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Inducement and Evaluation of a Murine Model of Experimental Myopia
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Efficacy in myopia control.

Noel A Brennan1, Youssef M Toubouti1, Xu Cheng1

  • 1Johnson & Johnson Vision, 7500 Centurion Pkwy, Jacksonville, FL, 32256, USA.

Progress in Retinal and Eye Research
|November 30, 2020
PubMed
Summary
This summary is machine-generated.

Understanding myopia control efficacy is crucial for children and teenagers. Cumulative Absolute Reduction in Axial Elongation (CARE) is a more reliable metric than percentage reduction for assessing treatment effectiveness.

Keywords:
Axial lengthChildrenEfficacyMyopiaMyopia controlRetinal disease

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Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Myopia Control Research

Background:

  • Rapidly expanding interest exists in interventions to slow myopia progression in children and teenagers.
  • Reducing the risk of myopia-associated complications later in life is a key intent of myopia control.
  • Little attention has been devoted to understanding 'efficacy' in myopia control and its application, hindering treatment comparison and prognosis.

Purpose of the Study:

  • To critically review and interpret available data on myopia control efficacy.
  • To identify reliable metrics for assessing treatment effectiveness and long-term outcomes.
  • To provide evidence-based recommendations for myopia control treatment decisions.

Main Methods:

  • Review of existing literature on myopia control treatments.
  • Analysis of clinical study data, including the authors' own research.
  • Assessment of demonstrated myopia control treatments, considering data limitations and context.

Main Results:

  • Axial elongation is the preferred endpoint for assessing myopic progression.
  • The initial rate of axial elongation reduction by myopia control treatments is not sustained over time.
  • Cumulative Absolute Reduction in Axial Elongation (CARE) is a more reliable efficacy metric than percentage reduction, with a maximum measured CARE of 0.44 mm (approximately 1 D).
  • No single treatment method has shown consistent superiority; commonly prescribed therapies like low-dose atropine and progressive addition lenses have not always yielded clinically significant effects.
  • Efficacy illusions can arise from measurement error, sample bias, and regression to the mean.
  • Treatment decisions should be based on age of onset or current refraction, not solely on past progression rates.

Conclusions:

  • Conservative efficacy projection is essential, not extending beyond empirically established data.
  • Treatment is advised for all young myopes due to the decreased risk of future complications, even with modest progression reduction.
  • Given the limitations of current interventions, myopia control treatment should be aggressive.