Xiaoqian Ma, Yang Zhao, Yuanpei Zhou, Hongyan Sun, Subing Liu, Weijing Yin
The 12-month myopia incidence was 30.7% (36/117) and 13.3% (10/75) for the LDA and RLRL groups, respectively. The former was significantly higher than the latter (difference, 17.4%, 95% CI: 5.2% to 28.1%; p=0.028). 69 pairs of children were matched from each group using propensity matching score method, where age, gender, baseline SER, and baseline AL were balanced between groups. The 12-month myopia incidence was 29.0% (20/69) and 11.6% (8/69) for the LDA and RLRL groups, respectively. The LDA group was still significantly higher than the RLRL group (difference, 17.4%, 95% CI: 3.9% to 30.3%; p=0.038). The 12-month changes in the SER were 0.08 D and -0.49 D for the RLRL group and the LDA group, respectively, the mean difference was -0.57 (95% CI:-0.73 to -0.41) D, p<0.001. The average changes in AL were 0.02 mm and 0.29 mm for the RLRL group and LDA group, respectively, the mean difference was 0.27 (95% CI: 0.11 to 0.43) mm, p<0.001. 19.7% (23/117) Children in the LDA group reported photophobia, no adverse event was observed in the RLRL group.
OBJECTIVE: To compare the preventive effect of daily repeated low-level red light (RLRL) and 0.01% low-dose atropine eye drops (LDA) on myopia.
METHODS: This was a 12-month prospective comparative study. 216 Children aged 7-12 years using either RLRL or LDA for myopia prevention were enrolled between July 10, 2024 to August 15, 2024. 192 completed the 12-month follow-up, last case went for clinical visit on August 28, 2025. The primary outcome was the 12-month myopia incidence. Secondary outcomes included changes in the spherical equivalent error (SER) and changes in the axial length (AL).
RESULTS: The 12-month myopia incidence was 30.7% (36/117) and 13.3% (10/75) for the LDA and RLRL groups, respectively. The former was significantly higher than the latter (difference, 17.4%, 95% CI: 5.2% to 28.1%; p=0.028). 69 pairs of children were matched from each group using propensity matching score method, where age, gender, baseline SER, and baseline AL were balanced between groups. The 12-month myopia incidence was 29.0% (20/69) and 11.6% (8/69) for the LDA and RLRL groups, respectively. The LDA group was still significantly higher than the RLRL group (difference, 17.4%, 95% CI: 3.9% to 30.3%; p=0.038). The 12-month changes in the SER were 0.08 D and -0.49 D for the RLRL group and the LDA group, respectively, the mean difference was -0.57 (95% CI:-0.73 to -0.41) D, p<0.001. The average changes in AL were 0.02 mm and 0.29 mm for the RLRL group and LDA group, respectively, the mean difference was 0.27 (95% CI: 0.11 to 0.43) mm, p<0.001. 19.7% (23/117) Children in the LDA group reported photophobia, no adverse event was observed in the RLRL group.
CONCLUSION AND RELEVANCE: In this 12-month study, daily RLRL demonstrated superior myopia prevention compared to 0.01% LDA. Myopia incidence was significantly lower with RLRL, with a 60% reduced risk. Propensity-matched analysis confirmed RLRL's efficacy, which better stabilized refractive status and axial elongation. No adverse events occurred with RLRL, while 19.7% of LDA users reported photophobia. RLRL emerges as a safer, more effective preventive intervention for childhood myopia.