Optical interventions for myopia control

Abstract

A range of optical interventions have been developed to slow the progression of myopia. This review summarizes key studies and their outcomes. Peer-reviewed, randomized controlled clinical trials of at least 18 months duration were identified. Randomized clinical trials were identified and summarised: 13 for spectacles, 5 for overnight orthokeratology, 5 for soft contact lenses, and 3 for orthokeratology combined with low concentration atropine. Overnight orthokeratology trials were the most consistent with 2-year slowing of axial elongation between 0.24 and 0.32 mm. Other modalities were more variable due to the wide range of optical designs. Among spectacle interventions, progressive addition lenses were the least effective, slowing axial elongation and myopia progression by no more than 0.11 mm and 0.31 D, respectively. In contrast, novel designs with peripheral lenslets slow 2-year elongation and progression by up to 0.35 mm and 0.80 D. Among soft contact lens interventions, medium add concentric bifocals slow 3-year elongation and progression by only 0.07 mm and 0.16 D, while a dual-focus design slows 3-year elongation and progression by 0.28 mm and 0.67 D. In summary, all three optical interventions have the potential to significantly slow myopia progression. Quality of vision is largely unaffected, and safety is satisfactory. Areas of uncertainty include the potential for post-treatment acceleration of progression and the benefit of adding atropine to optical interventions.

摘要

目前已开发出一系列减缓近视进展的干预手段。本综述总结了主要的研究及其成果。确定了至少18个月的同行评审随机对照临床试验。确定并总结了随机临床试验: 13项关于眼镜, 5项夜间角膜塑形镜, 5项软性角膜接触镜, 3项行角膜塑形镜联合低浓度阿托品。夜间角膜塑形镜临床试验表明两年眼轴增长可减缓0.24mm-0.32 mm。由于光学设计的差异性, 其他形式的变化更大。在眼镜干预措施中, 渐进多焦点眼镜的效果最差, 减缓眼轴增长和近视进展分别为0.11mm和0.31D; 相比离焦镜的新型设计可使眼轴2年增长和近视进展减缓高达0.35 mm 和0.80 D。在软性接触镜干预中, 介质添加同心双焦距使眼轴3年增长和近视进展减缓仅0.07 mm 和0.16 D, 而双焦软性塑形镜可使眼轴3年增长和近视进展减缓0.28 mm 和0.67 D。总之, 这三种光学干预的方法都有可能显著减缓近视进展。而视觉质量基本未受影响, 安全性令人满意。当前有关光学干预后可能加速近视进展以及在光学干预中加入阿托品的益处尚不明确。