Abstract
Purpose :
Few myopia control treatment comparisons exist in the literature, and none include descriptive statistics. There is also conjecture in describing efficacy as absolute or proportional. This study compared 12-month myopia control efficacy in randomized controlled trials reporting axial length (AL) outcomes. With data represented as 95% confidence intervals (CI), the purposes were to (1) compare efficacy of treatments and (2) evaluate total eye growth of treatment and control groups.
Methods :
The literature was searched for randomized controlled trials of myopia control efficacy for orthokeratology, dual-focus concentric, extended depth of focus (EDOF) and multifocal myopia control soft contact lenses, low-concentration atropine (0.01 to 0.05%), bifocal and novel (DIMS, HAL, SAL, DOT) myopia control spectacle lenses. Included studies reported descriptive statistics (mean and standard deviation or error) for change in AL in test and control groups. Standard deviations and errors were converted to CI’s for graphical comparison of AL outcomes of treatment effect and total growth of treatment and control groups.
Results :
Treatment effects over 12 months (mean 0.14mm) show CI overlap for most treatments except for 0.01% atropine and CD +1.50 Add multifocal contact lenses which cross zero. Distinctly better efficacy can be seen between DIMS and HAL spectacles and the less effective EDOF contact lenses, SAL and DOT Test2 spectacles and CD +2.50 Add multifocal contact lenses. CI’s for dual-focus concentric, CD +2.50 Add multifocal and orthokeratology contact lenses overlap with DIMS, HAL, SAL, DOT0.2 and bifocal spectacles and 0.02% to 0.05% atropine. Total AL growth analysis reveals differences between control groups confounding direct comparison of treatment effects. Entire CI’s for dual-focus concentric, CD multifocal and DOT spectacle lens control groups fall below the mean control group AL growth (0.35mm) while atropine control groups exceed the mean.
Conclusions :
Wide CI outcomes caution against claiming superiority of any treatment, with 0.01% atropine and centre-distance +1.50 Add multifocal contact lenses identified as less effective. Postulation of an absolute treatment effect deserves similar caution owing to CI spread and dissimilarity of control groups. Accounting for control group variability may be better served by analysis of proportional myopia control efficacy.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.