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Sofia Peixoto-de-Matos, Ana I. Amorim-de-Sousa, Jose Manuel Gonzalez-Meijome; Factors affecting overall efficacy and 6-month efficacy of optical interventions for myopia control in clinical trials. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2151.
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The purpose of this review of the literature was to re-calculate the efficacy of different myopia control interventions at 6-month intervals to check for consistency overtime and discuss the potential factors involved in any variability observed.
A search was conducted in Pubmed for controlled clinical trials prescribing spectacles or contact lenses (Test group) to control myopia progression as the intended outcome against a control group with single vision spectacles or contact lenses (Control group). Both randomized and non-randomized controlled trials were included if they recruited children up to 12 years of age, had at least a follow-up period of 2 years, with axial length measured with low coherence biometry (IOLMaster) at 6 months intervals. Additionally, an overall efficacy in eye growth control of at least 25% after 2 years was required to qualify for the analysis. Overall (24 months) treatment efficacy against and 6-month efficacy was calculated. Positive values represent lower growth in Control group, 0% represents equal growth in Test and Control and -100% refers to stabilization of AL growth with Test group.
Twelve clinical trials were identified involving custom-designed spectacle lenses, orthokeratology lenses and bifocal or multifocal contact lenses. Their 2-year efficacy varied between -29% to -67%. Six-month efficacy varied between +25% to -100% including periods of 0% efficacy. Treatments revealed to be more effective on average in the first 6-month period (-43±7%) and less effective in the third period (-20±6%) in 65% of the trials analyzed. The rate of progression in the Test group (r2=0.505, p<0.001) but not in the Control group (r2<0.010, p<0.05) influenced the overall efficacy results.
Efficacy of myopia control interventions with spectacles or contact lenses is not significantly affected by the rate of progression in the control group, is not uniform over the course of the treatment during 2 years being minimum in the 3rd semester. Six-month efficacy shows large asymmetries with periods of high efficacy followed by periods of lower or no efficacy
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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