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Myopia prevention and control in children: a systematic review and network meta-analysis

Eye volume 37, pages 3461–3469 (2023)Cite this article

Subjects

Abstract

Objectives

To analyse and compare the efficacy of different interventions for myopia prevention and control in children.

Methods

We searched CNKI, VIP, Wan-Fang, CBM, Chinese Clinical Registry, PubMed, The Cochrane Library, Web of Science, Embase and ClinicalTrials.gov from inception to July 2022. We selected randomized controlled trials (RCTs) that included interventions to slow myopia progression in children. The main outcomes included mean annual change in axial length (AL) (millimetres/year) and in refraction (R) (dioptres/year).

Results

A total of 80 RCTs (27103 eyes) were included. In comparison with control, orthokeratology (AL, −0.36 [−0.53, −0.20], P < 0.05; R, 0.56 [0.34, 0.77], P < 0.05), 1%Atropine (AL, −0.39 [−0.65, −0.13], P < 0.05; R, 0.54 [0.31, 0.77], P < 0.05), 0.01%Atropine + orthokeratology (AL, −0.47 [−0.80, −0.14], P < 0.05; R, 0.81 [0.43, 1.20], P < 0.05) could significantly slow the progression of myopia; in addition, progressive multi-focal spectacle lenses (PMSL) (0.42, [0.06, 0.79], P < 0.05), bifocal soft contact lenses (0.40, [0.03, 0.77], P < 0.05), 0.5%Atropine (0.67 [0.25, 1.10], P < 0.05), 0.1%Atropine (0.42 [0.15, 0.71], P < 0.05), 0.05%Atropine (0.57 [0.28, 0.86], P < 0.05), 0.01%Atropine (0.33 [0.15, 0.52], P < 0.05), 1%Atropine + bifocal spectacle lenses (BSL) (1.30 [0.54, 2.00], P < 0.05), 1%Atropine + PMSL (0.66 [0.23, 1.10], P < 0.05), 0.01%Atropine + single vision spectacle lenses (SVSL) (0.70 [0.23, 1.10], P < 0.05), 0.01%Atropine + orthokeratology (0.81 [0.43, 1.20], P < 0.05), BSL + Massage (0.85 [0.22, 1.50], P < 0.05), SVSL + Red light (0.59 [0.06, 0.79], P < 0.05) showed significant slowing effect on the increase in R.

Conclusions

This network meta-analysis suggests that the combined measures were most effective in AL and R, followed by Atropine.

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Fig. 1: Literature screening flowchart.
Fig. 2: Network meta-analysis of eligible comparisons.
Fig. 3: Forest plots of axial length and refraction comparing control.
Fig. 4: Cumulative probability ranking results for axial length and refraction.
Fig. 5: Cluster analysis results of co-interventions for axial length and refraction.

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Data availability

The authors confirm that the data supporting the findings of this study are available within the article [and/or] its supplementary materials.

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Funding

This work was supported by the Natural Science Foundation of China under Grant [No. 82171026].

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Authors and Affiliations

  1. School of Medicine, University of Electronic Science and Technology of China, Chengdu, CN, 611731, China

    Guanghong Zhang, Jun Jiang & Chao Qu

  2. Department of Ophthalmology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, CN, 611731, China

    Guanghong Zhang, Jun Jiang & Chao Qu

  3. Sichuan Key Laboratory for Disease Gene Study, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, CN, 611731, China

    Guanghong Zhang, Jun Jiang & Chao Qu

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GZ and JJ extracted data from published studies and analysed the results. GZ retrieved, ranked documents and drafted the manuscript. CQ provided oversight for the extraction and analysis and identified the accuracy of results and discussion presented in the manuscript.

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Correspondence to Chao Qu.

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Zhang, G., Jiang, J. & Qu, C. Myopia prevention and control in children: a systematic review and network meta-analysis. Eye 37, 3461–3469 (2023). https://doi.org/10.1038/s41433-023-02534-8

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