Ophthalmology
Ophthalmology
5 years ago

Efficacy Comparison of 16 Interventions for Myopia Control in Children

To determine the effectiveness of different interventions to slow down the progression of myopia in children. Methods We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov from inception to August 2014. We selected randomized controlled trials (RCTs) involving interventions for controlling the progression of myopia in children with a treatment duration of at least 1 year for analysis. Main Outcome Measures The primary outcomes were mean annual change in refraction (diopters/year) and mean annual change in axial length (millimeters/year). Results Thirty RCTs (involving 5422 eyes) were identified. Network meta-analysis showed that in comparison with placebo or single vision spectacle lenses, high-dose atropine (refraction change: 0.68 [0.52–0.84]; axial length change: −0.21 [−0.28 to −0.16]), moderate-dose atropine (refraction change: 0.53 [0.28–0.77]; axial length change: −0.21 [−0.32 to −0.12]), and low-dose atropine (refraction change: 0.53 [0.21–0.85]; axial length change: −0.15 [−0.25 to −0.05]) markedly slowed myopia progression. Pirenzepine (refraction change: 0.29 [0.05–0.52]; axial length change: −0.09 [−0.17 to −0.01]), orthokeratology (axial length change: −0.15 [−0.22 to −0.08]), and peripheral defocus modifying contact lenses (axial length change: −0.11 [−0.20 to −0.03]) showed moderate effects. Progressive addition spectacle lenses (refraction change: 0.14 [0.02–0.26]; axial length change: −0.04 [−0.09 to −0.01]) showed slight effects. Conclusions This network analysis indicates that a range of interventions can significantly reduce myopia progression when compared with single vision spectacle lenses or placebo. In terms of refraction, atropine, pirenzepine, and progressive addition spectacle lenses were effective. In terms of axial length, atropine, orthokeratology, peripheral defocus modifying contact lenses, pirenzepine, and progressive addition spectacle lenses were effective. The most effective interventions were pharmacologic, that is, muscarinic antagonists such as atropine and pirenzepine. Certain specially designed contact lenses, including orthokeratology and peripheral defocus modifying contact lenses, had moderate effects, whereas specially designed spectacle lenses showed minimal effect.

Publisher URL: www.sciencedirect.com/science

DOI: S0161642015013561

You might also like
Discover & Discuss Important Research

Keeping up-to-date with research can feel impossible, with papers being published faster than you'll ever be able to read them. That's where Researcher comes in: we're simplifying discovery and making important discussions happen. With over 19,000 sources, including peer-reviewed journals, preprints, blogs, universities, podcasts and Live events across 10 research areas, you'll never miss what's important to you. It's like social media, but better. Oh, and we should mention - it's free.

  • Download from Google Play
  • Download from App Store
  • Download from AppInChina

Researcher displays publicly available abstracts and doesn’t host any full article content. If the content is open access, we will direct clicks from the abstracts to the publisher website and display the PDF copy on our platform. Clicks to view the full text will be directed to the publisher website, where only users with subscriptions or access through their institution are able to view the full article.