Progression with myopia control spectacles: identifying predictors of response to defocus incorporated multiple...

To identify predictive factors of myopia progression in children wearing highly aspherical lenslets (HAL) and defocus incorporated multiple segment (DIMS) spectacles.

The 3-year longitudinal, retrospective real-world study included progressive children (≤ -0.5 dioptre (D)/year), aged 4-14 years collected from the French Myopia Cohort, between 2020 and 2025 who were prescribed myopia control spectacles (MCS). Myopia progression (spherical equivalent, D/year) was assessed at 12±3, 24±3 and 36±3 months after treatment initiation. A latent class growth model, adjusted for age, identified potential poor responders to MCS. Model performance was evaluated using Akaike information criterion, entropy and posterior class-membership probabilities. Logistic regression was then used to determine factors associated with persistent progression under MCS, including treatment group, renewal rate, baseline age, spherical equivalent, J0 and J45, sex and initial progression.

A total of 723 children (mean age 8.9 ± 2.4 years) were included, with no baseline differences between the DIMS and the HAL groups. Latent class growth modelling identified three distinct progression profiles: stable, moderate myopia progression and progressive myopia, with slopes of -0.05, -0.31 and -0.58 D/year, respectively. Fast initial progression strongly predicted progressive myopia class, while neither treatment type influenced class allocation. Progression risk under treatment was statistically independent of age, sex and baseline myopia.

Our study is limited as it examines only two types of myopia control treatments and lacks data on environmental factors. Myopic children treated with DIMS or HAL showed three distinct progression trajectories, with a small group of progressors continuing to progress at a clinically meaningful rate.