Myopia Control Effect of Repeated Low-Level Red-Light Therapy in Chinese Children

Dong, Jing; Zhu, Zhuoting; Xu, Haifeng; He, Mingguang

doi:10.1016/j.ophtha.2022.08.024

Cited by 70 publications

(92 citation statements)

References 12 publications

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“…Participants with an afterimage duration exceeding 6 minutes were clinically considered too sensitive to visual stimulus . No other structural changes were noted in this study, consistent with other RLRL studies …”

Section: Discussionsupporting

confidence: 88%

“… 54 No other structural changes were noted in this study, consistent with other RLRL studies. 36 , 40 …”

Section: Discussionmentioning

confidence: 99%

“…[11][12][13][14][15][16][17][18][19][20][21][22] Repeated low-level red-light (RLRL) therapy delivered by a device emitting 650-nm visible red light has been proposed as an alternative myopia control intervention. [36][37][38][39][40][41] Recent research has reported increased blood flow and stabilization of axial elongation among children after the RLRL intervention, which might suggest that RLRL therapy could ameliorate scleral hypoxia and thus prevent the development of myopia. 36 Despite that, its efficacy at preventing myopia remains unknown.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Repeated Low-level Red Light on Myopia Prevention Among Children in China With Premyopia

Wang

Zhu

et al. 2023

JAMA Netw Open

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ImportanceMyopia is a global concern, but effective prevention measures remain limited. Premyopia is a refractive state in which children are at higher risk of myopia, meriting preventive interventions.ObjectiveTo assess the efficacy and safety of a repeated low-level red-light (RLRL) intervention in preventing incident myopia among children with premyopia.Design, Setting, and ParticipantsThis was a 12-month, parallel-group, school-based randomized clinical trial conducted in 10 primary schools in Shanghai, China. A total of 139 children with premyopia (defined as cycloplegic spherical equivalence refraction [SER] of −0.50 to 0.50 diopter [D] in the more myopic eye and having at least 1 parent with SER ≤−3.00 D) in grades 1 to 4 were enrolled between April 1, 2021, and June 30, 2021; the trial was completed August 31, 2022.InterventionsChildren were randomly assigned to 2 groups after grade stratification. Children in the intervention group received RLRL therapy twice per day, 5 days per week, with each session lasting 3 minutes. The intervention was conducted at school during semesters and at home during winter and summer vacations. Children in the control group continued usual activities.Main Outcomes and MeasuresThe primary outcome was the 12-month incidence rate of myopia (defined as SER ≤−0.50 D). Secondary outcomes included the changes in SER, axial length, vision function, and optical coherence tomography scan results over 12 months. Data from the more myopic eyes were analyzed. Outcomes were analyzed by means of an intention-to-treat method and per-protocol method. The intention-to-treat analysis included participants in both groups at baseline, while the per-protocol analysis included participants in the control group and those in the intervention group who were able to continue the intervention without interruption by the COVID-19 pandemic.ResultsThere were 139 children (mean [SD] age, 8.3 [1.1] years; 71 boys [51.1%]) in the intervention group and 139 children (mean [SD] age, 8.3 [1.1] years; 68 boys [48.9%]) in the control group. The 12-month incidence of myopia was 40.8% (49 of 120) in the intervention group and 61.3% (68 of 111) in the control group, a relative 33.4% reduction in incidence. For children in the intervention group who did not have treatment interruption secondary to the COVID-19 pandemic, the incidence was 28.1% (9 of 32), a relative 54.1% reduction in incidence. The RLRL intervention significantly reduced the myopic shifts in terms of axial length and SER compared with the control group (mean [SD] axial length, 0.30 [0.27] mm vs 0.47 [0.25] mm; difference, 0.17 mm [95% CI, 0.11-0.23 mm]; mean [SD] SER, –0.35 [0.54] D vs –0.76 [0.60] D; difference, –0.41 D [95% CI, –0.56 to –0.26 D]). No visual acuity or structural damage was noted on optical coherence tomography scans in the intervention group.Conclusions and RelevanceIn this randomized clinical trial, RLRL therapy was a novel and effective intervention for myopia prevention, with good user acceptability and up to 54.1% reduction in incident myopia within 12 months among children with premyopia.Trial RegistrationClinicalTrials.gov Identifier: NCT04825769

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Section: Discussionsupporting

confidence: 88%

“… 54 No other structural changes were noted in this study, consistent with other RLRL studies. 36 , 40 …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of Repeated Low-level Red Light on Myopia Prevention Among Children in China With Premyopia

Wang

Zhu

et al. 2023

JAMA Netw Open

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“…RLRL was purchased/provided free of charge for the duration of the study period and delivered through a desktop light therapy device (Eyerising, Suzhou Xuanjia Optoelectronics Technology, Jiangsu, China) and is widely used in China for amblyopia in children and teenagers [22][23][24][25]. Details of the device are published elsewhere.…”

Section: Rlrl Therapymentioning

confidence: 99%

Clinically Significant Axial Shortening in Myopic Children After Repeated Low-Level Red Light Therapy: A Retrospective Multicenter Analysis

et al. 2023

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Introduction: Myopia is recognized as a progressive eye disease. The aim of this study was to evaluate the frequency and associated factors of clinically significant axial length (AL) shortening among myopic children following repeated low-level red light (RLRL) therapy. Methods: The clinical data that were collected for the myopic children aged 3-17 years who received an RLRL therapy delivered by homeuse desktop light device that emitted light at 650 nm for at least 1 year, were reviewed. The clinical data included AL, spherical equivalent refraction (SER), and visual acuity measured at baseline and follow-up. The primary outcomes were frequency of AL shortening of [ 0.05 mm, [ 0.10 mm, and [ 0.20 mm per year, and associated factors of AL shortening per year. Results: A total of 434 myopic children with at least 12 months of follow-up data were included. The mean age of participants was 9.7 (2.6) years with SER of -3.74 (2.60) diopters. There were 115 (26.50%), 76 (17.51%), and 20 (4.61%) children with AL shortening based on cutoffs of 0.05 mm/year, 0.10 mm/year, and 0.20 mm/ year, respectively. In the multivariable model, AL shortening was significantly associated with older baseline age, female gender, and longer baseline AL or greater spherical equivalent

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“…Thus, all of the above findings on decreased ALs were quite opposite to the traditional concept that the elongated eyeball was irreversible. Although some evidence has demonstrated that PBM therapy only slows AL growth 5 with a rebound effect 6,7 , it could be a promising pantheon for light-based therapeutic intervention.…”

mentioning

confidence: 99%

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

Zhou¹,

Tong²,

Liu

et al. 2023

Sci Rep

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To determine whether photobiomodulation (PBM) therapy can retard ocular axial length (AL) in children with myopia. A randomized controlled clinical trial was conducted on two consecutive cohorts of 50 eligible children aged 8–12 years with ≤ − 0.75 Diopter (D) of spherical equivalent refraction (SER). Participants were randomly assigned to the intervention group (n = 25) and treated with PBM therapy or the control group (n = 25) and treated with single vision spectacles only. At the 12-month follow-up, the changes in AL and cycloplegic SER from baseline were both compared between the two groups. In addition, the subfoveal choroidal thickness (SFChT), anterior chamber depth (ACD), and central corneal refractive power (CCP) were analysed at the 3-, 6-, 9-, and 12-month follow-ups, respectively. Among the 50 children, 78% were included at the final follow-up, with a mean age of 9.7 ± 1.5 years and a mean SER of − 2.56 ± 1.70. The mean difference in AL growth between the two groups at 12 months was 0.50 mm (PBM vs. Control, − 0.02 mm ± 0.11 vs. 0.48 mm ± 0.16, P < 0.001), and the mean difference in cycloplegic SER at 12 months was + 1.25 D (PBM vs. Control, + 0.28 D ± 0.26 vs. − 0.97 D ± 0.25, P < 0.001). There were no significant differences in any of the other parameters (including SFChT, ACD, and CCP) between the two groups at any time point. PBM therapy is an effective intervention for slightly decreasing the AL to control myopia in children.Trial registration: Chinese Clinical Trial Registration Number: ChiCTR2100043619. Registered on 23/02/2021; prospectively registered. http://www.chictr.org.cn/showproj.aspx?proj=121302.

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Myopia Control Effect of Repeated Low-Level Red-Light Therapy in Chinese Children

Cited by 70 publications

References 12 publications

Effect of Repeated Low-level Red Light on Myopia Prevention Among Children in China With Premyopia

Effect of Repeated Low-level Red Light on Myopia Prevention Among Children in China With Premyopia

Clinically Significant Axial Shortening in Myopic Children After Repeated Low-Level Red Light Therapy: A Retrospective Multicenter Analysis

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

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