Changes in Choroidal Thickness in Pre-Myopic Children After Repeated Low-Level Red-Light Therapy and Their Role in Predicting Myopia Prevention and Controlling Myopic Shift

Kaidi Xiang; Jingjing Wang; Zhuoting Zhu; Xinzi Zhang; Bo Zhang; Jun Chen; Jinliuxing Yang; Linlin Du; Zhijian Ai; Xiangui He; Xun Xu

doi:10.1016/j.apjo.2024.100115

Changes in Choroidal Thickness in Pre-Myopic Children After Repeated Low-Level Red-Light Therapy and Their Role in Predicting Myopia Prevention and Controlling Myopic Shift

Asia Pac J Ophthalmol (Phila). 2024 Dec 1:100115. doi: 10.1016/j.apjo.2024.100115. Online ahead of print.

Authors

Kaidi Xiang¹, Jingjing Wang², Zhuoting Zhu³, Xinzi Zhang⁴, Bo Zhang², Jun Chen², Jinliuxing Yang², Linlin Du², Zhijian Ai², Xiangui He⁵, Xun Xu⁶

Affiliations

¹ Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University; National Clinical Research Center for Eye Diseases; Shanghai Clinical Research Center for Eye Diseases; Shanghai Key Clinical Specialty; Shanghai Key Laboratory of Ocular Fundus Diseases; Shanghai Engineering Center for Visual Science and Photomedicine; Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China; Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China.
² Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China.
³ Centre for Eye Research Australia; Ophthalmology, University of Melbourne, Melbourne, Australia.
⁴ Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University; National Clinical Research Center for Eye Diseases; Shanghai Clinical Research Center for Eye Diseases; Shanghai Key Clinical Specialty; Shanghai Key Laboratory of Ocular Fundus Diseases; Shanghai Engineering Center for Visual Science and Photomedicine; Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China.
⁵ Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University; National Clinical Research Center for Eye Diseases; Shanghai Clinical Research Center for Eye Diseases; Shanghai Key Clinical Specialty; Shanghai Key Laboratory of Ocular Fundus Diseases; Shanghai Engineering Center for Visual Science and Photomedicine; Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China; Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China. Electronic address: xianhezi@163.com.
⁶ Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University; National Clinical Research Center for Eye Diseases; Shanghai Clinical Research Center for Eye Diseases; Shanghai Key Clinical Specialty; Shanghai Key Laboratory of Ocular Fundus Diseases; Shanghai Engineering Center for Visual Science and Photomedicine; Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China; Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China. Electronic address: drxuxun@sjtu.edu.cn.

PMID: 39626798
DOI: 10.1016/j.apjo.2024.100115

Abstract

Purpose: To investigate longitudinal changes in choroidal thickness (ChT) after 1-year treatment of repeated low-level red-light (RLRL) and their predictive value in efficacy on myopia prevention and myopic shift among pre-myopic children.

Methods: 278 pre-myopic (-0.50 D < spherical equivalent refraction, SER ≤ 0.50 D) participants were assigned to the RLRL group and control group randomly and evenly. The OCT, visual acuity, AL, SER and other parameters were measured before enrollment and every 3 months after intervention. The data from both eyes of the included participants were analyzed.

Results: A total of 463 eyes were analyzed. Due to the COVID-19 pandemic, 176 participants in the RLRL group had treatment interrupted. The continued RLRL group, interrupted RLRL group and control group were well balanced in baseline characteristics. In the continued and interrupted RLRL group, the average ChT increased significantly at 3-month visit (all P < 0.001) and the subfoveal ChT thickened evidently. The area under the curve (AUC) for the models including gender and 3-month change in ChT to predict satisfactory myopia prevention at 12 months was 0.983. The efficacy of the models that also used the combined indicators of baseline age, gender and the 3-month change in ChT to predict AL progression control over 12 months reached 0.944.

Conclusions: Continued RLRL intervention induced notable thickening of ChT in premyopic population, especially at the subfoveal sector. For participants received RLRL treatment, the 3-month change in ChT combined with other baseline factors have acceptable predictive discrimination of myopia prevention efficacy.

Keywords: myopia; prediction; prevention.