Spectacle lenses with diffusion optics technology (DOT) can slow myopia progression in pediatric patients, according to a study published in the British Journal of Ophthalmology. High compliance and low adverse event rates demonstrate the safety of this myopia control modality in children.
Researchers enrolled 256 children with myopia (58% girls, mean age, 8.1 years) in the multicenter, randomized, double-masked trial and assigned them to treatment with 1 of 2 test lenses using DOT (test lens 1, n=88; test lens 2, n=75) or single vision spectacles (control group; n=93). Test lens 1 used diffusers spaced 0.365 mm apart while test lens 2 had a higher density involving closer diffuser spacing (0.240 mm). Study participants underwent examination at baseline and during 1-, 6-, and 12-month follow-up visits and wore their spectacle correction for 10 or more hours per day. Primary endpoints were changes in axial length (AL) and spherical equivalent refraction (SER).
At 12 months, mean AL changes were -0.15, -0.20, and -0.30 mm among participants treated with the test 1, test 2, and single vision lenses, respectively, indicating a 50% AL reduction for test lens 1 (95% CI, 0.10-0.20 mm; P <.0001) and a 33% AL reduction for test lens 2 (95% CI, 0.04-0.17 mm; P =.0018) compared with spectacle lenses. Mean SER changes were -0.14, -0.22, and -0.54 diopters (D) among the test lens 1, test lens 2, and control groups, respectively, indicating a 74% SER reduction for test lens 1 (95% CI, -0.53 to -0.27 D; P <.0001) and 59% SER reduction for test lens 2 (95% CI. -0.47 to -0.17 D; P <.0001) compared with single vision spectacles.
Stratified according to age, mean SER changes for children aged 6 to 7 years were -0.19, -0.33, and -0.75 D for the test lens 1, test lens 2, and control groups, respectively. Individuals aged 8 to 10 years experienced SER changes of -0.12, -0.19, and -0.44 D, respectively. Similarly, children aged 6 to 7 years experienced larger AL changes from baseline compared with those aged 8 to 10 years (P <.0001), but with little difference in treatment effect (P =.07).
“Myopia typically develops in the school age years, which presents unique challenges for implementing measures to delay myopia onset or progression,” according to the researchers. “Parents are often hesitant to put their young children into contact lenses or use atropine on a chronic basis, and optometrists rarely prescribe contact lenses as the primary form of vision correction in children [younger than] 9 years of age. Management of myopia progression using spectacles is, therefore, an attractive option.”
A short duration and difficulty in masking participants to treatment are acknowledged limitations to the research.
Rappon J, Chung C, Young G, et al. Control of myopia using diffusion optics spectacle lenses: 12-month results of a randomised controlled, efficacy and safety study (CYPRESS). Br J Ophthalmol. Published online September 1, 2022. doi:10.1136/bjo-2021-321005