Meta-analysis Proposes Red-light Therapy as Most Effective Myopia Control Option

RLRL was significantly effective in controlling myopia, outperforming all other interventions, including 0.01% atropine+ortho-K combination therapy, which ranked first in previous meta-analyses. This study still found that combination therapy is often more effective than single interventions. Photo: Eyerising International. Click image to enlarge. It is particularly important to begin myopia intervention as early as possible. Repeated low-level red light (RLRL) therapy continues to show promise outside the US as a new myopia treatment for children—but with limited evidence in the literature, as well as some nagging concerns about safety. A recent study based in China assessed 41 randomized controlled trials to determine the most effective interventions for preventing the progression of myopia in children and ranked them to provide more comprehensive and reliable evidence-based medical recommendations. Their findings, published in British Journal of Ophthalmology, supported the potential of RLRL as a leading noninvasive intervention for pediatric myopia control and could also inform clinical decisions and future policy on early intervention strategies.The efficacy of interventions in slowing myopia progression ranked as follows at the 12-month follow-up for axial length (AL): RLRL>0.01% atropine+orthokeratology (ortho-K) combination therapy>ortho-K alone> 0.01% atropine alone. The rankings for spherical equivalent (SE): RLRL> atropine alone, atropine+ortho-K combination>ortho-K alone (RLRL in first place).The analysis included 41 trials with 6,434 eyes. Compared with the control group, all interventions were found to be effective at slowing myopia progression, combining direct and indirect evidence at the 12-month follow-up:Combining direct and indirect evidence at the 12-month follow-up, the researchers noted the changes the studies found: RLRL therapy (AL: -0.31mm; SE: 0.76D), 0.01% atropine (AL -0.13mm; SE 0.25D), ortho-K therapy (AL: -0.16mm; SE: 0.58D) and 0.01% atropine+ortho-K combination therapy (AL: -0.27mm; SE: 0.76D).The study authors suggested that RLRL’s potential effect on choroid thickening may explain the reduction in AL.“As RLRL studies emerged mainly between 2022 and 2024, it is important to conduct updated evidence-based analyses,” the team wrote in their paper. “In addition, we focused on interventions commonly used in East Asia, ensuring that each intervention had a sufficient number of trials.”This meta-analysis did not address the relative safety of the interventions. Recent reports of ocular injury associated with red light therapy have given some observers pause about the viability of the intervention. It is currently not approved for use in the US. Click here for the journal source. Zheng Z, Jian X, Chen R, Dong L. Efficacy comparison of atropine, orthokeratology and repeated low-level red-light therapy for myopia control in children: a systematic review and network meta-analysis. Br J Ophthalmol. July 3, 2025. [Epub ahead of print].