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Meta-Analysis
. 2024 Feb 20;24(1):78.
doi: 10.1186/s12886-024-03337-5.

Efficacy of Repeated Low-Level Red Light (RLRL) therapy on myopia outcomes in children: a systematic review and meta-analysis

Mohamed Ashraf Youssef  1 , Ahmed Ragab Shehata  2 , Ahmed Moataz Adly  2 , Mohamed Ragab Ahmed  2 , Hoda Fahmy Abo-Bakr  2 , Rehab Mahmoud Fawzy  2 , Ahmed Taha Gouda  2
Affiliations
Meta-Analysis

Efficacy of Repeated Low-Level Red Light (RLRL) therapy on myopia outcomes in children: a systematic review and meta-analysis

Mohamed Ashraf Youssef et al. BMC Ophthalmol. .

Abstract

Background: Myopia is the most prevalent form of refractive error that has a major negative impact on visual function and causes blurring of vision. We aimed to determine if Repeated Low-Level Red Light (RLRL) treatment is beneficial in treating childhood myopia in terms of axial length (AL), spherical equivalent refraction (SER), and sub foveal choroidal thickness (SFCT).

Methods: This systematic review was performed on RLRL for treatment of myopia in children compared to single vision spectacles (SVS). We employed the search strategy with key terms myopia and low-level light therapy then we searched PubMed, Scopus, Cochrane, and Web of Science databases. The mean differences (MD) were used to evaluate the treatment effects. Heterogeneity was quantified using I2 statistics and explored by sensitivity analysis.

Results: Five randomized controlled trials (RCTs) were included in our meta-analysis with a total of 833 patients, 407 in treatment group and 426 in control group. At a 3 month follow up period, pooled studies show a statistical difference in AL between RLRL and SVS group (MD = -0.16; 95% CI [-0.19, -0.12], SER (MD = 0.33; 95% CI [0.27, 0.38]), and SFCT (MD = 43.65; 95% CI [23.72, 45.58]). At a 6 month follow up period, pooled studies show a statistical difference in AL between RLRL and SVS group (MD = -0.21; 95% CI [-0.28, -0.15]), SER (MD = 0.46; 95% CI [0.26, 0.65]), and SFCT (MD = 25.07; 95% CI [18.18, 31.95]). At a 12 month follow up period, pooled studies show a statistical difference in AL between RLRL and SVS group (MD = -0.31; 95% CI [-0.42, -0.19]) and SER (MD = 0.63; 95% CI [0.52, 0.73]).

Conclusion: This is the first systematic review and meta-analysis investigating only RCTs evidence supporting the efficacy of 650 nm RLRL for myopia control in the short term of 3, 6, and 12 months follow up. The present review revealed the clinical significance of RLRL as a new alternative treatment for myopia control with good user acceptability and no documented functional or structural damage. However, the effect of long-term RLRL treatment and the rebound effect after cessation require further investigations.

Keywords: Axial length (AL); Childhood myopia; Repeated Low-Level Red Light (RLRL); Spherical equivalent refraction (SER); Sub foveal choroidal thickness (SFCT).

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flowchart of paper selection. PRISMA Flowchart outlining the search strategy and details on the studies finally included in the meta-analysis
Fig. 2
Fig. 2
Summary of risk of bias assessment. Shows the risk of bias assessment for each trial using the Cochrane risk of bias tool. Green-colored symbol corresponds to low risk of bias, yellow corresponds to unclear risk of bias, and red corresponds to high risk of bias
Fig. 3
Fig. 3
Forest plot of change in AL. Forest plot of change in AL with RLRL and single vision lens groups: (A) 3 months, (B) 6 months (1) before and (2) after sensitivity analysis, and (C) 12 months follow up interval
Fig. 4
Fig. 4
Forest plot of change in SER. Forest plot of change in SER with RLRL and single vision lens groups: (A) 3 months (1) before and (2) after sensitivity analysis (B) 6 months (1) before and (2) after sensitivity analysis, and (C) 12 months follow up interval
Fig. 5
Fig. 5
Forest plot of change in SFCT. Forest plot of change in SFCT with RLRL and single vision lens groups: (A) 3 months and (B) 6 months (1) before and (2) after sensitivity analysis
See this image and copyright information in PMC

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