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Retrospective Analysis of a Clinical Algorithm for Managing Childhood Myopia Progression
Jeffrey Cooper1, Thomas Aller2, Earl L Smith3
1College of Optometry, State University of New York, New York, New York.
Insights
This study shows an evidence-based myopia treatment algorithm effectively slowed myopia progression in children. The algorithm, using orthokeratology, multifocal lenses, and atropine, demonstrated significant control of refractive error and axial length.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Myopia Control Research
Background:
- The global increase in myopia necessitates effective interventions to slow its progression.
- Childhood myopia is a growing public health concern requiring evidence-based management strategies.
Purpose of the Study:
- To evaluate the effectiveness of a clinical myopia treatment algorithm in a real-world setting.
- To assess the algorithm's impact on refractive error and axial elongation in children with progressive myopia.
Main Methods:
- Retrospective cohort analysis of 342 myopic children treated for at least one year.
- The algorithm incorporated orthokeratology, multifocal lenses, and atropine.
- Outcomes measured included cycloplegic spherical equivalent autorefraction (CSER) progression and axial elongation at 1, 2, and 3 years.
Main Results:
- Mean annual CSER change ranged from -0.30 D to -0.13 D, with 56-60% of patients showing ≤0.25 D progression.
- Mean annual axial elongation ranged from 0.13 mm to 0.09 mm, with 46-65% of patients showing ≤0.10 mm progression.
- Cumulative absolute reduction in axial elongation reached 0.29 mm over three years.
Conclusions:
- The myopia treatment algorithm effectively controlled CSER and axial length in children.
- This supports the algorithm's utility in the clinical management of progressive childhood myopia.
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 ethnicity-matched 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.
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