Abstract
Purpose :
Myopia control treatment studies have specific inclusion criteria for age, refraction and ocular history which can limit application of their outcomes in clinical practice. There are no reports in the literature of these participant parameter ranges and comparison across treatment sub-types. The purpose of this study was to evaluate inclusion criteria for randomized controlled trials of myopia control interventions and provide descriptive statistical data on application of treatment sub-types based on age and refraction.
Methods :
A literature search was undertaken for randomized controlled trials of myopia control interventions which reported axial length as a primary outcome measure. Participant inclusion criteria for minimum and maximum age, minimum and maximum spherical component of refraction, maximum cylindrical component of refraction and maximum anisometropia were analyzed with descriptive statistics (mean and standard deviation) for each of the four intervention categories of spectacles, soft contact lenses, orthokeratology (OK) and topical atropine. Specific exclusion criteria were also tabulated.
Results :
Thirty studies were identified: OK (7), soft contact lenses (10), spectacles (9) and topical atropine (4). Based on median data, the evidence-base for all myopia control interventions currently supports efficacy for children aged 7 to 12 years at treatment commencement, with -0.75D to -4.50D of myopia, 1.25D or less of astigmatism and 1.00D or less of anisometropia. For children younger than 6 years of age there is limited evidence for atropine in controlling myopia. Other treatment categories have limited evidence in children 15 years or older at treatment commencement. Evidence for using OK and atropine extends to high myopia, and OK has evidence for higher levels of astigmatism and anisometropia. Children with amblyopia and strabismus are uniformly excluded from myopia control studies.
Conclusions :
This characterization of a ‘typical’ myopia control patient provides clinical guardrails for evidence-based practice, with specific extensions pertaining to treatment sub-types. Populations outside of these criteria require distinct consideration for informed consent in provision of evidence-based clinical care.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.