Systematic review and Meta-Analysis Low-level Red-Light Therapy for Myopia Control – A systematic review and Meta-Analysis of Randomized and Non-Randomized Controlled Studies

Abstract

Myopia being a public health problem, its management has become a major focus in contemporary optometry and ophthalmology, with interest in innovative approaches to slow myopia progression. Low-level red-light therapy (RLRL) is one of recent non-invasive approaches to the myopic individuals exposed for certain period. This is a relatively recent approach, and the currently available evidence remains limited. This article provides a systematic insight into efficacy of red-light therapy in controlling myopia progression. Out of 173 results, a total of 20 studies with 16 Randomized controlled trials and 4 non-randomized control trials were included in this study after a thorough database search on PubMed, Scopus and Web of Science for all the literature related to red light therapy. Selected articles were thoroughly reviewed and the data containing both axial length and spherical equivalent values were included from the studies for the analysis. Risk of bias assessment was also carried out independently for all the studies included. Results showed that in treatment with RLRL the total pooled mean difference of Axial Length (AL) change between treatment and control groups was -0.29mm (95% CI: -0.36 to -0.22) I2 = 98%; P<0.00001),and total pooled mean difference of Spherical Equivalent Refraction (SER) was 0.59D (95% CI: 0.49 to 0.69) I2 = 96%; P<0.0001). Random effect model was used because included studies were differed in sample size, protocols and methodologies, and high heterogeneity was noted in both RCT and Non-RCT studies. This review showed that low- level-red-light therapy can significantly reduce myopia progression however, long-term studies are required to determine whether the effects are sustained over time and whether rebound occurs after cessation.