Dropout rates among optical interventions for myopia control: a systematic review.

Area of Science:

• Ophthalmology
• Pediatric Optometry
• Clinical Trial Analysis

Background:

• Evaluating real-world feasibility of myopia control requires understanding adherence and discontinuation.
• Paediatric optical myopia control dropout rates and causes are poorly characterized.
• This study systematically quantified dropout rates and reasons for discontinuation in optical myopia control for children.

Purpose of the Study:

• To systematically quantify dropout rates in paediatric optical myopia control interventions.
• To examine the reasons for discontinuation across different optical myopia control modalities.
• To compare dropout rates and reasons between spectacles, soft contact lenses, and orthokeratology.

Main Methods:

• Systematic review adhering to PRISMA guidelines, registered in PROSPERO.
• Searched PubMed, Scopus, and Web of Science through April 2025, including reference screening.
• Included randomized and non-randomized trials of optical myopia control in children (≤18 years) reporting discontinuations; analyzed data using Poisson regression.

Main Results:

• Fifty-seven trials (7,000+ subject-years) analyzed; dropout ranged from 6-21% annually, lowest for spectacles, highest for soft contact lenses.
• Reasons for dropout significantly differed by modality: spectacles had fewer issues related to vision, appearance, or handling.
• Soft contact lenses had lower ocular adverse events than orthokeratology but higher unknown discontinuation; no differences for compliance or non-ocular health reasons.

Conclusions:

• Dropout in paediatric myopia control is modality-dependent, influenced by handling, ocular tolerance, and follow-up.
• Standardized reporting of discontinuation reasons is needed for better study comparability.
• Structured adherence support strategies are crucial for improving patient retention and myopia control outcomes.