This unique extended depth of focus (center distance) daily disposable multifocal contact lens was effective in slowing myopic progression in these children. These findings add to the growing evidence that center distance multifocal soft contact lenses may slow the progression of myopia.

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SIGNIFICANCE:As the myopia epidemic unfolds, there is growing urgency to identify and implement effective interventions to slow myopia progression. This investigation evaluated the effectiveness of an evidence-based myopia treatment algorithm in a clinical setting among 342 consecutive children. PURPOSE:This study aimed to evaluate effectiveness of a clinical treatment algorithm for myopia progression in children.METHODS: A retrospective cohort analysis was performed using data from myopic children treated for at least 1 year with a defined treatment algorithm incorporating orthokeratology, multifocal lenses, and atropine. The main outcome measures were the percentage of children experiencing ≤0.25 D of myopic cycloplegic spherical equivalent autorefraction (CSER) progression and ≤0.10 mm of axial elongation at 1, 2, and 3 years. The secondary outcome measures were the cumulative absolute reduction of axial elongation values derived from age-and ethnicitymatched virtual control data at 1, 2, and 3 years.RESULTS: Mean annual CSER change values (excluding orthokeratology) were −0.30, −0.20, and −0.13 D at 1, 2, and 3 years, respectively, with 59, 56, and 60% of patients demonstrating ≤0.25 D of change over the prior year. Mean annual axial elongation values were 0.13, 0.12, and 0.09 mm at 1, 2, and 3 years, respectively, with 52, 46, and 65% of patients demonstrating ≤0.10 mm of change over the prior year. The cumulative absolute reduction of axial elongation values were 0.11, 0.20, and 0.29 mm for 1, 2, and 3 years, respectively. CONCLUSIONS:The treatment algorithm demonstrated effective control of CSER and axial length in a diverse group of progressive myopic children, supporting its use for the clinical management of childhood myopia.

To evaluate myopia progression over an approximately 6-year follow-up period in children and young adults wearing a commercially available, daily disposable, soft multifocal contact lens with an extended depth of focus (center distance) design. Methods: This retrospective cohort analysis included data from 196 patients of mean (SD) age 12.3 (2.7) years (range, 5-20 years), fit with the NaturalVue Multifocal (NVMF) contact lens at 15 practices in the United States over 6 years. All patients showed at least −0.50D of myopic progression in at least one eye prior to wearing the lens. Data from the right eye were analyzed. One-way ANOVA with Tukeys post-hoc t-tests were used for statistical analysis, with a significance level set at P < 0.05. Results: After wearing these lenses for 6-72 months, the average myopia progression slowed by approximately 0.84 D or 85% compared to baseline, which was statistically significant at all time points (P < 0.0001). Frequency distribution revealed that 91% of wearers showed a decrease in myopia progression compared to baseline, with 79% of wearers showing a ≥70% reduction in myopia progression. The average change in axial length in a subset of the population over 47 months of follow-up was approximately 0.10 mm/year. Compared with changes expected in an age-and ethnicity-matched myopic virtual control group obtained from published meta-analysis data, both myopic refractive error progression and axial elongation were significantly lower in NVMF wearers at 12, 24 and 36 months (P < 0.001). Analysis of the age-and ethnicity-matched virtual control group predicted that the Cumulative Absolute Reduction of axial Elongation (CARE) value over 3 years would be 0.45 mm. Conclusion: Wearers of the soft multifocal contact lens displayed significant reductions in myopia progression throughout a follow-up period of 6 years.

Childhood myopia progression occurs due to excessive axial elongation of the eye and results in increased risk for sight-threatening ocular comorbidities. Increased daily time spent outdoors and sustained use of peripheral defocus modifying lenses have been shown to exert anti-myopigenic effects in children. Here, we evaluate a novel spectacle device which projected bright, broad spectrum light combined with myopic peripheral retinal defocus in children. It was theorized that a significant decrease in myopic cycloplegic spherical equivalent autorefraction (CSER) and axial elongation would be observed in treated eyes of subjects who used the device 1.5 hours per day, five days per week, versus age- and ethnicity-matched untreated myopic virtual controls. Projected one-year myopic CSER increase and axial elongation were found to be significantly less in treated eyes, with estimated treatment effects of 0.46 D for CSER and -0.20 mm for axial length versus virtual controls. These treatment effects after part-time wear are similar to values reported for other spectacle and contact lens therapies which are worn on a full time basis for myopia control, which may suggest the novel study device exerts myopic inhibition effects via unique or multifactorial pathways.