in axial length (AL) and spherical equivalent cycloplegic autorefraction (SECAR) were 0.09 mm and -0.24D, respectively, indicating minimal myopia progression. Monocular distance visual acuity remained stable, with 95.3% of participants achieving binocular distance visual acuity of 0.00 logMAR or better. Participants reported an average lens wear time of 13.5 hours per day, meeting the compliance requirements. The findings suggest that the EE lens demonstrates excellent safety and vision performance, with minimal axial elongation and myopia progression observed. Eye care professionals may consider these lenses as a viable option for managing myopia in pediatric patients, with ongoing evaluations planned for further validation.
Two-year myopia management efficacy of extended depth of focus soft toric contact lenses in Caucasian children with progressive Myopia and Astigmatism
Jesús Carballo, Mercedes Burgos Martínez, Amaia Urkia-Solorzano, Mónica Velasco de la Fuente, Elena Durán Prieto, Sergio Díaz-Gómez
This study evaluated the effectiveness of extended depth of focus (EDOF) toric soft contact lenses (CL) in slowing myopia progression in Caucasian children with progressive myopia and astigmatism, compared to single-vision toric distance spectacles. With myopia affecting approximately 30% of the global population and a significant portion also experiencing astigmatism, understanding effective management strategies is crucial. In this longitudinal, non-randomized clinical trial, 16 children aged 7-13 years, with spherical equivalent (SE) refractive errors ranging from -1.75D to -8.75D and astigmatism from -0.75D to -2.75D, were recruited. Eight children were fitted with EDOF toric CL, while the other eight wore single-vision spectacles. Measurements of cycloplegic refraction and axial length (AL) were taken at six-month intervals over two years. Results indicated that the CL group experienced a mean change in SE of -0.45D and AL elongation of 0.29mm, while the spectacle group showed a more significant progression of -1.04D and 0.62mm, respectively (p<0.001). The study concluded that EDOF toric soft contact lenses effectively slowed myopia progression compared to monofocal spectacles, providing eye care professionals with a viable option for managing myopia in children with astigmatism.
