Abstract
Purpose :
Performing 3-year trials of treatments to slow myopia progression is burdensome, has potential ethical considerations and may suffer from contamination due to discontinuations and use of off-protocol treatments. Recently, we showed that 3-year myopia progression in treated and untreated groups can be predicted from 1-year data, with axial elongation being the preferred metric.1 Here, we include additional data and test the hypothesis that 1-year efficacy of a myopia control treatment can enable projection of 3-year efficacy.
Methods :
We systematically reviewed the literature to identify papers on myopia progression in children that contained 1-year and 3-year axial elongation for both test and control groups (Pubmed, Embase, OVID and Cochrane Register of Controlled Trials). Eligible studies were appraised for risk of bias. 3-year axial elongation was regressed against 1-year elongation.
Results :
A total of 14 data pairs from 24 cohorts in 10 different studies were eligible for analysis. Test conditions included myopia-control spectacles, contact lenses, orthokeratology and 0.01 and 0.02% atropine. The quality of data was generally low. Only three studies had robust experimental methods and outcomes. Five studies used ultrasound biometry, two studies were non-randomized trials, two studies began as randomized trials but were modified before collection of 3-year data, a control group was common to more than one treatment group in four instances, and, in two cases, the differences between test and control groups were clinically insignificant. Given this lack of quality, the correlation between 1- and 3-year efficacy was remarkably high (see figure: r = 0.98, p<<<0.01) with the 3-year efficacy being approximately double that at 1-year. Consistent with our earlier study,1 addition of covariates did not enhance the fit.
Conclusions :
This analysis builds on our previous observation that group mean 3-year myopia progression is highly correlated with mean 1-year progression. Our findings suggest that valid comparison between different treatment modalities is feasible on the basis of robust 1-year results. This has implications for myopia management in clinical practice and regulatory considerations of myopia control interventions.
1. Brennan et al. OptomVisSci 2023: eAbstract 230014
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.