Efficacy Comparison of Repeated Low-Level Red Light and Low-Dose Atropine for Myopia Control: A Randomized Controlled Trial

Abstract

Purpose To compare the treatment efficacy between repeated low-level red light (RLRL) therapy and 0.01% atropine eye drops for myopia control. Methods A single-masked, single-center, randomized controlled trial was conducted on children 7 to 15 years old with cycloplegic spherical equivalent refraction (SER) ≤ −1.00 diopter (D) and astigmatism ≤ 2.50 D. Participants were randomly assigned to the RLRL group or low-dose atropine (LDA, 0.01% atropine eye drops) group and were followed up at 1, 3, 6, and 12 months. RLRL treatment was provided by a desktop light therapy device that emits 650-nm red light. The primary outcome was the change in axial length (AL), and the secondary outcome was the change in SER. Results Among 62 eligible children equally randomized to each group (31 in the RLRL group, 31 in the LDA group), 60 children were qualified for analysis. The mean 1-year change in AL was 0.08 mm (95% confidence interval [CI], 0.03–0.14) in the RLRL group and 0.33 mm (95% CI, 0.27–0.38) in the LDA group, with a mean difference (MD) of −0.24 mm (95% CI, −0.32 to −0.17; P < 0.001). The 1-year change in SER was −0.03 D (95% CI, −0.01 to −0.08) in the RLRL group and −0.60 D (95% CI, −0.7 to −0.48) in the LDA group (MD = 0.57 D; 95% CI, 0.40–0.73; P < 0.001). The progression of AL < 0.1 mm was 53.2% and 9.7% ( P < 0.001) in the RLRL and LDA groups, respectively. For AL ≥ 0.36 mm, progression was 9.7% and 50.0% ( P < 0.001) in the RLRL and LDA groups, respectively. Conclusions In this study, RLRL was more effective for controlling AL and myopia progression over 12 months of use compared with 0.01% atropine eye drops. Translational Relevance RLRL therapy significantly slows axial elongation and myopia progression compared with 0.01% atropine; thus, it is an effective alternative treatment for myopia control in children.

Photobiomodulation therapy retarded axial length growth in children with myopia: evidence from a 12-month randomized controlled trial evidence

“…As one of the most effective interventions compared with other interventions 12 – 18 , 20 , 21 , we found evidence supporting our hypothesis that the progression of myopia as measured by the AL is reversible using PBM therapy twice a day.…”

Repeated Low-Level Red Light Therapy for the Control of Myopia in Children: A Meta-Analysis of Randomized Controlled Trials

“…Then, 14 of the 21 articles that received full-text reviews were further excluded for the reasons illustrated in Figure 1. Finally, seven RCTs [15][16][17][18][19][20][21] were deemed to be eligible for the meta-analysis.…”

“…13,14 Accordingly, several clinical trials have been published to evaluate the possible influence of a repeated low-level red light (RLRL) therapy on the progression of myopia in children. [15][16][17][18][19][20][21] However, these studies are generally with small sample sizes and the results of these studies were not always consistent, [15][16][17][18][19][20][21] which could not exclude the possibility of statistical inadequacy related to the limited sample size of some studies. Accordingly, a meta-analysis is particularly useful for the comprehensive evaluation of the potential therapeutic role of RLRL in myopia by pooling the results of the studies.…”

Longitudinal Changes in Choroidal Structure Following Repeated Low-Level Red-Light Therapy for Myopia Control: Secondary Analysis of a Randomized Controlled Trial

“…20 Repeated low-level red-light (RLRL) therapy has been confirmed as an effective and safe intervention for myopia control in children. [21][22][23][24][25][26][27] In addition, a clinically significant subfoveal choroidal thickening has been noted following RLRL therapy, [21][22][23][24]28 with the magnitude of the thickening associated with RLRL therapy's efficacy in myopia control. 28 Nevertheless, detailed vascular and morphometric changes in the choroid following RLRL therapy remain unknown.…”