Axial Shortening in Myopic Children after Repeated Low-Level Red-Light Therapy: Post Hoc Analysis of a Randomized Trial

Introduction Axial length (AL) elongation in myopia is considered irreversible. We aimed to systemically report unexpected AL shortening observed in a randomized clinical trial (RCT) after repeated low-level red-light (RLRL) therapy. Methods This is a post hoc analysis of a multicenter, single-maske...

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Published in:Ophthalmology and therapy Vol. 12; no. 2; pp. 1223 - 1237
Main Authors: Wang, Wei, Jiang, Yu, Zhu, Zhuoting, Zhang, Shiran, Xuan, Meng, Tan, Xingping, Kong, Xiangbin, Zhong, Hui, Bulloch, Gabriella, Xiong, Ruilin, Yuan, Yixiong, Chen, Yanping, Zhang, Jian, Zeng, Junwen, Morgan, Ian G., He, Mingguang
Format: Journal Article
Language:English
Published: Cheshire Springer Healthcare 01.04.2023
Adis, Springer Healthcare
Subjects:
Axial length shortening
Children
Internal Medicine
Medicine
Medicine & Public Health
Myopia
NCT
NCT04073238
Ophthalmology
Original Research
Randomized clinical trial
Repeated low-level red-light (RLRL) therapy
Repeated low-level red-light (RLRL) therapy
Axial length shortening
Randomized clinical trial
Children
Myopia
ISSN:2193-8245, 2193-6528
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Summary:Introduction Axial length (AL) elongation in myopia is considered irreversible. We aimed to systemically report unexpected AL shortening observed in a randomized clinical trial (RCT) after repeated low-level red-light (RLRL) therapy. Methods This is a post hoc analysis of a multicenter, single-masked RCT. Two hundred sixty-four myopic children aged 8–13 years allocated to RLRL treatment (intervention group) or a single vision spectacle (SVS, control group) were included. AL was measured using an IOL-master 500 at baseline, 1-, 3-, 6-, and 12-month follow-up visits. AL shortening was defined as AL reduction from baseline to follow-up visits at three cutoffs: > 0.05 mm, > 0.10 mm, and > 0.20 mm. Frequency of AL shortening at different cutoffs was calculated. Analysis was done with intent to treat (ITT). Results At 12-months follow up, frequency of AL shortening > 0.05 mm was 26/119 (21.85%) and 2/145 (1.38%) for the RLRL group versus the control group, respectively. The frequency was 18/119 (15.13%) versus 0/145 (0%) for AL shortening > 0.10 mm, and 7/119 (5.88%) versus 0/145 (0%), for AL shortening > 0.20 mm, respectively ( p  < 0.001). Mean AL shortening after 12 months (SD) was −0.156 (0.086) mm in the RLRL group and −0.06 mm in the control group. Age was significantly associated with AL shortening in the multivariable analysis. For the RLRL group that exhibited AL shortening ( n  = 56), choroidal thickness (ChT) thickening (0.056 mm) could only explain 28.3% of AL shortening (−0.20 mm). Conclusion Nearly a quarter of children had > 0.05 mm AL shortening following 12 months of RLRL therapy, whereas AL shortening rarely occurred among controls. Trial Registration ClinicalTrials.gov (NCT04073238).
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ISSN:2193-8245
2193-6528
DOI:10.1007/s40123-023-00671-7