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Comparison of effects between daily repeated low-level red light therapy and 0.01% low-dose atropine for myopia
Xiaoqian Ma1, Yang Zhao2, Yuanpei Zhou1
1Zhengzhou Huaxia Pure Vision Eye Hospital, Zhengzhou 450016, China.
Insights
Daily repeated low-level red light (RLRL) significantly reduced myopia incidence compared to low-dose atropine eye drops (LDA). RLRL therapy is a safer, more effective myopia prevention strategy for children.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Biomedical Optics
Background:
- Myopia is a growing global health concern, particularly in children.
- Current myopia control methods have limitations and potential side effects.
Purpose of the Study:
- To compare the efficacy and safety of daily repeated low-level red light (RLRL) versus 0.01% low-dose atropine eye drops (LDA) for myopia prevention in children.
Main Methods:
- A 12-month prospective comparative study involving 216 children aged 7-12 years.
- Participants received either RLRL therapy or LDA eye drops.
- Primary outcome: 12-month myopia incidence; Secondary outcomes: changes in spherical equivalent error (SER) and axial length (AL).
Main Results:
- RLRL group showed a significantly lower myopia incidence (13.3%) compared to the LDA group (30.7%).
- Propensity-matched analysis confirmed RLRL's superior efficacy, with a 60% reduced risk of myopia.
- RLRL treatment stabilized refractive status and axial elongation with no adverse events, unlike LDA which caused photophobia in 19.7% of users.
Conclusions:
- Daily RLRL is a more effective and safer myopia prevention strategy than 0.01% LDA for children.
- RLRL demonstrates significant potential in controlling myopia progression and stabilizing ocular growth.
- The absence of adverse events makes RLRL a promising alternative for childhood myopia management.
Objective:
To compare the preventive effect of daily repeated low-level red light (RLRL) and 0.01% low-dose atropine eye drops (LDA) on myopia.
Methods:
This was a 12-month prospective comparative study. 216 Children aged 7-12 years using either RLRL or LDA for myopia prevention were enrolled between July 10, 2024 to August 15, 2024. 192 completed the 12-month follow-up, last case went for clinical visit on August 28, 2025. The primary outcome was the 12-month myopia incidence. Secondary outcomes included changes in the spherical equivalent error (SER) and changes in the axial length (AL).
Results:
The 12-month myopia incidence was 30.7% (36/117) and 13.3% (10/75) for the LDA and RLRL groups, respectively. The former was significantly higher than the latter (difference, 17.4%, 95% CI: 5.2% to 28.1%; p = 0.028). 69 pairs of children were matched from each group using propensity matching score method, where age, gender, baseline SER, and baseline AL were balanced between groups. The 12-month myopia incidence was 29.0% (20/69) and 11.6% (8/69) for the LDA and RLRL groups, respectively. The LDA group was still significantly higher than the RLRL group (difference, 17.4%, 95% CI: 3.9% to 30.3%; p = 0.038). The 12-month changes in the SER were 0.08 D and -0.49 D for the RLRL group and the LDA group, respectively, the mean difference was -0.57 (95% CI:-0.73 to -0.41) D, p < 0.001. The average changes in AL were 0.02 mm and 0.29 mm for the RLRL group and LDA group, respectively, the mean difference was 0.27 (95% CI: 0.11 to 0.43) mm, p < 0.001. 19.7% (23/117) Children in the LDA group reported photophobia, no adverse event was observed in the RLRL group.
Conclusion And Relevance:
In this 12-month study, daily RLRL demonstrated superior myopia prevention compared to 0.01% LDA. Myopia incidence was significantly lower with RLRL, with a 60% reduced risk. Propensity-matched analysis confirmed RLRL's efficacy, which better stabilized refractive status and axial elongation. No adverse events occurred with RLRL, while 19.7% of LDA users reported photophobia. RLRL emerges as a safer, more effective preventive intervention for childhood myopia.
