Efficacy of Repeated Low-Level Red Light (RLRL) Therapy in Managing Childhood Myopia: A Systematic Review and...

Objectives: As Repeated Low-Level Red Light (RLRL) therapy is becoming increasingly prevalent in clinical practice, mainly in the Far East, largely due to its child-friendly nature and the feasibility of home use, this study aims to conduct a systematic review and meta-analysis to evaluate the efficacy of RLRL therapy in managing childhood myopia, specifically in relation to axial length (AL) and spherical equivalent refraction (SER), across a larger group of children aged from 6 to 16 years. Methods: A systematic literature search was performed using PubMed, Scopus, and Web of Science to access relevant databases and to locate outcome studies. Eligibility criteria included publication type, participant characteristics, and outcomes report. As appropriate, data analysis was conducted using either a random or fixed effects model. Results: Ten articles were included in the final analysis. All the studies included in the analysis were conducted in China and most of them is shortened to one year follow-up time. The mean difference in change of AL between the study and control groups was -0.33 mm with confidence levels ranging from -0.42 to -0.25 mm. The mean difference in change of SER between the study and control groups was 0.63 D with confidence levels ranging from 0.42 to 0.85 D, which was found to be statistically significant (p < 0.001). The mean difference in AL change at t = 6 months for the RLRL and SVS groups was 0.00 mm (95% CI: -0.10 to 0.10 mm) and 0.23 mm (95% CI: 0.15 to 0.32 mm) respectively. At t = 12 months mean difference in AL change for the RLRL and SVS groups was -0.01 mm (95% CI: -0.16 to 0.13 mm) and 0.35 mm (95% CI: 0.20 to 0.50 mm) respectively. The mean difference in SER change at t = 6 months for the RLRL and SVS groups was 0.18 D (95%CI: -0.03 to 0.39 D) and -0.48 D (95% CI: -0.69 to -0.27 D, respectively. At t = 12 months the mean difference in SER change for RLRL and SVS groups was 0.05 (95% CI -0.31 to 0.42 D), and -0.73 D (95% CI: -1.08 to -0.37 D), respectively. Conclusions: The results of the meta-analysis indicate that myopic children who received RLRL therapy in addition to standard myopia management demonstrated a slower progression of myopia compared to the control group. These findings suggest that RLRL therapy may be an effective novel adjunctive treatment for myopia controls.