Research Review

Myopia Control Effect of Repeated Low-Level Red-Light Therapy with Orthokeratology

February 3, 2025

By Durgasri Jaisankar, PhD, Research Scientist at Brien Holden Vision Institute

myopia control effect

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Outdoor bright light exposure has been identified as an effective factor in myopia prevention. Recent studies have explored the potential of repeated low-level red light (RLRL) therapy as a substitute to increase bright light exposure. Results indicate that RLRL therapy shows good efficacy in controlling myopia. 

Orthokeratology, a non-surgical method, eliminates the need for daytime optical correction and is a common first-line treatment for myopia. However, its effectiveness varies among individuals. The current study investigated whether combining orthokeratology with RLRL therapy could enhance myopia control in children with at least 0.5 mm of axial elongation per year, despite using orthokeratology.

Forty-seven children aged 8-13 years were included in the study. They were randomly assigned to either the RLRL therapy combined with orthokeratology (RCO) group (n=30) or the orthokeratology-only group (n=17). Both groups wore orthokeratology lenses for eight hours per night, while the RCO group also received RLRL therapy twice daily for three minutes. The baseline axial elongation rates were 0.60 mm/year in the RCO group and 0.61 mm/year in the orthokeratology group.

After 12 months, the adjusted mean axial length changes were -0.02 mm in the RCO group and +0.27 mm in the orthokeratology group. This suggests that combining RLRL therapy with orthokeratology may improve myopia control, though further long-term studies are needed to assess its safety, efficacy, and rebound effects.

 

Abstract

Myopia Control Effect of Repeated Low-Level Red-Light Therapy Combined with Orthokeratology — A Multicenter Randomized Controlled Trial

Ruilin Xiong, Wei Wang, Xianghua Tang, Meinan He, Yin Hu, Jian Zhang, Bei Du, Yu Jiang, Zhuoting Zhu, Yanping Chen, Shiran Zhang, Xiangbin Kong, Ruihua Wei, Xiao Yang, Mingguang He 

Purpose: To investigate the efficacy and safety of repeated low-level red-light (RLRL) therapy combined with orthokeratology among children who, despite undergoing orthokeratology, exhibited an axial elongation of at least 0.50 mm over 1 year.

Design: Multicenter, randomized, parallel-group, single-blind clinical trial (ClinicaTrials.gov identifier, NCT04722874).

Participants: Eligible children were 8-13 years of age with a cycloplegic spherical equivalent refraction of –1.00 to –5.00 diopters at the initial orthokeratology fitting examination and had annual axial length (AL) elongation of ≥0.50 mm despite undergoing orthokeratology. Forty-eight children were enrolled from March 2021 through January 2022, and the final follow-up was completed in March 2023.

Methods: Children were assigned randomly to the RLRL therapy combined with orthokeratology (RCO) group or to the orthokeratology group in a 2:1 ratio. The orthokeratology group wore orthokeratology lenses for at least 8 hours per night, whereas the RCO group received daily RLRL therapy twice daily for 3 minutes in addition to orthokeratology.

Main Outcome Measures: The primary outcome was AL change measured at 12 months relative to baseline. The primary analysis was conducted in children who received the assigned intervention and completed at least 1 follow-up after randomization using the modified intention-to-treat principle.

Results: Forty-seven children (97.9%) were included in the analysis (30 in the RCO group and 17 in the orthokeratology group). The mean axial elongation rate before the trial was 0.60 mm/year and 0.61 mm/year in the RCO and orthokeratology groups, respectively. After 12 months, the adjusted mean AL changes were –0.02 mm (95% confidence interval [CI], –0.08 to +0.03 mm) in the RCO group and 0.27 mm (95% CI, 0.19–0.34 mm) in the orthokeratology group. The adjusted mean difference in AL change was –0.29 mm (95% CI, –0.44 to –0.14 mm) between the groups. The percentage of children achieving an uncorrected visual acuity of more than 20/25 was similar in the RCO (64.3%) and orthokeratology (65.5%) groups (P = 0.937).

Conclusions: Combining RLRL therapy with orthokeratology may offer a promising approach to optimize axial elongation control among children with myopia. This approach also potentially allows children to achieve satisfactory visual acuity, reducing daytime dependence on corrective eyewear.

Xiong, R., Wang, W., Tang, X., He, M., Hu, Y., Zhang, J., … & He, M. (2024). Myopia Control Effect of Repeated Low-Level Red-Light Therapy Combined with Orthokeratology: A Multicenter Randomized Controlled Trial. Ophthalmology.                                                         

DOI: https://doi.org/10.1016/j.ophtha.2024.05.015

 

Durgasri Jaisankar, BS Optometry, PhD, is working as a  postdoctoral researcher in lens design and development at the Brien Holden Vision Institute, Sydney. Her current area of research is  spectacle and contact lens designs for myopia management and presbyopia.
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