Customized myopia control regimen successful over 3 years in children
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CHICAGO — An individualized protocol of combined treatments provided “remarkable” control of cycloplegic spherical equivalent refractive error and axial length in children over a 3-year period, according to a poster at Optometry’s Meeting.
Kevin Chan, OD, MS, FAAO, senior clinical director at Treehouse Eyes, told Healio that the 3-year retrospective cohort analysis included more than 340 children who fit the researchers’ criteria.
“They underwent various treatment modalities, including optical (ie, orthokeratology and soft multifocal contact lenses) and pharmaceutical (atropine medication) interventions, using our Treehouse Vision System clinical protocol,” Chan said.
According to the poster, the cohort at initial visit (53% girls; mean age, 10.84 years; 45% Asian) had a cycloplegic spherical equivalent refractive error (CSER) of –4.01 D (0.15 D) and axial length (AL) of 24.97 mm (0.07 mm), and 91% had at least one myopic parent.
Potential treatment modalities included ortho-K, ortho-K plus atropine, soft multifocal contact lenses, soft multifocal contact lenses plus atropine, and atropine of any concentration, according to the study.
Chan described the Treehouse clinical algorithm for myopia progression (CAMP): “Patients were reviewed and categorized based on a number of risk profiles involved. Risk factors include but are not limited to: young age, age of myopia onset, gender, ethnicity, parental history and behavioral lifestyle (ie, amount of screen time and outdoor time). We generate the progression risk analysis based on the number of risk profiles involved. For those with three or more risk profiles, they are put in the ‘high risk’ category; for those with less than three risk profiles, they are in the ‘low risk’ category.”
He said there was “remarkable control of CSER (86% decrease) and AL changes (34% decrease)” compared with the age- and ethnicity-matched virtual control group data over 3 years.
Chan told Healio that over the 3 years, 78% of treated children had minimal change (< 0.25 D/year) in CSER. Nearly 60% had a change in AL of 0.1 mm per year or less.
“Each patient was treated using a customized approach for the best treatment outcomes; however, I am particularly impressed that ortho-K and soft multifocal contact lenses yielded cumulative control of AL progression over a 3-year period,” Chan said. “This suggests that adopting myopia management early for children can help change the trajectory of their vision for a lifetime.
“In addition, I see that a combined treatment regimen, while currently still in infancy, is expected to become the next paradigm shift for myopia management,” he continued. “Patients having multiple predisposing risk profiles or on atropine regimen as monotherapy likely warrant combined treatments.”
Chan added that the study showed a one-size-fits-all approach to myopia management is not applicable to all children, especially those who are at risk.
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Chan K et al. Assessing effectiveness of a clinical treatment algorithm for myopia progression (CAMP) treatment strategy in real-world practice settings. Presented at: Optometry’s Meeting; June 15-18, 2022; Chicago.
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