July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Modelling of cumulative treatment efficacy in myopia progression interventions
Author Affiliations & Notes
  • Xu Cheng
    Johnson & Johnson Vision, Jacksonville, Florida, United States
  • Noel A Brennan
    Johnson & Johnson Vision, Jacksonville, Florida, United States
  • Youssef Toubouti
    Johnson & Johnson Vision, Jacksonville, Florida, United States
  • Mark A Bullimore
    College of Optometry, University of Houston , Houston, Texas, United States
  • Footnotes
    Commercial Relationships   Xu Cheng, Johnson & Johnson Vision (E); Noel Brennan, Johnson & Johnson Vision (E); Youssef Toubouti, Johnson & Johnson Vision (E); Mark Bullimore, Acucela, Inc. (C), Alcon Research (C), Amorphex Therapeutics, LLC (C), Apellis Pharmaceuticals, Inc. (C), CooperVision, Inc. (C), Eyenovia, Inc (C), Genentech, Inc. (C), Johnson & Johnson Vision (C), Novartis Pharma AG (C), Tear Film Innovations (C)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 4345. doi:
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      Xu Cheng, Noel A Brennan, Youssef Toubouti, Mark A Bullimore; Modelling of cumulative treatment efficacy in myopia progression interventions. Invest. Ophthalmol. Vis. Sci. 2019;60(9):4345.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Multiple publications report treatment efficacy data for interventions to control myopia progression. Evidence (Brennan & Cheng, 2018 Eye & Contact Lens, e-pub ahead of print) suggests that
i. efficacy is best described as absolute rather than relative reduction in axial elongation across the progression range, and
ii. relative treatment effect slows over time,
indicating that quoted percentage treatment estimates are demonstrably misleading. Here, we perform different regression models to estimate maximum cumulative treatment efficacy of three interventions of interest.

Methods : We reviewed 56 studies reporting myopia control interventions. Analysis was restricted to unique data sets, treatments with efficacy greater than 40% at one timepoint in the first 12 months, studies reporting axial length data and treatments with a minimum of 10 data points contributing to the analysis (treatment effect in reduction of axial elongation by time). Eleven orthokeratology (OK), six soft multifocal contact lens (SMCL) and four spectacle (Spec) data sets remained for analysis. Pharmaceuticals and outdoor activity did not meet criteria for inclusion. Linear, exponential and logarithmic regression models were explored.

Results : Logarithmic modelling provided the best overall fit (OK R2=0.74, SMCL R2=0.73, Spec R2=0.30). Projected average maximum absolute treatment efficacy is reduction of axial elongation by 0.47 mm at 7 years (see figure 1). Different treatments can be regarded as clinically equivalent. On average, 48% of the projected 7-year treatment efficacy occurred in the first year.

Conclusions : The projected best-case treatment effect over 7 years for any individual undergoing myopia control is 0.47 mm, which is equivalent to little more than one diopter. This estimate is lower than previously anticipated but can still provide meaningful reductions in risk of myopia-associated disease. This information is important to moderate expectations for practitioners and patients with respect to likely cumulative outcomes of myopia control treatments.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

Figure 1: Logarithmic fit to cumulative absolute myopia control efficacy for each of OK, SMCL and Spec data sets. (Broken lines represent extrapolation beyond the range of available data).

Figure 1: Logarithmic fit to cumulative absolute myopia control efficacy for each of OK, SMCL and Spec data sets. (Broken lines represent extrapolation beyond the range of available data).

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