Controversies over interventions for high myopia in children and adolescents

Authors: Zhao Wenchen,  He Xiangui,  Deng Junjie
DOI: 10.3760/cma.j.cn115989-20211019-00567
Published 2022-06-10
Cite asChin J Exp Ophthalmol, 2022, 40(6): 588-593.

Abstract

With the high incidence and early onset age of myopia, continuous attention has been paid to the prevention and control of high myopia.Interventions to control the progression of high myopia in children and adolescents at present mainly include low-dose atropine eye drops, orthokeratology, multifocal soft contact lenses and posterior scleral reinforcement.The interventions have also been applied among children with high myopia and have been proved effective in controlling the progression of myopia.Controversies over their clinical usages and safety still exist.There is a contradiction between concentration and safety of low-dose atropine eye drops, namely, higher concentration showing better efficacy is accompanied by the higher risk of adverse reactions.Meanwhile, there exist some children having poor response to atropine treatment.The long-term effect of orthokeratology lens is unclear, and how to choose the power of orthokeratology lens has not come to an agreement.The effect of multifocal soft contact lens on high myopia needs to be further verified by clinical trials with large sample size.Posterior scleral reinforcement is a surgical procedure, having a higher risk of adverse reactions and trauma than other interventions, and there is a lack of high-level evidence-based medical evidence to prove its efficacy.The promotion and application of interventions for high myopia still require the support of high-level medical evidences.From the perspectives of medicine, optics, surgery and other strategies, the recent controversies about the intervention for high myopia in children and adolescents were reviewed in this article.

Key words:

Myopia; Prevention and control; Child; Adolescent; High myopia

Contributor Information

Zhao Wenchen

Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center, Shanghai 200040, China

He Xiangui

Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center, Shanghai 200040, China

Deng Junjie

Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai Key Laboratory of Ocular Fundus Diseases, National Eye Disease Clinical Medicine Research Center, Shanghai 200080, China

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