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The compliance patterns and personalized management of repeated red light therapy in children: A 4-year multicenter
Guihua Liu1, Na Li1, Yuexuan Ma1
1Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.
Insights
Higher adherence to repeated red light therapy (RRLT) slows eye growth in children. Consistent RRLT use, particularly in younger children, is key for managing myopia progression effectively.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Biomedical Engineering
Background:
- Limited real-world data exists on the long-term impact of repeated red light therapy (RRLT) compliance on axial elongation in children.
- Myopia management in pediatric populations requires effective, real-world treatment strategies.
Purpose of the Study:
- To investigate the association between RRLT compliance and axial length (AL) elongation patterns over four years in a large pediatric cohort.
- To identify optimal compliance thresholds for favorable myopia control efficacy.
Main Methods:
- A 4-year multicenter retrospective study involving 2575 children (aged 6-16) using home-based RRLT.
- Axial length (AL) elongation was monitored annually, with favorable efficacy defined as ≤0.10 mm/year.
- Statistical analyses, including correlation and spline modeling, were used to assess compliance impact.
Main Results:
- Higher cumulative RRLT compliance significantly correlated with slower AL elongation (β = -0.322, p < 0.001).
- Favorable efficacy was observed with cumulative compliance levels around 58%-69% across the four years.
- A minimum cumulative compliance of 58% is suggested for a favorable long-term treatment response.
Conclusions:
- Real-world RRLT compliance is a critical factor influencing myopia progression in children.
- Personalized RRLT strategies should consider individual compliance rates to optimize treatment efficacy and manage patient burden.
- Achieving at least 58% cumulative compliance is essential for successful long-term myopia management with RRLT.
Abstract:
Limited real-world evidence exists on how repeated red light therapy (RRLT) compliance influences axial elongation patterns across multiple years. This 4-year multicenter retrospective real-world study included 2575 children aged 6-16 years (spherical equivalent -10.00 D to +3.00 D) using home-based RRLT. The annual axial length (AL) elongation ≤0.10 mm defined favorable efficacy. After 4 years, the cumulative AL increase was 0.32 ± 0.02 mm. Higher cumulative compliance correlated with slower AL elongation (β = -0.322; p < 0.001), particularly in children with higher baseline AL (6-9 years: >24.00 mm; 10-13 years: >25.00 mm). Spline models identified that cumulative compliance levels of approximately 58%, 69%, 58%, and 67% were associated with favorable efficacy outcome over 1-4 years, respectively. These findings indicate that at least 58% cumulative compliance is necessary for a favorable long-term response. This study provides suggestions for personalized treatment strategies to balance efficacy and usage burden in children receiving RRLT.