Retrospective Analysis of a Clinical Algorithm for Managing Childhood Myopia Progression

Abstract

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.

Understanding Posterior Staphyloma in Pathologic Myopia: Current Overview, New Input, and Perspectives

“… 82 , 83 Combined treatments appear more effective than monotherapy 84 , 85 and are under investigation. 86 , 87 …”

Myopia management algorithm. Annexe to the article titled Update and guidance on management of myopia. European Society of Ophthalmology in cooperation with International Myopia Institute

“…If one intervention method fails, another maybe tried, or methods can be combined. 1,2,73,74 It should be noted that at present, while these interventions have been shown to be efficacious in many children, children do not all respond equally, and some children do not respond and continue to progress at pace. Eye care practitioners should not over-promise and more research is needed to develop more targeted and personalised approaches to myopia management.…”

Talkin' 'bout my(opia) generation: The impact of Optometry and Vision Science

“…More recently, an article that clinicians can reference regarding the predictability of future myopia progression from previous myopia progression appeared 12 . Myopia treatment studies and reviews of same have filled OVS 's pages for clinicians and researchers alike 13–19 . So have pieces derived from modeled or existing data 20–22 .…”

“…12 Myopia treatment studies and reviews of same have filled OVS's pages for clinicians and researchers alike. [13][14][15][16][17][18][19] So have pieces derived from modeled or existing data. [20][21][22] Many methodological articles related to animal model results and ocular measurements in humans have been published in the Academy's journal.…”