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Meta-Analysis
. 2020 Jan 13;1(1):CD004916.
doi: 10.1002/14651858.CD004916.pub4.

Interventions to slow progression of myopia in children

Jeffrey J Walline  1 , Kristina B Lindsley  2 , S Swaroop Vedula  3 , Susan A Cotter  4 , Donald O Mutti  1 , Sueko M Ng  5 , J Daniel Twelker  6
Affiliations
Meta-Analysis

Interventions to slow progression of myopia in children

Jeffrey J Walline et al. Cochrane Database Syst Rev. .

Abstract

Background: Nearsightedness (myopia) causes blurry vision when one is looking at distant objects. Interventions to slow the progression of myopia in children include multifocal spectacles, contact lenses, and pharmaceutical agents.

Objectives: To assess the effects of interventions, including spectacles, contact lenses, and pharmaceutical agents in slowing myopia progression in children.

Search methods: We searched CENTRAL; Ovid MEDLINE; Embase.com; PubMed; the LILACS Database; and two trial registrations up to February 2018. A top up search was done in February 2019.

Selection criteria: We included randomized controlled trials (RCTs). We excluded studies when most participants were older than 18 years at baseline. We also excluded studies when participants had less than -0.25 diopters (D) spherical equivalent myopia.

Data collection and analysis: We followed standard Cochrane methods.

Main results: We included 41 studies (6772 participants). Twenty-one studies contributed data to at least one meta-analysis. Interventions included spectacles, contact lenses, pharmaceutical agents, and combination treatments. Most studies were conducted in Asia or in the United States. Except one, all studies included children 18 years or younger. Many studies were at high risk of performance and attrition bias. Spectacle lenses: undercorrection of myopia increased myopia progression slightly in two studies; children whose vision was undercorrected progressed on average -0.15 D (95% confidence interval [CI] -0.29 to 0.00; n = 142; low-certainty evidence) more than those wearing fully corrected single vision lenses (SVLs). In one study, axial length increased 0.05 mm (95% CI -0.01 to 0.11) more in the undercorrected group than in the fully corrected group (n = 94; low-certainty evidence). Multifocal lenses (bifocal spectacles or progressive addition lenses) yielded small effect in slowing myopia progression; children wearing multifocal lenses progressed on average 0.14 D (95% CI 0.08 to 0.21; n = 1463; moderate-certainty evidence) less than children wearing SVLs. In four studies, axial elongation was less for multifocal lens wearers than for SVL wearers (-0.06 mm, 95% CI -0.09 to -0.04; n = 896; moderate-certainty evidence). Three studies evaluating different peripheral plus spectacle lenses versus SVLs reported inconsistent results for refractive error and axial length outcomes (n = 597; low-certainty evidence). Contact lenses: there may be little or no difference between vision of children wearing bifocal soft contact lenses (SCLs) and children wearing single vision SCLs (mean difference (MD) 0.20D, 95% CI -0.06 to 0.47; n = 300; low-certainty evidence). Axial elongation was less for bifocal SCL wearers than for single vision SCL wearers (MD -0.11 mm, 95% CI -0.14 to -0.08; n = 300; low-certainty evidence). Two studies investigating rigid gas permeable contact lenses (RGPCLs) showed inconsistent results in myopia progression; these two studies also found no evidence of difference in axial elongation (MD 0.02mm, 95% CI -0.05 to 0.10; n = 415; very low-certainty evidence). Orthokeratology contact lenses were more effective than SVLs in slowing axial elongation (MD -0.28 mm, 95% CI -0.38 to -0.19; n = 106; moderate-certainty evidence). Two studies comparing spherical aberration SCLs with single vision SCLs reported no difference in myopia progression nor in axial length (n = 209; low-certainty evidence). Pharmaceutical agents: at one year, children receiving atropine eye drops (3 studies; n = 629), pirenzepine gel (2 studies; n = 326), or cyclopentolate eye drops (1 study; n = 64) showed significantly less myopic progression compared with children receiving placebo: MD 1.00 D (95% CI 0.93 to 1.07), 0.31 D (95% CI 0.17 to 0.44), and 0.34 (95% CI 0.08 to 0.60), respectively (moderate-certainty evidence). Axial elongation was less for children treated with atropine (MD -0.35 mm, 95% CI -0.38 to -0.31; n = 502) and pirenzepine (MD -0.13 mm, 95% CI -0.14 to -0.12; n = 326) than for those treated with placebo (moderate-certainty evidence) in two studies. Another study showed favorable results for three different doses of atropine eye drops compared with tropicamide eye drops (MD 0.78 D, 95% CI 0.49 to 1.07 for 0.1% atropine; MD 0.81 D, 95% CI 0.57 to 1.05 for 0.25% atropine; and MD 1.01 D, 95% CI 0.74 to 1.28 for 0.5% atropine; n = 196; low-certainty evidence) but did not report axial length. Systemic 7-methylxanthine had little to no effect on myopic progression (MD 0.07 D, 95% CI -0.09 to 0.24) nor on axial elongation (MD -0.03 mm, 95% CI -0.10 to 0.03) compared with placebo in one study (n = 77; moderate-certainty evidence). One study did not find slowed myopia progression when comparing timolol eye drops with no drops (MD -0.05 D, 95% CI -0.21 to 0.11; n = 95; low-certainty evidence). Combinations of interventions: two studies found that children treated with atropine plus multifocal spectacles progressed 0.78 D (95% CI 0.54 to 1.02) less than children treated with placebo plus SVLs (n = 191; moderate-certainty evidence). One study reported -0.37 mm (95% CI -0.47 to -0.27) axial elongation for atropine and multifocal spectacles when compared with placebo plus SVLs (n = 127; moderate-certainty evidence). Compared with children treated with cyclopentolate plus SVLs, those treated with atropine plus multifocal spectacles progressed 0.36 D less (95% CI 0.11 to 0.61; n = 64; moderate-certainty evidence). Bifocal spectacles showed small or negligible effect compared with SVLs plus timolol drops in one study (MD 0.19 D, 95% CI 0.06 to 0.32; n = 97; moderate-certainty evidence). One study comparing tropicamide plus bifocal spectacles versus SVLs reported no statistically significant differences between groups without quantitative results. No serious adverse events were reported across all interventions. Participants receiving antimuscarinic topical medications were more likely to experience accommodation difficulties (Risk Ratio [RR] 9.05, 95% CI 4.09 to 20.01) and papillae and follicles (RR 3.22, 95% CI 2.11 to 4.90) than participants receiving placebo (n=387; moderate-certainty evidence).

Authors' conclusions: Antimuscarinic topical medication is effective in slowing myopia progression in children. Multifocal lenses, either spectacles or contact lenses, may also confer a small benefit. Orthokeratology contact lenses, although not intended to modify refractive error, were more effective than SVLs in slowing axial elongation. We found only low or very low-certainty evidence to support RGPCLs and sperical aberration SCLs.

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Conflict of interest statement

Jeffrey Walline was the Principal Investigator (PI) of the Contact Lens and Myopia Progression (CLAMP) Study, which was a randomized controlled trial conducted to examine the effects of rigid gas permeable contact lenses (RGPCLs) on myopia progression in children. Susan Cotter, OD, MS, was a clinical site PI and served on the writing committee for the PIR‐205 study—a trial evaluating pirenzepine ophthalmic gel for slowing myopia progression in children. Dr. Cotter was also a clinical site PI and served on the steering committee and the writing committee for the Correction of Myopia Evaluation Trial‐2 (COMET‐2) study evaluating progressive addition lenses versus single vision lenses for slowing progression of myopia in children with high accommodative lag and near esophoria. Both studies were included in this review.

Jeffrey Walline received research funding, consulted for companies, received honoraria from companies, and has pending grants with companies, all related to myopia and/or myopia progression. Susan Cotter's institution received grant funding for participation in the NIH/NEI‐funded multicenter study COMET‐2 and the industry‐sponsored PIR‐205 study. Susan Cotter and J. Daniel Twelker are clinical site PIs for an industry‐sponsored multicenter trial—the Childhood Atropine for Myopia Progression (CHAMP) Study, which evaluates low‐dose atropine for myopia progression in children. Donald O. Mutti received research funding, consulted for companies, and has received honoraria from companies with interests in myopia and/or myopia progression.

Kristina Lindsley and Swaroop Vedula were methodologists employed by CEV@US; CEV@US has been funded by various grants/contracts over years from the National Eye Institute, National Institutes of Health.

Figures

1
1
Study flow diagram.
2
2
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
3
3
Forest plot of comparison: 1 Undercorrection vs full correction spectacles, outcome: 1.2 Change in refractive error from baseline (1 year).
4
4
Forest plot of comparison: 2 Multifocal lenses vs single vision lenses, outcome: 2.1 Change in refractive error from baseline (1 year).
5
5
Forest plot of comparison: 5 Rigid gas permeable contact lenses vs control, outcome: 5.1 Change in refractive error from baseline [D].
6
6
Forest plot of comparison: 6 Orthokeratology contact lenses versus single vision lenses, outcome: 6.1 Change in axial length from baseline (2 years).
7
7
Forest plot of comparison: 6 Antimuscarinic agents vs placebo, outcome: 6.1 Change in refractive error from baseline (1 year).
1.1
1.1. Analysis
Comparison 1: Undercorrection vs full correction spectacles, Outcome 1: Change in refractive error from baseline
1.2
1.2. Analysis
Comparison 1: Undercorrection vs full correction spectacles, Outcome 2: Change in axial length from baseline
2.1
2.1. Analysis
Comparison 2: Multifocal lenses vs single vision lenses, Outcome 1: Change in refractive error from baseline (1 year)
2.2
2.2. Analysis
Comparison 2: Multifocal lenses vs single vision lenses, Outcome 2: Change in refractive error from baseline (2 years)
2.3
2.3. Analysis
Comparison 2: Multifocal lenses vs single vision lenses, Outcome 3: Change in refractive error from baseline (3 years)
2.4
2.4. Analysis
Comparison 2: Multifocal lenses vs single vision lenses, Outcome 4: Change in axial length from baseline (1 year)
2.5
2.5. Analysis
Comparison 2: Multifocal lenses vs single vision lenses, Outcome 5: Change in axial length from baseline (2 years)
2.6
2.6. Analysis
Comparison 2: Multifocal lenses vs single vision lenses, Outcome 6: Change in axial length from baseline (3 years)
2.7
2.7. Analysis
Comparison 2: Multifocal lenses vs single vision lenses, Outcome 7: Change in corneal radius of curvature from baseline, horizontal (3 years)
3.1
3.1. Analysis
Comparison 3: Peripheral plus spectacles vs single vision lenses, Outcome 1: Change in refractive error from baseline (1 year)
3.2
3.2. Analysis
Comparison 3: Peripheral plus spectacles vs single vision lenses, Outcome 2: Change in refractive error from baseline (2 years)
3.3
3.3. Analysis
Comparison 3: Peripheral plus spectacles vs single vision lenses, Outcome 3: Change in axial length from baseline (1 year)
3.4
3.4. Analysis
Comparison 3: Peripheral plus spectacles vs single vision lenses, Outcome 4: Change in axial length from baseline (2 years)
4.1
4.1. Analysis
Comparison 4: Bifocal soft contact lenses vs single vision soft contact lenses, Outcome 1: Change in refractive error from baseline (1 year)
4.2
4.2. Analysis
Comparison 4: Bifocal soft contact lenses vs single vision soft contact lenses, Outcome 2: Change in axial length from baseline (1 year)
4.3
4.3. Analysis
Comparison 4: Bifocal soft contact lenses vs single vision soft contact lenses, Outcome 3: Change in corneal radius of curvature from baseline (1 year)
5.1
5.1. Analysis
Comparison 5: Rigid gas permeable contact lenses vs control, Outcome 1: Change in refractive error from baseline
5.2
5.2. Analysis
Comparison 5: Rigid gas permeable contact lenses vs control, Outcome 2: Change in axial length from baseline
5.3
5.3. Analysis
Comparison 5: Rigid gas permeable contact lenses vs control, Outcome 3: Change in corneal radius of curvature from baseline
6.1
6.1. Analysis
Comparison 6: Orthokeratology contact lenses vs single vision lenses, Outcome 1: Change in axial length from baseline (2 years)
7.1
7.1. Analysis
Comparison 7: Antimuscarinic agents vs placebo, Outcome 1: Change in refractive error from baseline (1 year)
7.2
7.2. Analysis
Comparison 7: Antimuscarinic agents vs placebo, Outcome 2: Change in refractive error from baseline (2 years)
7.3
7.3. Analysis
Comparison 7: Antimuscarinic agents vs placebo, Outcome 3: Change in axial length from baseline (1 year)
7.4
7.4. Analysis
Comparison 7: Antimuscarinic agents vs placebo, Outcome 4: Change in axial length from baseline (2 years)
7.5
7.5. Analysis
Comparison 7: Antimuscarinic agents vs placebo, Outcome 5: Incidence of adverse events
8.1
8.1. Analysis
Comparison 8: Atropine vs tropicamide, Outcome 1: Change in refractive error from baseline (1 year)
8.2
8.2. Analysis
Comparison 8: Atropine vs tropicamide, Outcome 2: Change in refractive error from baseline (2 years)
9.1
9.1. Analysis
Comparison 9: Systemic 7‐methylxanthine vs placebo, Outcome 1: Change in refractive error from baseline (1 year)
9.2
9.2. Analysis
Comparison 9: Systemic 7‐methylxanthine vs placebo, Outcome 2: Change in axial length from baseline (1 year)
9.3
9.3. Analysis
Comparison 9: Systemic 7‐methylxanthine vs placebo, Outcome 3: Change in corneal radius of curvature from baseline (1 year)
10.1
10.1. Analysis
Comparison 10: Timolol eye drops vs no eye drops, Outcome 1: Change in refractive error from baseline
11.1
11.1. Analysis
Comparison 11: Atropine + multifocal lenses vs placebo + single vision lenses, Outcome 1: Change in refractive error from baseline (1 year)
11.2
11.2. Analysis
Comparison 11: Atropine + multifocal lenses vs placebo + single vision lenses, Outcome 2: Change in axial length from baseline (1 year)
12.1
12.1. Analysis
Comparison 12: Atropine + multifocal lenses vs cyclopentolate + single vision lenses, Outcome 1: Change in refractive error from baseline (1 year)
13.1
13.1. Analysis
Comparison 13: Bifocal spectacles vs single vision lenses + timolol, Outcome 1: Change in refractive error from baseline
See this image and copyright information in PMC

Update of

Comment in

References

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    1. Pärssinen O, Kauppinen M, Viljanen A. Astigmatism among myopics and its changes from childhood to adult age: a 23-year follow-up study. Acta Ophthalmologica 2015;93(3):276-83. - PubMed
    1. Pärssinen O, Kauppinen M, Viljanen A. The progression of myopia from its onset at age 8-12 to adulthood and the influence of heredity and external factors on myopic progression. A 23-year follow-up study. Acta Ophthalmologica 2014;92(8):730-9. - PubMed
PIR‐205 Study 2004 {published data only}
    1. Bartlett JD, Niemann K, Houde B, Allred T, Edmondson MJ, Crockett RS. A tolerability study of pirenzepine ophthalmic gel in myopic children. Journal of Ocular Pharmacology and Therapeutics 2003;19(3):271-9. - PubMed
    1. Bartlett JD, Niemann K, Houde B, Allred T, Edmondson MJ. Safety and tolerability of pirenzepine ophthalmic gel in pediatric, myopic patients. In: Investigative Ophthalmology & Visual Science. Vol. 41. 2000:ARVO E-abstract 1598.
    1. Bartlett JD, Voce M, Than TP, Edmondson M, Novack GD. Electronic monitoring system to assess patient adherence in pediatric drug studies. In: Investigative Ophthalmology and Visual Science. Vol. 44. 2003:ARVO E-abstract 1930.
    1. Chu R, Cotter S, Kwon S, PIR-205 Investigator Group. Pirenzepine 2% ophthalmic gel retards myopia progression in 8-12 year old children. In: American Academy of Optometry. 2003:170.
    1. Cotter SA, Chu RH, Kwon S. Pirenzepine 2% ophthalmic gel retards myopia progression in 8- to 12-year-old children. Optometry 2003;74:382-3.
ROMIO Study 2012 {published data only}
    1. Chan KY, Cheung SW, Cho P. Clinical performance of an orthokeratology lens fitted with the aid of a computer software in Chinese children. Contact Lens & Anterior Eye 2012;35(4):180-4. - PubMed
    1. Cheung SW, Cho P. Long-term effect of orthokeratology on the anterior segment length. Contact Lens & Anterior Eye 2016;39(4):262-5. - PubMed
    1. Cheung SW, Cho P. Validity of axial length measurements for monitoring myopic progression in orthokeratology. Investigative Ophthalmology & Visual Science 2013;54(3):1613-5. - PubMed
    1. Cho P, Cheung SW. Orthokeratology for slowing myopic progression: a randomised controlled trial. Contact Lens & Anterior Eye 2011;34:S2-3. - PubMed
    1. Cho P, Cheung SW. Protective role of orthokeratology in reducing risk of rapid axial elongation: a reanalysis of data from the ROMIO and TO-SEE studies. Investigative Ophthalmology and Visual Science 2017;58(3):1411-6. - PubMed
Sankaridurg 2010 {published data only}
    1. Donovan L, Sankaridurg P, Ho A, Chen X, Lin Z, Thomas V, et al. Myopia progression in Chinese children is slower in summer than in winter. Optometry and Vision Science 2012;89(8):1196-202. - PMC - PubMed
    1. Sankaridurg P, Chen X, Naduvilath T, la Jara PL, Lin Z, Li L, et al. Adverse events during 2 years of daily wear of silicone hydrogels in children. Optometry and Vision Science 2013;90(9):961-9. - PMC - PubMed
    1. Sankaridurg P, Donovan L, Varnas S, Ho A, Chen X, Martinez A, et al. Spectacle lenses designed to reduce progression of myopia: 12-month results. Optometry and Vision Science 2010;87(9):631-41. - PMC - PubMed
    1. Sankaridurg P, Holden B, Smith E, Naduvilath T, Chen X, Jara PL, et al. Decrease in rate of myopia progression with a contact lens designed to reduce relative peripheral hyperopia: one-year results. Investigative Ophthalmology and Visual Science 2011;52(13):9362-7. - PubMed
Schwartz 1981 {published data only}
    1. Schwartz JT. A monozygotic cotwin control study of a treatment for myopia. Acta Geneticae Medicae et Gemellologiae 1974;23(spec. nr.):26. - PubMed
    1. Schwartz JT. A monozygotic co-twin control study of a treatment for myopia. Acta Geneticae Medicae et Gemellologiae 1976;25:133-6. - PubMed
    1. Schwartz JT. Results of a monozygotic co-twin control study on a treatment for myopia. Acta Geneticae Medicae et Gemellologiae 1980;29(1):30. - PubMed
    1. Schwartz JT. Results of a monozygotic co-twin control study on a treatment for myopia. Progress in Clinical & Biological Research 1981;Pt C:249-58. - PubMed
Shih 1999 {published data only}
    1. Chen CH, Shih YF, Chou AC, Ho TC, Lin LLK, Hung PT. The effect of different concentrations of atropine on myopia controlling in myopic children. In: Investigative Ophthalmology & Visual Science. Vol. 38. 1997:ARVO E-abstract 4537.
    1. Shih YF, Chen CH, Chou AC, Ho TC, Lin LL, Hung PT. Effects of different concentrations of atropine on controlling myopia in myopic children. Journal of Ocular Pharmacology and Therapeutics 1999;15(1):85-90. - PubMed
STAMP Study 2012 {published data only}
    1. Berntsen D, Mutti D, Zadnik K. The effect of bifocal add, correction type, and adaptation on accommodative lag in myopic children. In: American Academy of Optometry. 2009.
    1. Berntsen D, Mutti DO, Zadnik K. Baseline characteristics of the study of theories about myopia progression (STAMP). In: American Academy of Optometry. 2008. - PMC - PubMed
    1. Berntsen DA, Barr CD, Mutti DO, Zadnik K. Peripheral defocus and myopia progression in myopic children randomly assigned to wear single vision and progressive addition lenses. Investigative Ophthalmology and Visual Science 2013;54(8):5761-70. - PMC - PubMed
    1. Berntsen DA, Mutti DO, Zadnik K. Study of Theories About Myopia Progression (STAMP) design and baseline data. Optometry and Vision Science 2011;87(11):823-32. - PMC - PubMed
    1. Berntsen DA, Mutti DO, Zadnik K. The effect of bifocal add on accommodative lag in myopic children with high accommodative lag. Investigative Ophthalmology and Visual Science 2010;51(12):6104-10. - PMC - PubMed
Swarbrick 2015 {published data only}
    1. Swarbrick HA, Alharbi A, Lum E, Watt K. Overnight orthokeratology for myopia control: short-term effects on axial length and refractive error. Contact Lens & Anterior Eye 2011;34:S3.
    1. Swarbrick HA, Alharbi A, Watt K, Lum E, Kang P. Myopia control during orthokeratology lens wear in children using a novel study design. Ophthalmology 2015;122(3):620-30. - PubMed
Tan 2005 {published data only}
    1. Tan D, Chia A, Han CW, Bun CY. Author reply: one-year multicenter, double-masked, placebo-controlled, parallel safety and efficacy study of 2% pirenzepine ophthalmic gel in children with myopia. Ophthalmology 2012;119(12):2653-4. - PubMed
    1. Tan DT, Lam D, Chua WH, Crockett RS. Pirenzepine ophthalmic gel (PIR): safety and efficacy for pediatric myopia in a one-year study in Asia. In: Investigative Ophthalmology and Visual Science. Vol. 44. 2003:ARVO E-abstract 801.
    1. Tan DT, Lam DS, Chua WH, Shu-Ping DF, Crockett RS, Asian Pirenzepine Study Group. One-year multicenter, double-masked, placebo-controlled, parallel safety and efficacy study of 2% pirenzepine ophthalmic gel in children with myopia. Ophthalmology 2005;112(1):84-91. - PubMed
Trier 2008 {published data only}
    1. Trier K, Munk Ribel-Madsen S, Cui D, Brøgger Christensen S. Systemic 7-methylxanthine in retarding axial eye growth and myopia progression: a 36-month pilot study. Journal of Ocular Biology, Diseases, and Informatics 2008;1(2-4):85-93. - PMC - PubMed
    1. Trier K, Ribel-Madsen SM. Effect of 7-methylxanthine on axial eye growth in myopic children—24 months follow-up. In: Investigative Ophthalmology & Visual Science. Vol. 48. 2007:ARVO E-abstract 4421.
    1. Trier K, Ribel-Madsen SM. Effect of 7-methylxanthine on eye growth in myopic children—36 months follow-up. In: Investigative Ophthalmology & Visual Science. Vol. 49. 2008:ARVO E-abstract 2609.
Wang 2005 {published data only}
    1. Wang X, Chu R. Wearing progressive addition lenses (PALs) to slow down the progression of juvenile myopia. In: Investigative Ophthalmology & Visual Science. Vol. 46. 2005:ARVO E-abstract 5595.
Wang 2017 {published data only}
    1. Wang YR, Bian HL, Wang Q. Atropine 0.5% eyedrops for the treatment of children with low myopia: a randomized controlled trial. Medicine 2017;96(27):e7371. - PMC - PubMed
Yang 2009 {published data only}
    1. Lan W, Yang Z, Ge J, Liu W, Chen X. The effectiveness of progressive additional lens on Chinese juvenile-onset acquired myopia: the first year report. Ophthalmic & Physiological Optics 2006;26:8.
    1. Yang Z, Lan W, Ge J, Liu W, Chen X, Chen L, et al. The effectiveness of progressive addition lenses on the progression of myopia in Chinese children. Ophthalmic & Physiological Optics 2009;29(1):41-8. - PubMed
Yen 1989 {published data only}
    1. Yen MY, Liu JH, Kao SC, Shiao CH. Comparison of the effect of atropine and cyclopentolate on myopia. Annals of Ophthalmology 1989;21(5):180-2, 187. - PubMed
Yi 2015 {published data only}
    1. Yi S, Huang Y, Yu SZ, Chen XJ, Yi H, Zeng XL. Therapeutic effect of atropine 1% in children with low myopia. Journal of AAPOS 2015;19(5):426-9. - PubMed

References to studies excluded from this review

Abraham 1966 {published data only}
    1. Abraham SV. Control of myopia with tropicamide. Journal of Pediatric Ophthalmology 1966;3:10-22.
ACHIEVE Study 2008 {published data only}
    1. Jones-Jordan LA, Chitkara M, Coffey B, Jackson JM, Manny RE, Rah MJ, et al. A comparison of spectacle and contact lens wearing times in the ACHIEVE study. Clinical and Experimental Optometry 2010;93(3):157-63. - PubMed
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Aller 2008 {published data only}
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Andreo 1990 {published data only}
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ATOM 2 Study 2012 {published data only}
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Baldwin 1969 {published data only}
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Baltimore Myopia Project 1946 {published data only}
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Baronet 1979 {published data only}
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Bedrossian 1979 {published data only}
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Berkeley OK Study 1983 {published data only}
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Bier 1988 {published data only}
    1. Bier N, Lowther G. Myopia Control Study: effect of different contact lens refractive corrections on the progression of myopia. Optometry Today 1988;28:38-40.
Brodstein 1984 {published data only}
    1. Brodstein RS, Brodstein DE, Olson RJ, Hunt SC, Williams RR. The treatment of myopia with atropine and bifocals: a long-term prospective study. Ophthalmology 1984;91(11):1373-9. - PubMed
Chan 2014 {published data only}
    1. Chan KY, Cheung SW, Cho P. Orthokeratology for slowing myopic progression in a pair of identical twins. Contact Lens & Anterior Eye 2014;37(2):116-9. - PubMed
Chen 2012 {published data only}
    1. Chen Z, Niu LL, Xue F, Qu XM, Zhou ZM, Zhou XT, et al. Impact of pupil diameter on axial growth in orthokeratology. Optometry and Vision Science 2012;89(11):1636-40. - PubMed
Chen 2014a {published data only}
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Chen 2016 {published data only}
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Cho 2012 {published data only}
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Cho 2017 {published data only}
    1. Cho P, Cheung SW. Discontinuation of orthokeratology on eyeball elongation (DOEE). Contact Lens & Anterior Eye 2017;40(2):82-7. - PubMed
Choi 2005 {published data only}
    1. Choi YY, Jeong JW, Park DJ. Effect of 1% atropine with tinted bifocal glasses in slowing the progression of myopia in children. In: American Academy of Ophthalmology. 2005:234.
Chou 1997 {published data only}
    1. Chou AC, Shih YF, Ho TC, Lin LL. The effectiveness of 0.5% atropine in controlling high myopia in children. Journal of Ocular Pharmacology and Therapeutics 1997;13(1):61-7. - PubMed
Dumbleton 1999 {published data only}
    1. Dumbleton KA, Chalmers RL, Richter DB, Fonn D. Changes in myopic refractive error with nine months' extended wear of hydrogel lenses with high and low oxygen permeability. Optometry and Vision Science 1999;76(12):845-9. - PubMed
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Dyer 1979 {published data only}
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Ebri 2007 {published data only}
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Eissa 2018 {published data only}
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Filip 2000 {published data only}
    1. Filip M, Stefaniu I, Stefan C. Changes in myopic refractive errors after 9 months of extensive wear of hydrogel lenses with high oxygen permeability and compared with those with low permeability. Oftalmologia 2000;51(2):35-40. - PubMed
Gimbel 1973 {published data only}
    1. Gimbel HV. The control of myopia with atropine. Canadian Journal of Ophthalmology 1973;8(4):527-32. - PubMed
Goss 1984 {published data only}
    1. Goss DA. Overcorrection as a means of slowing myopic progression. American Journal of Optometry and Physiological Optics 1984;61(2):85-93. - PubMed
Grosvenor 1991 {published data only}
    1. Grosvenor T, Perrigin D, Perrigin J, Quintero S. Do rigid gas-permeable contact lenses control the progress of myopia? Contact Lens and Spectacles 1991;6(7):29-35.
He 2016 {published data only}
    1. He MM, Du YR, Liu QY, Ren CD, Liu JL, Wang QY, et al. Short-term effects of orthokeratology on the development of low-to-moderate myopia in Chinese children. International Eye Science 2016;16(2):237-41. - PMC - PubMed
He 2018 {published data only}
    1. He X, Sankaridurg P, Xiong S, Li W, Zhang B, Weng R, Zhu J, et al. Shanghai time outside to reduce myopia trial: design and baseline data. Clinical & Experimental Ophthalmology 2019;47:171-8. - PubMed
Horner 1999 {published data only}
    1. Horner DG, Gross DA, Soni PS, Schroeder TL. Principal axis analysis to determine the contribution of axial elongation to myopia progression. In: Investigative Ophthalmology & Visual Science. Vol. 38. 1997:ARVO E-abstract 4546.
    1. Horner DG, Salmon TO, Soni PS. Junior high age children's myopia progression in soft lenses vs. spectacles. In: American Academy of Optometry. 1994:78.
    1. Horner DG, Salmon TO, Soni PS. Junior high age children's myopia progression in soft lenses vs. spectacles. In: American Academy of Optometry. 1995:96.
    1. Horner DG, Soni PS, Ross J. Junior high age children's myopia progresses equally in soft lenses and spectacles. Investigative Ophthalmology & Visual Science 1994;35:ARVO E-abstract 735.
    1. Horner DG, Soni PS, Salmon TO, Schroeder T. Junior high age children's myopia progression in soft lenses vs. spectacles. In: Investigative Ophthalmology & Visual Science. Vol. 37. 1996:ARVO E-abstract 4610.
Hosaka 1982 {published data only}
    1. Hosaka A, Abiko Y, Teranishi C. Topical use of labetalol in the treatment of pseudomyopia. In: Proceedings from the 2nd International Conference on Myopia, San Francisco, 1978. New York: Myopia International Research Foundation Proceedings, 1982:339-52.
Hosaka 1988 {published data only}
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Hua 2017 {published data only}
    1. Hua WJ, Jin JX, Wu XY, Yang JW, Jiang X, Gao GP, et al. Elevated light levels in schools have a protective effect on myopia. Ophthalmic & Physiological Optics 2015;35(3):252-62. - PubMed
Huffman 2002 {published data only}
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Jiang 2018 {published data only}
    1. Jiang J. Effect of orthokeratology, low concentration atropine and frame glasses on juvenile myopia prevention and control. International Eye Science 2018;18:1349-52.
Kao 1988 {published data only}
    1. Kao SC, Lu HY, Liu JH. Atropine effect on school myopia. A preliminary report. Acta Ophthalmologica 1988;185(Suppl):132-3. - PubMed
Keller 1996 {published data only}
    1. Keller J. Myopia control with RGPs in children. Contact Lens and Spectacles 1996;11(12):45-8.
Kennedy 1995 {published data only}
    1. Kennedy RH. Progression of myopia. Transactions of the American Ophthalmological Society 1995;93:755-800. - PMC - PubMed
Khoo 1999 {published data only}
    1. Khoo CY, Chong J, Chew SJ, Cheng HM, Rajan U. The effect of RGP contact lens wear on school myopia: a three-year study. In: Investigative Ophthalmology & Visual Science. Vol. 39. 1998:ARVO E-abstract 1289.
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Kubena 2002 {published data only}
    1. Kubena T, Kubena K Jr, Kubena K. Effect of TLT absorptive eyeglasses on progression of myopia in children. Ceska a Slovenska Oftalmologie 2002;58(6):377-81. - PubMed
Lakkis 2006 {published data only}
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Lee 2016 {published data only}
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Leung 1999 {published data only}
    1. Brown B, Edwards MH, Leung JT. Is esophoria a factor in slowing of myopia by progressive lenses? Optometry and Vision Science 2002;79(10):638-42. - PubMed
    1. Brown B, Edwards MH. Is esophoria a factor in slowing of myopia by progressive lenses? Author's response. Optometry and Vision Science 2003;80(3):199. - PubMed
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Li 2005 {published data only}
    1. Li JP, Wang W. Effect of progressive multifocal lenses for juvenile myopia in 876 cases. International Journal of Ophthalmology 2005;5(3):599-601.
Liang 2008 {published data only}
    1. Liang CK, Ho TY, Li TC, Hsu WM, Li TM, Lee YC, et al. A combined therapy using stimulating auricular acupoints enhances lower-level atropine eyedrops when used for myopia control in school-aged children evaluated by a pilot randomized controlled clinical trial. Complementary Therapies in Medicine 2008;16(6):305-10. - PubMed
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Lu 2010 {published data only}
    1. Lu PC, Chen JC. Retarding progression of myopia with seasonal modification of topical atropine. Journal of Ophthalmic and Vision Research 2010;5(2):75-81. - PMC - PubMed
Ma 2014 {published data only}ISRCTN03252665
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Mandell 1959 {published data only}
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Meythaler 1971 {published data only}
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NCT00348166 {published data only}
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NCT03372551 {published data only}
    1. NCT03372551. Comparison of Somofilcon a daily disposable test contact lens and Somofilcon a daily disposable control contact lens. clinicaltrials.gov/ct2/show/NCT03372551 (first received July 23, 2019).
NCT03512626 {published data only}
    1. NCT03512626. Clinical evaluation of multifocal intraocular lens: OPTIVIS.TM. clinicaltrials.gov/ct2/show/NCT03512626 (first received May 1, 2018).
Neetens 1985 {published data only}
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Nesterov 1990 {published data only}
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Oakley 1975 {published data only}
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Parker 1958 {published data only}
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Perrigin 1990 {published data only}
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Pirenzepine 2003 {published data only}
    1. No author. Pirenzepine for the treatment of myopia [Schärfer sehen mit Pirenzepin]. Deutsche Apotheker Zeitung 2003;143(12):54.
Plowright 2015 {published data only}
    1. Plowright AJ, Maldonado-Codina C, Howarth GF, Kern J, Morgan PB. Daily disposable contact lenses versus spectacles in teenagers. Optometry and Vision Science 2015;92(1):44-52. - PubMed
Pritchard 1999 {published data only}
    1. Pritchard N, Fonn D. Myopia associated with extended wear of low-oxygen-transmissible hydrogel lenses. In: American Academy of Optometry. 1999:169.
Rah 2002 {published data only}
    1. Rah MJ, Jackson JM, Jones LA, Marsden HJ, Bailey MD, Barr JT. Overnight orthokeratology: preliminary results of the Lenses and Overnight Orthokeratology (LOOK) study. Optometry and Vision Science 2002;79(9):598-605. - PubMed
Rainey 2000 {published data only}
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Ritchey 2005 {published data only}
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Sankaridurg 2003 {published data only}
    1. Sankaridurg PR, Sweeney DF, Holden BA, Naduvilath T, Velala I, Gora R, et al. Comparison of adverse events with daily disposable hydrogels and spectacle wear: results from a 12-month prospective clinical trial. Ophthalmology 2003;110(12):2327-34. - PubMed
Santodomingo‐Rubido 2012 {published data only}
    1. Santodomingo-Rubido J, Villa-Collar C, Gilmartin B, Gutierrez-Ortega R, Sugimoto K. Long-term efficacy of orthokeratology contact lens wear in controlling the progression of childhood myopia. Current Eye Research 2017;42(5):713-20. - PubMed
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    1. Santodomingo-Rubido J, Villa-Collar C, Gilmartin B, Gutierrez-Ortega R. Myopia control with orthokeratology contact lenses in Spain: a comparison of vision-related quality-of-life measures between orthokeratology contact lenses and single-vision spectacles. Eye & Contact Lens 2013;39(2):153-7. - PubMed
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Savoliuk 1968 {published data only}
    1. Savoliuk MM. Optical correction and progressive myopia. Vestnik Oftalmologii 1968;81(1):82-3. - PubMed
Shen 2011 {published data only}
    1. Shen EP, Hsieh YT, Hsu WC. Axial length and optical coherence tomography (OCT) characteristics of myopic children with atropine treatment [Presented at the 43rd Annual Scientific Congress of The Royal Australian and New Zealand College of Ophthalmologists Canberra, ACT Australia]. Clinical and Experimental Ophthalmology 2011;39(Suppl 1):68.
Shimmyo 2003 {published data only}
    1. Shimmyo M, Rho DS. Retardation of myopic progression and axial growth in human children by muscarinic inhibitor. In: American Academy of Ophthalmology. 2003:143-4.
Shum 2003 {published data only}
    1. Shum P. Control of myopia by using overnight orthokeratology. In: Investigative Ophthalmology and Visual Science. Vol. 44. 2003:ARVO E-abstract 3718.
SightGlass 2018 {published data only}
    1. Tolerability of a novel spectacle design with reduced peripheral contrast. NCT03761758.
SMART Study 2009 {published data only}
    1. Eiden S, Davis R. Stabilization of Myopia by Accelerated Reshaping Technique (SMART) study: one year results. In: American Academy of Optometry. 2009.
    1. Gerowitz RS. SMART study: three year outcomes. Contact Lens & Anterior Eye 2012;35(Suppl):e40.
Soni 2006 {published data only}
    1. Soni PS, Nguyen TT. Overnight orthokeratology experience with XO material. Eye & Contact Lens 2006;32(1):39-45. - PubMed
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Sun 2007 {published data only}
    1. Sun J, Li Y. Study on near-distance reading addition controlling the aggravating of adolescent myopia. Chinese Ophthalmic Research 2007;25(6):462-4.
Syniuta 2001 {published data only}
    1. Syniuta LA, Isenberg SJ. Atropine and bifocals can slow the progression of myopia in children. Binocular Vision and Strabismus Quarterly 2001;16(3):203-8. - PubMed
Takano 1964 {published data only}
    1. Takano J. Treatment of myopia by the instillation of tropicamide. Japanese Journal of Clinical Ophthalmology 1964;18:45-50. - PubMed
Tan 2012 {published data only}
    1. Tan D, Chia A, Han CW, Bun CY. Author reply: one-year multicenter, double-masked, placebo-controlled, parallel safety and efficacy study of 2% pirenzepine ophthalmic gel in children with myopia. Ophthalmology 2012;119:2653-4. - PubMed
Toki 1960 {published data only}
    1. Toki T. Treatment of myopia with local use of Neosynephrine hydrochloride. Japanese Journal of Clinical Optometry 1960;14:248-52.
Tokoro 1964 {published data only}
    1. Tokoro T, Kabe S. Treatment of myopia and changes in optical components. I. Topical application of Neosynephrine and N-ethyln9gamma-picolyl)-tropamide. Nippon Ganka Gakkai Zasshi 1964;68(13):1958-61. - PubMed
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TO‐SEE Study 2013 {published data only}
    1. Chen C, Cheung S, Cho P. Toric orthokeratology for slowing eye elongation (TO-SEE) study. Contact Lens & Anterior Eye 2013;36:e10.
Xiao 2009 {published data only}
    1. Xiao ZG, Tao LJ, Guo Y, Wang P. Effect of rigid gas permeable contact lenses in controlling the progress of high myopia in children. International Journal of Ophthalmology 2009;9(5):991-3.
Yamada 2004 {published data only}
    1. Yamada Y. Myopia in primary school children. Japanese Journal of Clinical Ophthalmology 2004;58(2):125-9.
Yamaji 1967 {published data only}
    1. Yamaji R, Sakiyama A, Yoshihara M, Furuta I, Nakamura R. Clinical study of the effect of tropic acid amide on the visual acuity and refraction in myopic children. Part VII. Nippon Ganka Kiyo - Folia Ophthalmologica Japonica - Bulletin of Japanese Ophthalmology 1967;18(3):333-45. - PubMed
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Yang 2017 {published data only}
    1. Yang Y, Wang L, Liu WL, Yan J. Comparison of the accommodative response with two refractive corrections for myopic teenagers. International Eye Science 2017;17(2):302-5.
Yi 2011 {published data only}
    1. Yi JH, Li RR. Influence of near-work and outdoor activities on myopia progression in school children. Chinese Journal of Contemporary Pediatrics 2011;13(1):32-5. - PubMed
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Zhou 2015 {published data only}
    1. Zhou C, Yan BX. Comparison of accommodative lag between rigid gas permeable contact lens and spectacles in adolescents after 1 year. International Eye Science 2015;15(5):924-7.
Zhou 2016 {published data only}
    1. Zhou ZX, Xu SS, Yi SP. Clinical effect of orthokeratology for juvenile with myopia astigmatism and its effects on corneal endothelial cells. International Eye Science 2016;16(8):1525-7.

References to studies awaiting assessment

Anderson 2016 {published and unpublished data}
    1. Anderson HA, Benoit J, Manny RE. Evaluation of progressive addition lens wear and age-related changes in phoria magnitude in myopic children. Investigative Ophthalmology and Visual Science 2016;57:ARVO E-abstract 1523.
Bakaraju 2015 {published and unpublished data}
    1. Bakaraju RC, Xu P, Song S, Ma M, Chen X, Jong M, et al. Extended depth-of-focus contact lenses can slow the rate of progression of myopia. Investigative Ophthalmology and Visual Science 2015;56:ARVO E-abstract 1728.
BLINK Study 2017b {published and unpublished data}
    1. Berntsen DA, Schulle KL, Sinnott LT, Bickle KM, Group TBS . Visual acuity and over-refraction in myopic children fitted with soft multifocal contact lenses in the BLINK Study. Investigative Ophthalmology and Visual Science 2017;58:ARVO E-Abstract 3052. - PMC - PubMed
Cheung 2018 {published data only}
    1. Cheung SW, Cho P. Does a two-year period of orthokeratology lead to changes in the endothelial morphology of children? Contact Lens & Anterior Eye 2018;41:214-8. - PubMed
ChiCTR1800018092 {published and unpublished data}
    1. ChiCTR1800018092. Comparison of myopia control effect between single use ortho-k and combined with 0.01% atropine eye drops in children. ChiCTR1800018092.
Diaz‐Llopis 2018 {published and unpublished data}
    1. Diaz-Llopis M, Pinazo-Duran MD. Superdiluted atropine at 0.01% reduces progression in children and adolescents. A 5 year study of safety and effectiveness. Archivos de la Sociedad Espanola de Oftalmologia 2018;93:182-5. - PubMed
EUCTR2016‐003340‐37‐IE {published and unpublished data}36732601
    1. EUCTR2016-003340-37-IE. Preventing the progression of shortsightedness in children using an eye drop called atropine. EUCTR2016-003340-37-IE.
EUCTR2018‐001286‐16‐DK {published and unpublished data}
    1. EUCTR2018-001286-16-DK. Low-dose atropine for the prevention of nearsightedness in Danish children. EUCTR2018-001286-16-DK.
Jong 2015 {published data only}
    1. Jong M, Xu P, Bakaraju RC, Chen X, Sankaridurg P, Ma M, et al. A dose-response relationship between duration of daily lens wear and reduction in rate of axial elongation. Investigative Ophthalmology & Visual Science 2015;56:2941.
Kinoshita 2017 {published data only}
    1. Kinoshita N, Konno Y, Hamada N, Kakehashi A. Suppressive effect of combined treatment of orthokeratology and 0.01% atropine instillation on axial length elongation in childhood myopia. Investigative Ophthalmology & Visual Science 2017;58:2386.
Lam 2018 {published data only}
    1. Lam AK, Leung SY, Hon Y, Shu-Ho L, Wong KY, Tiu PK, Lam DC. Influence of short-term orthokeratology on corneal tangent modulus: a randomized study. Current Eye Ressearch 2018;43:474-81. - PubMed
Maekawa 2016 {published and unpublished data}
    1. Maekawa H, Hieda O, Nakamura Y, Koizumi N, Sotozono C, Kinoshita S. Comparison of the correction effect to suppress the progression of myopia between two types of orthokeratology lenses. Investigative Ophthalmology and Visual Science 2016;57:2485.
NCT02055378 {published and unpublished data}
    1. NCT02055378. The effect of low-concentration atropine combined with auricular acupoint stimulation in myopia control. clinicaltrials.gov/ct2/show/NCT02055378 (first received February 5, 2014). - PubMed
NCT02700139 {published and unpublished data}
    1. NCT02700139. Shamir aspheric ophthalmic lenses (MyLens) for myopic control clinical trial. clinicaltrials.gov/ct2/show/NCT02700139 (first received March 7, 2016).
NCT03519490 {published and unpublished data}
    1. NCT03519490. Can distance center and near center multifocal contact lenses control myopia progression in children? clinicaltrials.gov/ct2/show/NCT03519490 (first received May 9, 2019).
Pärssinen 2017 {published and unpublished data}
    1. Pärssinen O, Kauppinen M. Anisometropia of spherical equivalent and astigmatism among myopes: a 23-year follow-up study of prevalence and changes from childhood to adulthood. Acta Ophthalmologica 2017;95:518-24. - PubMed
Ren 2017 {published data only}
    1. Ren QJ, Yue H, Wang P, Liu RJ, Lu P. Effects of low concentration atropine and orthokeratology on myopia prevention and control. International Eye Science 2017;17:794-6.
Sankaridurg 2017 {published and unpublished data}
    1. Sankaridurg P, Bakaraju RC, Morgan J, Chen X, Tilia D, Ho A, et al. Novel contact lenses designed to slow progress of myopia: 12 month results. Investigative Ophthalmology & Visual Science 2017;58:2391.
Tan 2019 {published data only}
    1. Tan Q, Ng AL, Cheng GP, Woo VC, Cho P. Combined atropine with orthokeratology for myopia control: study design and preliminary results. Current Eye Research 2019;44:671-8. - PubMed
Tilia 2018 {published data only}
    1. Tilia D, Sha J, Thomas V, Bakaraju RC. Vision performance and accommodative/binocular function in children wearing prototype extended depth-of-focus contact lenses. Eye Contact Lens 2019;27:260-70. - PubMed
Trier 2015 {published data only}
    1. Trier K. 7-methylxanthine treatment. Acta Ophthalmologica 2015;93:NR.
Wei 2017 {published data only}
    1. Wei S, Li S, Sun Y, Kang M, Meng B, Ran A, et al. A randomized controlled clinical trial on the effects of wearing orthokeratology and spectacles on ocular peripheral refraction in myopic children. Chinese Journal of Experimental Ophthalmology 2017;35:930-5.
Wu 2018 {published and unpublished data}
    1. Wu WH, Wang HS. Effectiveness of AC custom-made Ortho-K lens. International Eye Science 2018;18:1742-5.
Yam 2019 {published and unpublished data}
    1. Yam JC, Jiang Y, Tang SM, Law AKP, Chan JJ, Wong E, et al. Low-concentration atropine for myopia progression (LAMP) study: a randomized, double-blinded, placebo-controlled trial of 0.05%, 0.025%, and 0.01% atropine eye drops in myopia control. Ophthalmology 2019;126:113-24. - PubMed
Zhao 2017 {published and unpublished data}
    1. Zhao HL, Jiang J, Yu J, Xu HM. Role of short-wavelength filtering lenses in delaying myopia progression and amelioration of asthenopia in juveniles. International Journal of Ophthalmology 2017;10:1261-7. - PMC - PubMed

References to ongoing studies

ACTRN12605000633684 {published and unpublished data}
    1. ACTRN12605000633684. Trial of an experimental soft contact lens designed to inhibit the progression of axial myopia in children. apps.who.int/trialsearch/Trial2.aspx?TrialID=ACTRN12605000633684 (date registered October 13, 2005).
ACTRN12608000566336 {published and unpublished data}
    1. ACTRN12608000566336. Myopia control lens efficacy trial. www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=83124 (date registered November 12, 2008).
ACTRN12611000499987 {unpublished data only}
    1. ACTRN12611000499987. Overnight contact lens treatment for myopia (short-sight) progression in children. www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=336636 (date registered May 12, 2011).
ACTRN12611000582954 {published and unpublished data}
    1. ACTRN12611000582954. Myopia control with progressive spectacle lenses trial. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=343027 (date registered June 6, 2011).
ACTRN12611001148965 {published and unpublished data}
    1. ACTRN12611001148965. To determine the rate of refractive error change in children wearing multifocal soft contact lens as compared to those wearing single vision soft contact lenses. www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12611001148965 (date registered November 2, 2011).
ACTRN12617000598381 {published and unpublished data}
    1. ACTRN12617000598381. Western Australian ATOM pilot study: atropine for the treatment of myopia. www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12617000598381 (date registered April 27, 2017).
ACTRN12618000242224 {published and unpublished data}
    1. ACTRN12618000242224. Contralateral myopia progression trial. anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12618000242224 (date registered February 14, 2018).
BLINK Study 2017a {published data only}
    1. Walline JJ, Gaume Giannoni A, Sinnott LT, Chandler MA, Huang J, Mutti DO, et al. A randomized trial of soft multifocal contact lenses for myopia control: baseline data and methods. Optometry and Vision Science 2017;94(9):856-66. - PMC - PubMed
ChiCTR1800016504 {published and unpublished data}
    1. ChiCTR1800016504. Clinical effect of vitamin B12 eye drops on myopia in children. chictr.org.cn/showprojen.aspx?proj=26962 ChiCTR1800016504.
ChiCTR1800017683 {published and unpublished data}
    1. ChiCTR1800017683. A double-masked comparative study of peripheral defocus lenses. ChiCTR1800017683.
ChiCTR1900021316 {published and unpublished data}
    1. ChiCTR1900021316. Clinical observation for acupuncture in myopia control and its effect on accommodative microfluctuations. ChiCTR1900021316.
ChiCTR‐INR‐17013794 {published and unpublished data}
    1. ChiCTR-INR-17013794. The effectiveness safety of corneal contact lens used to correct myopia: a multi-center, randomized, open and positive parallel control clinical trials. www.chictr.org.cn/showprojen.aspx?proj=23702 (date registered December 9, 2017).
ChiCTR‐INR‐17013853 {published and unpublished data}
    1. ChiCTR-INR-17013853. Effects of orthokeratology and combined with 0.01% atropine on myopia control: a multicenter comparative study. www.chictr.org.cn/showprojen.aspx?proj=22940 (date registered December 11, 2017).
ChiCTR‐IOR‐17010432 {published and unpublished data}
    1. ChiCTR-IOR-17010432. Myopia progression with Invisible round segment bifocal spectacle lenses. www.chictr.org.cn/com/25/showprojen.aspx?proj=17727 (date registered January 14, 2017).
ChiCTR‐IOR‐17011993 {published and unpublished data}
    1. ChiCTR-IOR-17011993. Prospective, masked, contralateral, randomised, crossover dispensing clinical trial to compare the myopia progression rate between myopia control contact lens and single vision contact lenses. www.chictr.org.cn/showprojen.aspx?proj=20301 (date registered July 14, 2017).
ChiCTR‐IPD‐16008844 {published and unpublished data}
    1. ChiCTR-IPD-16008844. Clinical study of low concentration atropine in controlling children myopia. www.chictr.org.cn/showprojen.aspx?proj=14705 (date registered July 14, 2016).
ChiCTR‐TRC‐07000029 {published and unpublished data}
    1. ChiCTR-TRC-07000029. Double-blinded, randomized controlled trial about the influence of new lenses on the progress of children's myopia. www.chictr.org.cn/showprojen.aspx?proj=9496 (date registered November 30, 2007).
ChiCTR‐TRC‐07000044 {published and unpublished data}
    1. ChiCTR-TRC-07000044. Clinical randomized controlled trial of progressive addition lenses on the control of myopia in Chinese adolescents. http://www.chictr.org.cn/showproj.aspx?proj=9481 (date registered December 12, 2007).
ChiCTR‐TRC‐09000476 {published and unpublished data}
    1. ChiCTR-TRC-09000476. Novel spectacle lenses versus single-vision spectacle lenses on the progression of myopia in children: a randomised clinical trial. chictr.org.cn/showprojen.aspx?proj=9058 (date registered August 4, 2009).
ChiCTR‐TRC‐10000914 {published and unpublished data}
    1. ChiCTR-TRC-10000914. Progression of refractive error in myopic Chinese children wearing commercially-available single vision spectacles. www.chictr.org.cn/showproj.aspx?proj=8624 (date registered June 27, 2007).
ChiCTR‐TRC‐11001463 {published and unpublished data}
    1. ChiCTR-TRC-11001463. Efficacy of MyoVision spectacle lenses. www.chictr.org.cn/showproj.aspx?proj=8076 (date registered August 2, 2011).
ChiCTR‐TRC‐11001746 {published and unpublished data}
    1. ChiCTR-TRC-11001746. Assessment of myopia progression rates in children wearing either a multifocal centre near or single vision soft contact lens. www.chictr.org.cn/showprojen.aspx?proj=7799 (date registered December 1, 2011).
ChiCTR‐TRC‐13003396 {published and unpublished data}
    1. ChiCTR-TRC-13003396. Myopia progression with sedentary-use, small segment, concentric bifocals. www.chictr.org.cn/showprojen.aspx?proj=6163 (date registered August 1, 2013).
ChiCTR‐TRC‐13004032 {published and unpublished data}
    1. ChiCTR-TRC-13004032. Chinese University low dose atropine for myopia progression study (CU-LAMP). ChiCTR-TRC-13004032.
ChiCTR‐TRC‐14004227 {published and unpublished data}
    1. ChiCTR-TRC-14004227. Assessment of rate of progression of myopia with contact lenses in Chinese children. www.chictr.org.cn/hvshowproject.aspx?id=8971 (date registered August 9, 2016).
ChiCTR‐TRC‐14004990 {published and unpublished data}
    1. ChiCTR-TRC-14004990. Low concentration atropine to slow myopic progression in children. www.chictr.org.cn/showproj.aspx?proj=4584 (date registered July 3, 2014).
CTRI/2016/11/007450 {published and unpublished data}
    1. CTRI/2016/11/007450. Atropine eye drops to decrease myopia progression in children. ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=15817&EncHid=&am... (date registered November 8, 2016).
IRCT20100414003714N3 {published and unpublished data}
    1. IRCT20100414003714N3. Effect of atropine eye drop for inhibition of myopic progression. http://en.irct.ir/trial/31944 (date registered October 7, 2018).
IRCT20180216038747N1 {published and unpublished data}
    1. IRCT20180216038747N1. Controlling myopia progression. https://www.irct.ir/trial/30096 (date registered April 17, 2018).
ISRCTN36732601 {published and unpublished data}
    1. ISRCTN36732601. Efficacy, safety and mechanisms of atropine eyedrops in slowing the progression of shortsightedness (myopia) in children. www.isrctn.com/ISRCTN36732601 (date assigned October 4, 2017).
JPRN‐UMIN000005054 {unpublished data only}
    1. JPRN-UMIN000005054. Clinical trial to evaluate effect of spectacle lens that reduces myopia progression. apps.who.int/trialsearch/Trial2.aspx?TrialID=JPRN-UMIN000005054 (date registered February 8, 2011).
JPRN‐UMIN000007989 {published and unpublished data}
    1. JPRN-UMIN000007989. Clinical trial to prevent myopia progression by progressive additional soft contact lens compared with monofocal soft contact lens in children. apps.who.int/trialsearch/Trial2.aspx?TrialID=JPRN-UMIN000007989 (date registered June 1, 2012).
JPRN‐UMIN000013698 {published and unpublished data}
    1. JPRN-UMIN000013698. Examination of the nearsighted progress depression effect of the low-concentrated atropine in the Japanese primary schoolchild. apps.who.int/trialsearch/Trial2.aspx?TrialID=JPRN-UMIN000013698 (date registered April 11, 2014).
JPRN‐UMIN000014362 {published and unpublished data}
    1. JPRN-UMIN000014362. Examination of the myopia progress suppressive effect by combined treatment of orthokeratology and 0.01% atropine instillation. JPRN-UMIN000014362.
JPRN‐UMIN000018041 {published and unpublished data}
    1. JPRN-UMIN000018041. The efficacy of 0.01% atropine ophthalmic solution for controlling the progression of childhood myopia (ATOM-J Study). apps.who.int/trialsearch/Trial2.aspx?TrialID=JPRN-UMIN000018041 (date registered June 23, 2015).
JPRN‐UMIN000019237 {published and unpublished data}
    1. JPRN-UMIN000019237. Effect of dual-focus soft contact lens wear on myopia progression. apps.who.int/trialsearch/Trial2.aspx?TrialID=JPRN-UMIN000018041 (date registered June 23, 2013).
JPRN‐UMIN000023386 {published and unpublished data}
    1. JPRN-UMIN000023386. Clinical trial on the use of outdoor environment glasses for a suppressive effect on myopia progression. apps.who.int/trialsearch/Trial2.aspx?TrialID=JPRN-UMIN000023386 (date registered July 29, 2016).
JPRN‐UMIN000027940 {published and unpublished data}
    1. JPRN-UMIN000027940. Clinical study on the effect of multifocal contact lens on myopia progression in myopia school children. apps.who.int/trialsearch/Trial2.aspx?TrialID=JPRN-UMIN000027940 (date registered July 21, 2017).
Kinoshita 2018 {published data only}
    1. Kinoshita N, Konno Y, Hamada N, Kanda Y, Shimmura-Tomita M, Kakehashi A. Additive effects of orthokeratology and atropine 0.01% ophthalmic solution in slowing axial elongation in children with myopia: first year results. Japanese Journal of Ophthalmology 2018;62:544-53. - PubMed
Li 2013 {published data only}
    1. Li SM, Li SY, Liu LR, Guo JY, Chen W, Wang Nl, et al. Full correction and undercorrection of myopia evaluation trial: design and baseline data of a randomized, controlled, double-blind trial. Clinical & Experimental Ophthalmology 2013;41(4):329-38. - PubMed
MASS 2018 {published and unpublished data}
    1. Ruiz-Pomeda A, Perez-Sanchez B, Canadas P, Prieto-Garrido FL, Gutierrez-Ortega R, Villa-Collar C. Binocular and accommodative function in the controlled randomized clinical trial MiSight Assessment Study Spain (MASS). Graefe's Archive for Clinical and Experimental Ophthalmology 2018;257:207-15. - PubMed
    1. Ruiz-Pomeda A, Perez-Sanchez B, Prieto-Garrido FL, Gutierrez-Ortega R, Villa-Collar C. MiSight assessment study Spain: adverse events, tear film osmolarity, and discontinuations. Eye Contact Lens 2018;12:S180-6. - PubMed
    1. Ruiz-Pomeda A, Perez-Sanchez B, Valls I, Prieto-Garrido FL, Gutierrez-Ortega R, Villa-Collar C. MiSight Assessment Study Spain (MASS). A 2-year randomized clinical trial. Graefes Archive for Clinical & Experimental Ophthalmology 2018;3:1011-21. - PubMed
NCT00214487 {published and unpublished data}
    1. NCT00214487. Bifocal soft contact lenses and their effect on myopia progression in children and adolescents. clinicaltrials.gov/ct2/show/NCT00214487 (first received September 22, 2005).
NCT00627874 {published and unpublished data}
    1. NCT00627874. Trial of myopia prevention using +3D lenses. clinicaltrials.gov/ct2/show/NCT00627874 (first received March 4, 2008).
NCT00762970 {published and unpublished data}
    1. NCT00762970. Controlling myopia progression with soft contact lenses. clinicaltrials.gov/ct2/show/NCT00762970 (first received September 30, 2008).
NCT01704729 {published and unpublished data}
    1. NCT01704729. The children's WEAR trial (Phase 1 & 2). clinicaltrials.gov/ct2/show/NCT01704729 (first received October 11, 2012).
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References to other published versions of this review

Walline 2008
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