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Non-invasive myopia control methods: a review

https://doi.org/10.33791/2222-4408-2025-1-64-74

Abstract

Relevance. Myopia is a significant issue in ophthalmology and public health. Its progression not only leads to a decline in visual function and reduced quality of life but also increases the risk of vision-threatening complications. In recent years, alongside contact lens-based approaches that slow excessive eye growth, pharmacological, optical, and behavioral myopia control strategies have been actively developed. Objective: to summarize and systematize data from randomized clinical trials conducted over the past five years on the efficacy of non-invasive myopia control methods, identifying the most effective approaches and their combinations. Materials and methods. A literature search was conducted in the eLibrary, PubMed, and Scopus databases using the keywords “Myopia Control” and “progressive myopia”. A total of 3,714 studies published between 2020 and 2025 were identified, of which 52 full-text articles met the inclusion criteria. The final analysis included 36 publications that provided data on both refractive error progression and axial length changes. Results. The use of defocus-incorporated multiple segment (DIMS) and other myopia control spectacle lenses has demonstrated high efficacy in slowing axial elongation, confirming the clinical significance and promise of this approach. However, questions remain regarding the magnitude and consistency of their long-term efficacy. Low-dose atropine has shown the greatest effect when combined with single-vision spectacle correction. However, the variability in results due to different atropine concentrations necessitates further research. Increased time spent outdoors has been associated with a reduced risk of myopia progression in individuals with pre-myopia and low myopia. The combination of red-light therapy with spectacle correction has proven more effective than red-light therapy alone. While these methods show promising results, long-term studies are required to confirm their efficacy and safety. Conclusion. Effective myopia control in children requires the development of combined strategies incorporating optical, pharmacological, and behavioral interventions. Despite the availability of effective non-invasive myopia control methods, questions remain regarding their mechanisms of action and the long-term efficacy of combination treatments.

About the Authors

S. E. Avetisov
Sechenov First Moscow State Medical University; Krasnov Research Institute of Eye Diseases
Russian Federation

Sergey E. Avetisov, Dr. Sci. (Med.), Professor, Academician of the Russian Academy of Sciences, Scientific Director at the Krasnov Research Institute of Eye Diseases; Head of the Department of Ophthalmology of the Sechenov First Moscow State Medical University

11 a, b, Rossolimo Str., Moscow, 119021

8, bldg. 2, Trubetskaya Str., Moscow, 119048



D. A. Myagkov
Krasnov Research Institute of Eye Diseases
Russian Federation

Daniil A. Myagkov, Resident Physician at the Department of Ophthalmology

8, bldg. 2, Trubetskaya Str., Moscow, 119048



References

1. World Health Organization. World report on vision; 2020.

2. Tarutta EP, Proskurina OV, Tarasova NA, Markosyan GA. Analysis of risk factors that cause myopia in pre-school children and primary school students. Health Risk Analysis. 2019;(3):26–33. (In Russ.) doi: 10.21668/health.risk/2019.3.03

3. Surico PL, Parmar UPS, Singh RB, et al. Myopia in children: Epidemiology, genetics, and emerging therapies for treatment and prevention. Children. 2024;11(12). doi: 10.3390/children11121446

4. Tarutta EP, Proskurina OV, Tarasova NA, Ibatulin RA, Kovychev AS. Myopia predictors as a starting point for active prevention of myopia development. Russian Ophthalmological Journal. 2018;11(3):107–112. (In Russ.) doi: 10.21516/2072-0076-2018-11-3-107-112

5. Sorokovikova TV, Morozov AM, Zhukov SV, et al. The role of non-invasive research methods in modern clinical practice. Modern Problems of Science and Education. 2022;(2):137. (In Russ.) doi: 10.17513/spno.31502

6. Bao J, Yang A, Huang Y, et al. One-year myopia control efficacy of spectacle lenses with aspherical lenslets. British Journal of Ophthalmology. 2022;106(8):1171–1176. doi: 10.1136/bjophthalmol-2020-318367 7. Carlà MM, Boselli F, Giannuzzi F, et al. Overview on defocus incorporated multiple segments lenses: A novel perspective in myopia progression management. Vision (Switzerland). 2022;6(2):20. doi: 10.3390/vision6020020

7. 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. 2023;107:1709–1715. doi: 10.1136/bjophthalmol-2021-321005

8. Liu X, Wang P, Xie Z, et al. One-year myopia control efficacy of cylindrical annular refractive element spectacle lenses. Acta Ophthalmol. 2023;101(6):651–657. doi: 10.1111/aos.15649

9. Yuval C, Otzem C, Laura BS, et al. Evaluating the effect of a myopia control spectacle lens among children in Israel: 12-month results. Am J Ophthalmol. 2024;257:103–112. doi: 10.1016/j.ajo.2023.08.019

10. Liu Y, Zhu M, Yan X, et al. The effect of repeated low-level red-light therapy on myopia control and choroid. Transl Vis Sci Technol. 2024;13(10):29. doi: 10.1167/tvst.13.10.29

11. Zhu Q, Cao X, Zhang Y, et al. Repeated low-level red-light therapy for controlling onset and progression of myopia-a review. Int J Med Sci. 2023;20(10):1363–1376. doi: 10.7150/ijms.85746

12. Hamblin MR. Mechanisms and applications of the anti-inflammatory effects of photobiomodulation. AIMS Biophys. 2017;4(3):337–361. doi: 10.3934/biophy.2017.3.337

13. Markova EY, Isabekov RS, Avakyants GV, Yаh’yaeva MM. Myopia: pathogenesis and actual methods of control. Literature review. Oftalmologiya. 2022;19(1):149–155. (In Russ.) doi: 10.18008/1816-5095-2022-1-149-155

14. Rose KA, Morgan IG, Ip J, et al. Outdoor activity reduces the prevalence of myopia in children. Ophthalmology. 2008;115(8):1279–85.

15. Rudnicka AR, Kapetanakis VV, Wathern AK, et al. Global variations and time trends in the prevalence of childhood myopia, a systematic review and quantitative meta-analysis: implications for aetiology and early prevention. British Journal of Ophthalmology. 2016;100(7):882–890.

16. 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. 2023;107:1709–1715. doi: 10.1136/bjophthalmol-2021-321005

17. Laughton D, Hill JS, McParland M, et al. Control of myopia using diffusion optics spectacle lenses: 4-year results of a multicentre randomised controlled, efficacy and safety study (CYPRESS). BMJ Open Ophthalmol. 2024;9(1):e001790. doi: 10.1136/bmjophth-2024-001790

18. Bao J, Yang A, Huang Y, et al. One-year myopia control efficacy of spectacle lenses with aspherical lenslets. British Journal of Ophthalmology. 2022;106(8):1171–1176. doi: 10.1136/bjophthalmol-2020-318367

19. Li X, Huang Y, Yin Z, et al. Myopia control efficacy of spectacle lenses with aspherical lenslets: Results of a 3-year follow-up study. Am J Ophthalmol. 2023;253:160–168. doi: 10.1016/j.ajo.2023.03.030

20. Zhao Q, Hao Q. Clinical efficacy of 0.01% atropine in retarding the progression of myopia in children. Int Ophthalmol. 2021;41(3):1011–1017. doi: 10.1007/s10792-020-01658-0

21. Wang Z, Li T, Zuo X, et al. 0.01% atropine eye drops in children with myopia and intermittent exotropia. JAMA Ophthalmol. 2024;142(8):722–730. doi: 10.1001/jamaophthalmol.2024.2295

22. Jethani J. Efficacy of low-concentration atropine (0.01%) eye drops for prevention of axial myopic progression in premyopes. Indian J Ophthalmol. 2022;70(1):238–240. doi: 10.4103/ ijo.IJO_1462_21

23. Sen S, Yadav H, Jain A, et al. Effect of atropine 0.01% on progression of myopia. Indian J Ophthalmol. 2022;70(9):3373– 3376. doi: 10.4103/ijo.IJO_256_22

24. Xiong Y, Liao Y, Zhou W, et al. Effectiveness of low-level red light for controlling progression of Myopia in children and adolescents. Photodiagnosis Photodyn Ther. 2024;49:104267. doi: 10.1016/j.pdpdt.2024.104267

25. Xuan M, Zhu Z, Jiang Y, et al. Longitudinal changes in choroidal structure following repeated low-level red-light therapy for myopia control: Secondary analysis of a randomized controlled trial. Asia-Pacific Journal of Ophthalmology. 2023;12(4):377–383. doi: 10.1097/APO.0000000000000618

26. Jiang Y, Zhu Z, Tan X, et al. Effect of repeated low-level red-light therapy for myopia control in children: A multicenter randomized controlled trial. Ophthalmology. 2022;129(5):509–519. doi: 10.1016/j.ophtha.2021.11.023

27. Chen Y, Xiong R, Chen X, et al. Efficacy comparison of repeated low-level red light and low-dose atropine for myopia control: A randomized controlled trial. Transl Vis Sci Technol. 2022;11(10):33. doi: 10.1167/tvst.11.10.33

28. Zhou L, Tong L, Li Y, et al. Photobiomodulation therapy retarded axial length growth in children with myopia: evidence from a 12-month randomized controlled trial evidence. Sci Rep. 2023;13(1):3321. doi: 10.1038/s41598-023-30500-7

29. Chen J, Zhuo R, Chen J, et al. Spectacle lenses with slightly aspherical lenslets for myopia control: clinical trial design and baseline data. BMC Ophthalmol. 2022;22(1):345. doi: 10.1186/s12886-022-02562-0

30. Lam CSY, Tang WC, Qi H, et al. Effect of defocus incorporated multiple segments spectacle lens wear on visual function in myopic chinese children. Transl Vis Sci Technol. 2020;9(9):1– 10. doi: 10.1167/tvst.9.9.11

31. Cui C, Li X, Lyu Y, et al. Safety and efficacy of 0.02% and 0.01% atropine on controlling myopia progression: a 2-year clinical trial. Sci Rep. 2021;11(1):22267. doi: 10.1038/s41598-021-01708-2

32. Chan HHL, Choi KY, Ng ALK, et al. Efficacy of 0.01% atropine for myopia control in a randomized, placebo-controlled trial depends on baseline electroretinal response. Sci Rep. 2022;12(1):11588. doi: 10.1038/s41598-022-15686-6

33. Lee SSY, Lingham G, Blaszkowska M, et al. Low-concentration atropine eyedrops for myopia control in a multi-racial cohort of Australian children: A randomised clinical trial. Clin Exp Ophthalmol. 2022;50(9):1001–1012. doi: 10.1111/ceo.14148

34. Hansen NC, Hvid-Hansen A, Møller F, et al. Safety and efficacy of 0.01% and 0.1% low-dose atropine eye drop regimens for reduction of myopia progression in Danish children: a randomized clinical trial examining one-year effect and safety. BMC Ophthalmol. 2023;23(1):438. doi: 10.1186/s12886-023-03177-9

35. Yam JC, Zhang XJ, Zhang Y, et al. Effect of low-concentration atropine eyedrops vs placebo on myopia incidence in children: The LAMP2 randomized clinical trial. JAMA. 2023;329(6):472–481. doi: 10.1001/jama.2022.24162

36. Li Q, Guo L, Zhang J, et al. Effect of school-based family health education via social media on children’s myopia and parents’ awareness: A randomized clinical trial. JAMA Ophthalmol. 2021;139(11):1165–1172. doi: 10.1001/jamaophthalmol.2021.3695

37. He X, Sankaridurg P, Wang J, et al. Time outdoors in reducing myopia: A school-based cluster randomized trial with objective monitoring of outdoor time and light intensity. Ophthalmology. 2022;129(11):1245–1254. doi: 10.1016/j.ophtha.2022.06.024

38. Li SM, Ran AR, Kang MT, et al. Effect of text messaging parents of school-aged children on outdoor time to control myopia: A randomized clinical trial. JAMA Pediatr. 2022;176(11):1077– 1083. doi: 10.1001/jamapediatrics.2022.3542

39. Wang D, Xiong R, Zhang J, et al. Effect of extracurricular after-school physical activities on academic performance of schoolchildren: A cluster randomized clinical trial. JAMA Pediatr. 2023;177(11):1141–1148. doi: 10.1001/jamapediatrics.2023.3615

40. He X, Wang J, Zhu Z, et al. Effect of repeated low-level red light on myopia prevention among children in China with premyopia: A randomized clinical trial. JAMA Netw Open. 2023;6(4):E239612. doi: 10.1001/jamanetworkopen.2023.9612

41. Xiong R, Zhu Z, Jiang Y, et al. Longitudinal changes and predictive value of choroidal thickness for myopia control after repeated low-level red-light therapy. Ophthalmology. 2023;130(3):286–296. doi: 10.1016/j.ophtha.2022.10.002

42. Xu Z, Zou A, Li L, et al. Effect of virtual reality-based visual training for myopia control in children: a randomized controlled trial. BMC Ophthalmol. 2024;24(1):358. doi: 10.1186/s12886-024-03580-w

43. Zhou W, Liao Y, Wang W, et al. Efficacy of different powers of low-level red light in children for myopia control. Ophthalmology. 2024;131(1):48–57. doi: 10.1016/j.ophtha.2023.08.020

44. Xie R, Zhao F, Yu J, et al. Naked-eye 3-dimensional vision training for myopia control: A randomized clinical trial. JAMA Pediatr. 2024;178(6):533–539. doi: 10.1001/jamapediatrics.2024.0578

45. Xu Y, Cui L, Kong M, et al. Repeated low-level red light therapy for myopia control in high myopia children and adolescents: A randomized clinical trial. Ophthalmology. 2024;131(11):1314–1323. doi: 10.1016/j.ophtha.2024.05.023

46. Liu G, Rong H, Liu Y, et al. Effectiveness of repeated low-level red light in myopia prevention and myopia control. British Journal of Ophthalmology. 2024;108:1299–1305. doi: 10.1136/bjo-2023-324260

47. Zhu M, Liu Y, Fang D, et al. Safety of repeated low-level redlight therapy for children with myopia. Photodiagnosis Photodyn Ther. 2024;47:104198. doi: 10.1016/j.pdpdt.2024.104198

48. Cao K, Tian L, Ma D, et al. Daily low-level red light for spherical equivalent error and axial length in children with myopia: A randomized clinical trial. JAMA Ophthalmol. 2024;142(6):560–567. doi: 10.1001/jamaophthalmol.2024.0801

49. Liu G, Liu L, Rong H, et al. Axial shortening effects of repeated low-level red-light therapy in children with high myopia: A multicenter randomized controlled trial. Am J Ophthalmol. 2025;270:203–215. doi: 10.1016/j.ajo.2024.10.011


Review

For citations:


Avetisov S.E., Myagkov D.A. Non-invasive myopia control methods: a review. The EYE GLAZ. 2025;27(1):64-74. (In Russ.) https://doi.org/10.33791/2222-4408-2025-1-64-74

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