BACKGROUND Myopia, as one of the common ocular diseases, often occurs in adolescence. In addition to the harm from itself, it may also lead to serious complications. Thus, prevention and control of myopia are attracting more and more attention. Previous research revealed that single-focal glasses and orthokeratology lenses (OK lenses) played an important part in slowing down myopia and preventing high myopia. AIM To compare the clinical effects of OK lenses and frame glasses against the increase of diopter in adolescent myopia and further explore the mechanism of the OK lens. METHODS Changes in diopter and axial length were collected among 70 adolescent myopia patients (124 eyes) wearing OK lenses for 1 year (group A) and 59 adolescent myopia patients (113 eyes) wearing frame glasses (group B). Refractive states of their retina were inspected through multispectral refraction topography. The obtained hyperopic defocus was analyzed for the mechanism of OK lenses on slowing down the increase of myopic diopter by delaying the increase of ocular axis length and reducing the near hyperopia defocus. RESULTS Teenagers in groups A and B were divided into low myopia (0D - -3.00 D) and moderate myopia (-3.25D - -6.00 D), without statistical differences among gender and age. After 1-year treatment, the increase of diopter and axis length and changes of retinal hyperopic defocus amount of group A were significantly less than those of group B. According to the multiple linear analysis, the retinal defocus in the upper, lower, nasal, and temporal directions had almost the same effect on the total defocus. The amount of peripheral retinal defocus (15°-53°) in group A was significantly lower than that in group B. CONCLUSION Multispectral refraction topography is progressive and instructive in clinical prevention and control of myopia.