November 15, 2023
By Dwight Akerman, OD, MBA, FAAO, FBCLA, FIACLE
AndreyPopov, Getty Images
This systematic review and meta-analysis by Sarkar et al. (2023) aimed to compare the treatment efficacy of different optical interventions for myopia progression control in children, explore the consistency of treatment efficacies during the treatment period, and evaluate the impact of baseline spherical equivalent refraction (SER), axial length (AL), and age on the treatment effect. The authors searched the EMBASE, PubMed, and Google Scholar databases for articles published between January 2000 and April 2022 that reported the treatment efficacy by differences in the SER and AL change between intervention and control groups. Thirty-five articles were included in the analysis.
The authors found that:
- For refractive error, peripheral add design spectacles and soft contact lenses had large and similar effect sizes (0.66D and 0.53D, respectively), while orthokeratology lenses had a moderate effect size (0.28D).
- For eye length, orthokeratology lenses had the largest effect size (-0.93mm), followed by soft contact lenses (-0.55mm) and peripheral add design spectacles (-0.37mm).
- The effect sizes were largest during the first 12 months of treatment for all interventions but decreased over time.
- Baseline refractive error impacted the treatment effect with peripheral add design spectacles only.
The authors concluded that optical interventions are effective in controlling childhood myopia progression, but their effects diminish over time. OrthoK lenses are the most effective optical intervention, but all three interventions can be beneficial. Regarding implications for clinical practice, the results of this study have important implications for clinical practice. Eye care practitioners should consider optical interventions for all juvenile-onset myopes. Early treatment is likely to be most effective, so it is important to identify and treat myopia in children as early as possible.
Abstract
A Systematic Review and Meta-Analysis of the Efficacy of Different Optical Interventions on the Control of Myopia in Children
Samrat Sarkar, Sieu Khuu, Pauline Kang
To compare the treatment efficacy of childhood myopia control optical interventions [spectacles, soft contact lenses (SCLs), and orthokeratology (OK) lenses], explore the consistency of treatment efficacies during the treatment period and evaluate the impact of baseline spherical equivalent refraction (SER), axial length (AL) and age on the treatment effect. A literature search of EMBASE, PubMed, and Google Scholar databases identified 220 articles published between January 2000 and April 2022, which reported the treatment efficacy by differences in the SER and AL change between intervention and control groups. Thirty-five articles were included in the analysis. Treatment effect sizes (ESs) were calculated, where more positive and negative directions indicated greater treatment efficacy for SER and AL, respectively. For SER, the ESs with peripheral add design spectacles (0.66) and SCLs (0.53) were large but not significantly different between treatment types (p = 0.69). For AL, ESs with peripheral add design spectacles (-0.37), SCLs (-0.55), and OK lenses (-0.93) were large, but OK lenses had a significantly greater effect than peripheral add design spectacles (p ≤ 0.001). ESs were large during the first 12 months of treatment for all interventions [peripheral add design SCLs and OK (F ≥ 5.39, p ≤ 0.01), peripheral add design spectacles (F = 0.47, p = 0.63)] but reduced towards the end of 24-36 months of treatment. Baseline SER had an impact on the treatment effect with peripheral add design spectacles only. Optical interventions are efficacious in controlling childhood myopia progression. However, treatment effects were largest only during the first 12 months of treatment and reduced over time.
Sarkar, S., Khuu, S., & Kang, P. (2023). A systematic review and meta‐analysis of the efficacy of different optical interventions on the control of myopia in children. Acta Ophthalmologica.
DOI: https://doi.org/10.1111/aos.15746
