Adjunctive repeated low-level red-light therapy enhances structural outcomes in optical myopia control: A...

Area of Science:

• Ophthalmology
• Biomedical Engineering
• Vision Science

Background:

• Photobiomodulation, specifically repeated low-level red-light (RLRL) therapy, is explored for myopia control.
• RLRL therapy's potential to modulate choroidal and axial structures is recognized.
• Combining RLRL with optical interventions (orthokeratology/OK, DIMS spectacles) is a novel approach, but its efficacy and safety require investigation.

Purpose of the Study:

• To synthesize current evidence on the efficacy and safety of RLRL therapy combined with optical interventions for pediatric myopia control.
• To evaluate the impact of combination therapy on axial length, refractive error, and choroidal thickness.
• To compare combination therapy against monotherapy using optical interventions.

Main Methods:

• Systematic literature search across major databases (PubMed, EMBASE, etc.) up to July 2025.
• Inclusion of randomized and cohort studies comparing RLRL combination therapy with monotherapy.
• Primary outcome measures included axial length (AL), spherical equivalent refraction (SER), and subfoveal choroidal thickness (SFChT); risk of bias assessed using ROB2 and ROBINS-I.

Main Results:

• Eight studies indicated combination therapy reduced axial elongation and SER progression compared to optical monotherapy.
• Combination therapy led to greater increases in subfoveal choroidal thickness (SFChT).
• Observed structural changes persisted from 1 to 12 months, with no significant short-term ocular surface adverse events noted, though heterogeneity was present.

Conclusions:

• Adjunctive RLRL therapy appears to enhance optical myopia control, potentially by modulating choroidal thickness and reducing axial elongation.
• Findings suggest early biological signals of efficacy, but long-term superiority is not definitively proven.
• Further large-scale, multicenter randomized trials are necessary to confirm durability, safety, and optimal dosing.