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Axial length shortening in myopic children after repeated low-level red-light therapy: a randomized trial

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Abstract

Purpose : Myopia progression is characterized by axial length (AL) elongation that is considered irreversible. In a recent randomized clinical trial using repeated low-level red-light (RLRL) therapy, we observed significant AL shortening among participants in the intervention group. In this analysis, we intend to report the frequency of this unexpected clinical phenomenon.

Methods : This analysis was conducted on a randomized, multicenter, single-masked trial (NCT04073238). Two hundred sixty-four myopic children aged 8 to 13 years who were allocated to the RLRL treatment (intervention group) or a single vision spectacle (SVS, control group) were included in this analysis. AL was measured by partial coherence interferometry (IOL-master 500) at baseline, 1-month, 3-month, 6-month and 12-month follow-up visits. The choroidal thickness (ChT) was measured using swept-source optical coherence tomography. AL shortening was defined as AL reduction from baseline to follow-up visits at three cutoffs: >0.05 mm, >0.10mm, and >0.20 mm. Logistic regression analyses identified influential factors for AL shortening at different cutoffs. The primary outcome was the frequency of AL shortening. Analysis was done with intention-to-treat.

Results : At the 12-month visit, the frequency of AL shortening >0.05 mm was 26/119 (21.85%) and 2/145 (1.38%) for the RLRL group and the control group, respectively. This frequency was 18/119 (15.13%) versus 0/145 (0%) for AL shortening >0.10 mm, respectively, and 7/119 (5.88%) versus 0/145 (0%), for AL shortening >0.20 mm, respectively (P<0.001). Mean AL shortening was -0.156 mm and subfoveal ChT increased by a mean of 0.056 mm in the RLRL group at the 12-month visit. In multivariate analysis, older baseline age was significantly associated with AL shortening.

Conclusions : Nearly a quarter of children had >0.05 mm AL shortening following 12 months of RLRL therapy, whereas AL shortening rarely occurred amongst controls. Most of the observed AL shortening could not be explained by measurement error and/or choroidal thickening. Further studies are needed to explore underlying biological mechanisms.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.
Original languageEnglish
Title of host publicationInvestigative Ophthalmology & Visual Science
Pages1965
Number of pages1
Volume64
Edition8
ISBN (Electronic)1552-5783
Publication statusPublished - 1 Jun 2023
EventAssociation for Research in Vision and Ophthalmology (ARVO) Annual Meeting 2023 - New Orleans, New Orleans, United States
Duration: 23 Apr 202327 Apr 2023

Conference

ConferenceAssociation for Research in Vision and Ophthalmology (ARVO) Annual Meeting 2023
Abbreviated titleARVO 2023
Country/TerritoryUnited States
CityNew Orleans
Period23/04/2327/04/23

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