TY - JOUR
T1 - Efficacy Comparison of 16 Interventions for Myopia Control in Children A Network Meta-analysis
AU - Huang, Jinhai
AU - Wen, Daizong
AU - Wang, Qinmei
AU - McAlinden, Colm Michael
AU - Flitcroft, Ian
AU - Chen, Haisi
AU - Saw, Seangmei
AU - Chen, Hao
AU - Bao, Fangjun
AU - Zhao, Yune
AU - Hu, Liang
AU - Li, Xuexi
AU - Gao, RongRong
AU - Lu, Weicong
AU - Du, Yaoqiang
AU - Jinag, Zhengxuan
AU - Yu, Ayong
AU - Lian, Hengli
AU - Jiang, Qiuruo
AU - Yu, Ye
AU - Qu, Jia
PY - 2016/4/1
Y1 - 2016/4/1
N2 - Purpose To determine the effectiveness of different interventions to slow down the progression of myopia in children. Methods We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov from inception to August 2014. We selected randomized controlled trials (RCTs) involving interventions for controlling the progression of myopia in children with a treatment duration of at least 1 year for analysis. Main Outcome Measures The primary outcomes were mean annual change in refraction (diopters/year) and mean annual change in axial length (millimeters/year). Results Thirty RCTs (involving 5422 eyes) were identified. Network meta-analysis showed that in comparison with placebo or single vision spectacle lenses, high-dose atropine (refraction change: 0.68 [0.52-0.84]; axial length change: -0.21 [-0.28 to -0.16]), moderate-dose atropine (refraction change: 0.53 [0.28-0.77]; axial length change: -0.21 [-0.32 to -0.12]), and low-dose atropine (refraction change: 0.53 [0.21-0.85]; axial length change: -0.15 [-0.25 to -0.05]) markedly slowed myopia progression. Pirenzepine (refraction change: 0.29 [0.05-0.52]; axial length change: -0.09 [-0.17 to -0.01]), orthokeratology (axial length change: -0.15 [-0.22 to -0.08]), and peripheral defocus modifying contact lenses (axial length change: -0.11 [-0.20 to -0.03]) showed moderate effects. Progressive addition spectacle lenses (refraction change: 0.14 [0.02-0.26]; axial length change: -0.04 [-0.09 to -0.01]) showed slight effects. Conclusions This network analysis indicates that a range of interventions can significantly reduce myopia progression when compared with single vision spectacle lenses or placebo. In terms of refraction, atropine, pirenzepine, and progressive addition spectacle lenses were effective. In terms of axial length, atropine, orthokeratology, peripheral defocus modifying contact lenses, pirenzepine, and progressive addition spectacle lenses were effective. The most effective interventions were pharmacologic, that is, muscarinic antagonists such as atropine and pirenzepine. Certain specially designed contact lenses, including orthokeratology and peripheral defocus modifying contact lenses, had moderate effects, whereas specially designed spectacle lenses showed minimal effect.
AB - Purpose To determine the effectiveness of different interventions to slow down the progression of myopia in children. Methods We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov from inception to August 2014. We selected randomized controlled trials (RCTs) involving interventions for controlling the progression of myopia in children with a treatment duration of at least 1 year for analysis. Main Outcome Measures The primary outcomes were mean annual change in refraction (diopters/year) and mean annual change in axial length (millimeters/year). Results Thirty RCTs (involving 5422 eyes) were identified. Network meta-analysis showed that in comparison with placebo or single vision spectacle lenses, high-dose atropine (refraction change: 0.68 [0.52-0.84]; axial length change: -0.21 [-0.28 to -0.16]), moderate-dose atropine (refraction change: 0.53 [0.28-0.77]; axial length change: -0.21 [-0.32 to -0.12]), and low-dose atropine (refraction change: 0.53 [0.21-0.85]; axial length change: -0.15 [-0.25 to -0.05]) markedly slowed myopia progression. Pirenzepine (refraction change: 0.29 [0.05-0.52]; axial length change: -0.09 [-0.17 to -0.01]), orthokeratology (axial length change: -0.15 [-0.22 to -0.08]), and peripheral defocus modifying contact lenses (axial length change: -0.11 [-0.20 to -0.03]) showed moderate effects. Progressive addition spectacle lenses (refraction change: 0.14 [0.02-0.26]; axial length change: -0.04 [-0.09 to -0.01]) showed slight effects. Conclusions This network analysis indicates that a range of interventions can significantly reduce myopia progression when compared with single vision spectacle lenses or placebo. In terms of refraction, atropine, pirenzepine, and progressive addition spectacle lenses were effective. In terms of axial length, atropine, orthokeratology, peripheral defocus modifying contact lenses, pirenzepine, and progressive addition spectacle lenses were effective. The most effective interventions were pharmacologic, that is, muscarinic antagonists such as atropine and pirenzepine. Certain specially designed contact lenses, including orthokeratology and peripheral defocus modifying contact lenses, had moderate effects, whereas specially designed spectacle lenses showed minimal effect.
UR - http://www.scopus.com/inward/record.url?scp=84955594621&partnerID=8YFLogxK
U2 - 10.1016/j.ophtha.2015.11.010
DO - 10.1016/j.ophtha.2015.11.010
M3 - Review article
SN - 0161-6420
VL - 123
SP - 697
EP - 708
JO - Ophthalmology
JF - Ophthalmology
IS - 4
ER -