November 1, 2024
Dwight Akerman, OD, MBA, FAAO, FBCLA, FIACLE
Photo Credit: WebMD
In their review article, “Efficacy in myopia control — The impact of rebound,” Bullimore and Brennan explore the phenomenon of rebound effect after the discontinuation of myopia control treatment. The authors aim to investigate whether myopia progression, after the cessation of treatment, reverts to expected values based on the age and race of the child, or if it accelerates further, which is termed as a rebound.
The authors conducted a comprehensive search on PubMed using the keywords “rebound” and “myopia control” to identify relevant studies. Their inclusion criteria were prospective studies with a treatment duration of at least six months, followed by a cessation period of at least three months, and included axial length data for calculating the rebound. A total of 19 studies comprising 24 treatment groups were identified for analysis.
The results of the analysis revealed that the mean annualized rebound for axial length was +0.05 ± 0.10 mm and for myopia progression was -0.09 ± 0.24D. Notably, these two measures were found to be correlated. The study also found that rebound was associated with one-year treatment efficacy, suggesting that the effectiveness of treatment plays a role in the rebound effect. Additionally, the authors observed that the mean annualized rebound with optical corrections was -0.01 ± 0.03 mm.
One of the significant findings of the study was the variation in rebound values across different types of treatments. For instance, the highest rebound values (≥0.14 mm) were observed in studies involving red light therapy and atropine, while rebound values for overnight orthokeratology ranged from +0.03 to +0.14 mm. Interestingly, the study did not find evidence of rebound for myopia control spectacles and soft contact lenses. This suggests that the rebound effect may be influenced by the specific type of myopia control treatment used.
The study highlights the importance of further research to explore the influence of age and the magnitude of treatment efficacy on the rebound effect. Understanding how these factors impact rebound can contribute to the development of more effective myopia control strategies.
In conclusion, Bullimore and Brennan’s review article sheds light on the impact of rebound after the cessation of myopia control treatment. The findings underscore the need for careful consideration of the potential rebound effect when evaluating myopia control strategies and emphasize the importance of long-term monitoring following the discontinuation of treatment. The variations in rebound effect across different treatment modalities and the correlation with treatment efficacy provide valuable insights for clinicians and researchers working in the field of myopia control. Further research in this area has the potential to advance our understanding of myopia progression and improve the management of this common vision condition.
Abstract
Efficacy in Myopia Control — The Impact of Rebound
Mark A Bullimore, Noel A Brennan
Purpose: When myopia control treatment is discontinued, progression will increase, but does it revert to expected values based on the age and race of the child, or does it accelerate further? The latter scenario is considered a rebound.
Methods: A PubMed search was conducted with the words ‘rebound’ and ‘myopia control,’ identifying further papers from reviews. Inclusion was limited to prospective studies with ≥6 months of treatment, ≥3 months of data following cessation, and with axial length data, which allowed calculation of rebound. Nineteen studies were identified, comprising 24 treatment groups. In 10 studies, untreated control children were followed both throughout the treatment and cessation periods, allowing for a concurrent comparison group. In three studies, a control group was followed for 1 or 2 years and thereafter received the treatment under evaluation. Later, treatment ceased in the originally treated children. Finally, six studies were cross-over designs. For these latter two study designs, initial axial elongation and myopia progression in the control group were extrapolated to the cessation period, accounting for annual slowing. Values from durations of <1 year were annualized.
Results: The mean annualized rebound was +0.05 ± 0.10 mm and -0.09 ± 0.24 D for axial length and myopia progression, respectively, and these were correlated (r2 = 0.59, p < 0.001). Rebound was associated with 1-year treatment efficacy (r2 = 0.43, p < 0.001). The mean annualized rebound with optical corrections was -0.01 ± 0.03 mm. Five of the six highest rebound values (≥0.14 mm) were from red light therapy and atropine studies. Rebound ranged from +0.03 to +0.14 mm for overnight orthokeratology.
Conclusions: Consistent with previous statements, no evidence for rebound was found for myopia control spectacles and soft contact lenses. Future research should explore the influence of age and magnitude of treatment efficacy on rebound.
Bullimore MA, Brennan NA. Efficacy in myopia control-The impact of rebound. Ophthalmic Physiol Opt. 2024 Oct 8. Epub ahead of print.
DOI: 10.1111/opo.13403
