Repeated low-intensity red light combined with defocus-incorporated multiple segments (DIMS) spectacles for controlling myopia progression in children.

OBJECTIVE: To investigate the efficacy and safety of repeated low-intensity red light (RLRL) therapy combined with defocus incorporated multiple segments (DIMS) spectacles for controlling myopia progression in children. METHODS: In this retrospective cohort study, medical records of 100 children with persistent myopia progression despite DIMS spectacle wear were reviewed. Patients were divided into two groups based on their treatment history: a DIMS-only control group (n=50) and an RLRL+DIMS combination group (n=50). Axial length (AL), spherical equivalent refraction (SER), uncorrected visual acuity (UCVA), central retinal thickness (CRT), subfoveal choroidal thickness (SFChT), corneal curvature (CC), fundus autofluorescence, adverse events were assessed at baseline and 1, 3, 6, 9 and 12 months. RESULTS: Of the 100 enrolled children, 92 completed the 12-month follow-up. Baseline characteristics were comparable between groups (all P>0.05). At 12 months, the combination group showed significantly less axial elongation than the control group (mean change: 0.060±0.237 mm vs. 0.386±0.183 mm, P<0.001), with 37.8% of children showing axial shortening. SER progression was also significantly slower in the combination group (change: +0.038±0.435 D vs. -0.720±0.295 D; P<0.001). SFChT increased significantly in the combination group (+13.2±27.4 μm) but decreased in controls (-3.3±12.4 μm, P<0.001). No significant changes in CRT or CC were observed. Transient glare occurred in nine children; one child withdrew due to an 8-minute afterimage. No abnormal fundus autofluorescence was detected. CONCLUSION: RLRL combined with DIMS spectacles effectively increased choroidal thickness, delayed axial elongation, and slowed SER progression in myopic children over 12 months, with a favorable short-term safety profile. Longer-term studies are warranted to confirm sustained efficacy and safety.