Background: To evaluate the efficacy and safety of repeated low-level red-light (RLRL) therapy for controlling myopia progression over 3 years in real-world settings. Methods: This multicentre cohort study included participants currently undergoing RLRL treatment, identified from electronic medical databases in three hospitals (myopic children and adolescents aged 7-18 years, who were prescribed RLRL therapy from 1 June 2018 to 1 June 2023), using stratified random sampling based on RLRL treatment duration (≥0.5-1 year, ≥1-2 years, ≥2-3 years and ≥3 years), with approximately 90 participants in each group. All participants voluntarily received RLRL therapy twice a daily (3 min/session, ≥4-hour interval), 5-7 days/week. Results: Among 362 participants, 90 were treated for ≥0.5-1 year (median 0.64 year), 91 for ≥1-2 years (median 1.40 years), 90 for ≥2-3 years (median 2.30 years) and 91 for ≥3 years (median 3.65 years). The satisfactory myopia control rate (defined as annual axial elongation ≤0.10 mm) was 72.53% (95% CI 62.17 to 81.37) over ≥3 years of RLRL treatment, with annual axial length change of 0.06 mm/year (95% CI 0.03 to 0.08). No subjective visual function damage was documented by best-corrected visual acuity, and no treatment duration-dependent changes in objective full-field electroretinogram were observed. A minimal, reversible optical coherence tomography change was noted in four eyes which did not impact visual function. Conclusions: This real-world study demonstrates that RLRL therapy provides promising long-term efficacy and safety in myopia control over 3 years among Chinese myopic children and adolescents.

Background: To evaluate the long-term prevention effectiveness and rebound effect of repeated red light therapy (RRLT) in children with premyopia over 2 years. Methods: A total of 108 premyopic children (cycloplegia spherical equivalent refraction (SER): -0.50 to +0.75 D) were enrolled and followed for 24 months. Participants were randomly assigned to the RRLT or control groups. The RRLT was administered two times per day for 3 min per session, with at least 4-hour interval. At the beginning of the second year, participants receiving RRLT were further randomised into continued treatment and washout subgroups. Axial length (AL), SER and subfoveal choroidal thickness (SChT) were measured. Results: Over 2 years, the RRLT group showed significantly smaller AL elongation (0.26 mm; 95% CI 0.18 to 0.35 mm) and SER progression (-0.21 D; 95% CI -0.35 to -0.08 D) compared with the controls (AL: 0.43 mm; 95% CI 0.36 to 0.49 mm; SER: -0.66 D; 95% CI -0.79 to -0.52 D). The RRLT group also demonstrated significantly less SChT thinning (-2.44 µm; 95% CI -16.11 to 11.23 µm) than the controls (-44.12 µm; 95% CI -53.05 to -35.19 µm). After RRLT cessation in the second year, the washout subgroup exhibited significantly faster AL elongation and more SChT thinning than the controls, with no significant difference in SER progression. Conclusions: The 2-year RRLT intervention effectively retarded AL elongation and SER progression in premyopic children by 0.17 mm and -0.45 D, respectively. Notably, a significant rebound effect was observed in AL growth following 1-year RRLT cessation.

Aim: To evaluate the 12-month efficacy and safety of repeated low-level red-light (RLRL) therapy combined with orthokeratology (ortho-k) (RCO) for controlling myopia in Spanish children. Methods: In this single-site, randomised, parallel-group, non-blinded clinical trial (NCT06899139), eligible myopic children aged 10-13 years were recruited and assigned randomly either to the RCO group or the ortho-k group. Follow-up assessments were conducted at 6, 9 and 12 months after baseline. The primary outcome and secondary outcome were the axial length (AL) and macular thickness (MT) changes at 12 months estimated by longitudinal mixed model. Results: All participants (n=26; 11 in the RCO group and 15 in the ortho-k group) were included in the analysis. After 12 months, the adjusted mean AL change was -0.124 mm (95% CI -0.164 to -0.084) in the RCO group, whereas the ortho-k group continued to exhibit a modest axial elongation of 0.102 mm (95% CI 0.068 to 0.136). The adjusted mean difference in AL change was -0.226 mm (95% CI -0.279 to -0.174) between the groups (p<0.001). Additionally, the adjusted mean change in MT showed no significant difference between groups at 12 months. In the RCO group, 80% of children achieved AL shortening >-0.05 mm, whereas no children in the ortho-k group showed AL shortening. No severe adverse events were reported during the study. Conclusions: Combining RLRL therapy with ortho-k is an effective and safe myopia control strategy in Caucasian Spanish children, supporting the potential generalisability of the synergistic effect across diverse ethnic groups.

目的 构建650 nm红色激光照射视网膜的辐照度数学模型，验证模型准确性，探索不同功率、瞳孔直径和眼轴长度对视网膜辐照度的影响。设计 动物实验研究。研究对象 4只2月龄普通级滇缅树鼩和6只4月龄三色豚鼠。方法 离体眼球（n=20）剥除后极部巩膜及对应视网膜，在红色激光发射功率为2 mW、5 mW、10 mW和18 mW时，测量实际视网膜辐照度。测量眼球生物参数并结合光学参数构建眼球光路模型。通过辐射传输方程（radiative transfer equation, RTE）和Henyey-Greenstein相函数构建数学模型，将理论值与实际测量值比较。主要指标 不同条件下视网膜辐照度、理论模型精确度。结果 豚鼠[瞳孔直径（5.0±0.3）mm、眼轴长度（7.52±0.11）mm]在2 mW、5 mW、10 mW和18 mW激光功率下，视网膜实际辐照度分别为121.62 W/cm2、396.67 W/cm2、690.95 W/cm2和1335.24 W/cm2，理论视网膜辐照度153.16 W/cm2、381.84 W/cm2、763.19 W/cm2和1373.75 W/cm2，平均相对差异为0.259、0.037、0.105、0.029。树鼩[瞳孔直径（4.5±0.2）mm、眼轴长度（6.78±0.17）mm]视网膜实际辐照度分别为163.21 W/cm2、385.71 W/cm2、751.19 W/cm2和1471.43 W/cm2，理论视网膜辐照度149.12 W/cm2、372.80 W/cm2、745.60 W/cm2和1339.66 W/cm2，平均相对差异为0.086、0.033、0.007、0.090。基于该模型对人眼（眼轴长度24 mm）的预测显示，2 mW激光功率下，随着瞳孔直径从2 mm增大到7 mm，视网膜辐照度从16.85 W/cm2增加到206.96 W/cm2。根据国家激光安全标准，确定人眼安全照射参数为：照射时间180 s时，瞳孔直径应不大于4.26 mm，发射光功率应不大于2 mW。结论 RTE数学模型可准确预测650 nm红色激光照射视网膜辐照度，视网膜辐照度随激光功率变大、眼轴变短、瞳孔变大而增加，呈不完全线性变化。

Repeated low-level red-light therapy (RLRL) has recently emerged as a new type of treatment to control myopia. In our study, we aim to compare the effects of RLRL and peripheral defocus modifying spectacle (PDMSL) in Medium-High myopia. This study is a randomized controlled trial. The participants were 25 children with ≥ −4.00 diopters (D) of myopia. Groups of intervention (RLRL) and control (PDMSL) were assigned 1:1. In the RLRL group, the participant would use the device and wore single-vision spectacles daily. In the control group, the participant wore PDMSL daily. The axial length, spherical equivalent refractions, and other ophthalmic examinations were measured at baseline, one, three, six, nine, and 12 months. There were 13 children in the RLRL group, and 12 children in the PDMSL group. Spherical equivalent refraction change was 0.28 ± 0.50D and −0.79 ± 0.48D at 12 months, in both groups, respectively. There was significant difference (p < 0.001). Axial length change was −0.18 ± 0.17 mm and 0.34 ± 0.13 mm at 12 months in both groups, respectively. There was significant difference (p < 0.001). There were no adverse events reported that were related to the treatment. RLRL was more effective in myopia control. RLRL could be well tolerated, with few adverse effects related to the treatment.

The alarming increase in childhood myopia has emerged as a significant public health concern. Due to its long-term consequences, there is also an expanding interest in adult-onset myopia. This review provides a comprehensive summary of interventions for slowing the onset and progression of myopia and discusses factors influencing their efficacy. Outdoor time is an effective intervention for at-risk pre-myopes, which can reduce myopia onset by up to 50 % and has been implemented on a large scale in some countries through school reforms. 0.05 % atropine and repeated low-level red light (RLRL) have also shown the potential to prevent myopia onset by approximately 50 %, though the cost-benefit of implementing them on a large scale warrants more research. Low-concentration atropine, various designs of peripheral defocus spectacles, contact lenses, and RLRL effectively slow myopia progression by at least 50 %. A history of higher baseline myopia status, faster baseline progression, parental myopia, high-risk lifestyle, and less outdoor time requires rigorous interventions. When combined with RLRL or atropine concentrations higher than 0.025 %, orthokeratology significantly improves myopia control in fast progressors and/or high myopes. Combining low-concentration atropine with peripheral defocus glasses or dual-focus contact lenses also yields better efficacy than monotherapy. There is limited research on adult myopia control, but offering comprehensive lifestyle and visual environment recommendations remains essential. Consistent use of these interventions and thorough safety monitoring are crucial for building clinical confidence. The success of myopia control hinges on personalization, given the diverse factors influencing efficacy and the challenges of large-scale implementation.

Background: To investigate the factors related to the change in axial length after repeated low-level red-light(RLRL) therapy. Methods: A retrospective case study. A total of 323 children and adolescents who underwent RLRL therapy concurrently with their eye examinations at Wuhan Children's Hospital from 2022 to 2023 were included. The biological eye parameters, including the axial length (AL), spherical equivalent refractive (SER), the subfoveal choroidal thickness (SFCT), intraocular pressure (IOP), corneal curvature and corneal thickness, were recorded at baseline, 3-month, 6-month, 12-month, 12-month, 18-month and 24-month. The factors related to the degree of change in axial length were analyzed. Results: There was a statistical difference in the amount of AL changes during the follow-up (F = 16.12, P < 0.001), and the amount of AL changes was significant at the 6-month follow-up (△AL=-0.16 ± 0.18), and then gradually decreased with the extension of follow-up time. There was a statistically positive correlation between baseline AL and baseline SER and changes in AL (P < 0.05). The axial regression in high myopia group was significantly greater than that in mild and moderate myopia group (P < 0.05). There was also a statistically positive correlation between age and changes in AL (P < 0.05). At the follow-up of 6 months, 12 months, 18 months, combined with other myopia prevention and control was correlated with the change of AL (P < 0.05). Baseline corneal thickness, baseline corneal curvature and baseline IOP were not correlated with changes in AL (all P > 0.05). Conclusion: The longer the baseline AL, the higher SER, the thinner SFCT, the older the age and the combination of other myopia prevention and control measures, the more obvious the change of AL. However, the changes of AL were not affected by IOP, corneal curvature and corneal thickness.

目的：通过比较激光周边虹膜切开（LPI）联合复合式小梁切除术与单纯复合式小梁切除术治疗慢性 闭角型青光眼术后眼压、滤过泡形成率等情况，评估2种不同方法治疗原发性慢性闭角型青光眼的 疗效。方法：前瞻性研究。采用简单随机抽样法收集2023年1月至2024年1月在成都普瑞眼科医院 和新疆四七四医院眼科选择复合式小梁切除术的（CPACG）患者120例（120眼）。采用抽签法分为试 验组60例（60眼）和对照组60例（60眼）。试验组行LPI联合复合式小梁切除术，对照组行复合式小梁 切除术。随访3个月，观察2组治疗后眼压控制情况、功能性滤过泡形成率、术后浅前房发生率的情 况。对比2组术后1个月的前房深度（ACD）、前房容积（ACV）和前房夹角（ACA）的变化。采用独立 样本t检验和卡方检验进行数据分析。结果：2组术后眼压均较术前低，且试验组术后1周、1个月眼 压低于对照组，差异有统计学意义（t=3.09，P=0.002；t=14.38，P=0.008）。术后1周、1个月、3个月 2组间滤过泡形成率比较差异无统计学意义（P>0.05）。试验组术后浅前房发生率（8.3％）低于对照 组（21.7％），差异有统计学意义（χ 2 =4.18，P=0.041）。术后1个月，试验组的ACD、ACV、ACA均较 对照组加深，且差异有统计学意义（t=11.84，P<0.001；t=10.23，P<0.001；t=2.01；P=0.047）。结论：LPI 联合复合式小梁切除术能有效控制（CPACG）患者眼压，减少并发症发生，手术安全性较高。

目的 探讨儿童青少年近视重复照射低强度单波长红光是否导致干眼的发生。方法 选取重庆大学附属沙坪坝医院就诊的50例（50眼）儿童青少年近视患者为研究对象,根据是否进行红光治疗分为试验组和对照组,每组各25例（25眼）。对照组配戴框架眼镜矫正近视,试验组在配戴框架眼镜的同时使用低强度单波长红光治疗。在治疗前及治疗3月后,对两组眼表疾病指数（OSDI）评分、泪膜破裂时间（BUT）、泪液分泌试验（SIT）及泪液炎性因子TNF-α、IL-6、IL-17、IL-1β、IL-8、IL-1RA、EGF水平进行组间比较,并在治疗前后对试验组上述指标进行组内比较,评估红光对近视儿童干眼的影响。结果 在治疗前及治疗3月后,试验组和对照组的OSDI评分、BUT、SIT及泪液炎性因子水平比较均无统计学差异（P＞0.05）。红光治疗3月后,试验组患者的OSDI评分较治疗前增加（P＜0.05）,但评分仍小于12分,属于正常范围内。试验组治疗后泪液中TNF-α、IL-6、IL-17、IL-1β、IL-8、IL-1RA、EGF水平与基线时比较,差异均无统计学意义（P＞0.05）。结论 儿童青少年近视重复照射低强度单波长红光,不会引起眼表症状及体征的变化,能较好维持眼表结构的稳定,具有较高的安全性,可推荐用于近视防控治疗。

Introduction: This research was designed to compare the effectiveness of repeated low-level red light (RLRL) and 0.01% atropine on axial length (AL), spherical equivalent refraction (SER), and choroidal parameters in children with myopia. Methods: We conducted a prospective, randomized, and single-blind controlled trial. Ninety-one children aged 6-12 years old were selected, with cycloplegic SER ≥ - 5.00 D and ≤ - 0.75 D. Participants were randomly assigned to the RLRL group and 0.01% atropine group. The primary outcomes included changes in AL, SER, and choroidal parameters after a duration of 6 months. Choroidal parameters specifically including the foveal, parafoveal, and perifoveal choroidal thickness (ChT) and the foveal, parafoveal, and perifoveal choroidal vessel volume (CVV). Results: At 6-month follow-up, the AL and SER changes were - 0.09 mm (- 0.18, 0.01) compared to 0.13 mm (0.05, 0.24) (p < 0.001) and 0.25 D (0, 0.50) compared to - 0.25 D (- 0.53, 0) (p < 0.001) in the RLRL and 0.01% atropine groups. The foveal, parafoveal and perifoveal ChT changes were 36.38 µm (14.05, 65.39), 31.04 µm (4.09, 59.35), and 28.48 µm (5.35, 55.15), compared to 0.94 µm (- 9.20, 9.36), 3.52 µm (- 10.24, 14.45), and 6.14 µm (- 5.21, 15.69) (all p < 0.001) in the RLRL and 0.01% atropine groups. The foveal, parafoveal, and perifoveal CVV changes were 0.01 μm3 (0.00, 0.02), 0.05 μm3 (0.02, 0.09), and 0.20 μm3 (0.05, 0.30) compared to 0.00 μm3 (- 0.00, 0.01), 0.01 μm3 (- 0.02, 0.03), and 0.01 μm3 (- 0.06, 0.09) (p < 0.001) in the corresponding two groups. Conclusions: After 6 months of treatment, RLRL was more effective than 0.01% atropine in controlling axial elongation and myopic progression among children with myopia. The foveal, parafoveal, and perifoveal ChT and foveal, parafoveal, and perifoveal CVV changes in the RLRL group were significantly higher than those in the 0.01% atropine group.