Efficacy of atropine, orthokeratology, and combined atropine with orthokeratology for childhood myopia: A systematic review and network meta-analysis

Tsai, Hou-Ren; Wang, Jen‐Hung; Huang, Huei‐Kai; Chen, Tai‐Li; Chen, Po‐Wei; Chiu, Cheng-Jen

doi:10.1016/j.jfma.2022.05.005

Cited by 29 publications

(22 citation statements)

References 65 publications

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“…Low-dose atropine 0.01% was not effective in the reduction of axial length elongation in two of the included studies. Previous reviews concluded that there is high-level evidence to support the use of atropine to prevent myopia progression (7,9,11,32). Those conclusions are consistent with our observations in this systematic review.…”

Section: Discussionsupporting

confidence: 93%

“…However, those studies did not compare the overall treatment effects. Additionally, 2-year data on highly aspherical lenslets (HAL) have been published (8)(9)(10). The present study updates the published evidence by comparing the efficacy of known treatments with HAL.…”

Section: Reviewed Bymentioning

confidence: 65%

“…Previous reviews concluded that there is high-level evidence to support the use of atropine to prevent myopia progression ( 7 , 9 , 11 , 32 ). Those conclusions are consistent with our observations in this systematic review.…”

Section: Discussionmentioning

confidence: 99%

“…A few meta-analyses on myopia treatment efficacy were published in 2022 (5)(6)(7). Those publications have analyzed the efficacy of individual therapies on myopia control, such as atropine (7), multifocal lens (8) or atropine and orthokeratology (9). However, those studies did not compare the overall treatment effects.…”

Section: Reviewed Bymentioning

confidence: 99%

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Effectiveness of myopia control interventions: A systematic review of 12 randomized control trials published between 2019 and 2021

Lança

Pang

Grzybowski

2023

Front. Public Health

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PurposeThis study aims to investigate the effectiveness of interventions to control myopia progression. In this systematic review, the primary outcomes were mean differences (MD) between treatment and control groups in myopia progression (D) and axial length (AL) elongation (mm).ResultsThe following interventions were found to be effective (p < 0.001): highly aspherical lenslets (HAL, 0.80 D, 95% CI, 0.77–0.83; −0.35 mm, 95% CI −0.36 to −0.34), MiSight contact lenses (0.66 D, 95% CI, 0.63–0.69; −0.28 mm, 95% CI −0.29 to −0.27), low dose atropine 0.05% (0.54 D, 95% CI, 0.38–0.70; −0.21 mm, 95% CI-0.28 to −0.14), Biofinity +2.50 D (0.45 D, 95% CI, 0.29, 0.61; −0.24 mm, 95% CI −0.33 to −0.15), defocus incorporated multiple segments [DIMS] (0.44 D, 95% CI, 0.42–0.46; −0.34 mm, 95% CI −0.35 to −0.33) and ortho-k lenses (−0.24 mm, 95% CI −0.33 to −01.5).ConclusionLow-dose atropine 0.01% was not effective in reducing AL progression in two studies. Treatment efficacy with low-dose atropine of 0.05% showed good efficacy. Spectacles (HAL and DIMS) and contact lenses (MiSight and Biofinity) may confer a comparable treatment benefit compared to atropine, to slow myopia progression.

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Section: Discussionsupporting

confidence: 93%

Section: Reviewed Bymentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Reviewed Bymentioning

confidence: 99%

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Effectiveness of myopia control interventions: A systematic review of 12 randomized control trials published between 2019 and 2021

Lança

Pang

Grzybowski

2023

Front. Public Health

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“…The meta-analysis of Wang et al (2021) and Gao et al (2021) showed that low-dose atropine combined with the OK lens produces more benefits than the OK lens alone in reducing ocular axial elongation in children with myopia, which is consistent also with the conclusion obtained by Yang et al (2022). Tsai et al (2022) have elaborated a meta-analysis about the effect of combining several dosages of atropine with OK and they found that atropine (0.01% -1%), Ortho-K, and 0.01% atropine combined with Ortho-K are comparable approaches in terms of efficacy in the slowdown of myopia progression. A synergistic effect has been observed in the combination of 0.01% atropine and Ortho-K, which demonstrated similar effectiveness to that of high-dose atropine for inhibiting axial elongation.…”

Section: Discussionsupporting

confidence: 80%

Myopia control: monotherapy or combination of treatments?

Giannone¹

2022

IJRP

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Introduction: Discovering the best approach in the management of myopia control is the main objective of several studies. Nowadays, different strategies are carried out to prevent myopia's development and reduce its progression, such as low-dose atropine eye drops, optical devices including multifocal spectacles and multifocal contact lenses, and orthokeratology (Ortho-K). This paper aims to compare the efficacy of the combination of different treatments for myopia control to the prescription of a single treatment.Methods: Studies related to the purpose of this review have been researched mainly on PubMed. Literature research using the database yielded 419 papers, 9 of which were analyzed and compared in this review.Results: A large number of studies is present in the literature concerning the effectiveness of combined therapy compared to monotherapy for the control of myopia progression. In this revision, four studies on the efficacy of low-dose atropine combined with optical devices were selected and also five studies on the combination of atropine with Ortho-K. Conclusion:Most results indicate that combination treatments offer better myopia control efficiency than some monotherapy strategies, but further research on etiology and management of myopia is needed to prevent its development.

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I Can See Clearly Now: Do Glasses Make You More Nearsighted?

Kramer

2023

Believe It or Not

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Efficacy of atropine, orthokeratology, and combined atropine with orthokeratology for childhood myopia: A systematic review and network meta-analysis

Cited by 29 publications

References 65 publications

Effectiveness of myopia control interventions: A systematic review of 12 randomized control trials published between 2019 and 2021

Effectiveness of myopia control interventions: A systematic review of 12 randomized control trials published between 2019 and 2021

Myopia control: monotherapy or combination of treatments?

I Can See Clearly Now: Do Glasses Make You More Nearsighted?

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