The Myopic Control Effect of Defocus Incorporated Multiple Segments' Spectacle Lens With Atropine in High Myopia Population

Abstract

Background/aim: This study investigated the efficiency of combined atropine (ATR) and defocus incorporated multiple segments' (DIMS) spectacle lens versus ATR monotherapy in controlling high myopia in children.

Patients and methods: A retrospective cohort study was performed, enrolling patients treated with either ATR monotherapy (n=35 eyes) or a combination of ATR and DIMS lenses (n=32 eyes). The primary outcomes were the spherical equivalent refraction (SER) progression and axial length (AXL) elongation, and were measured over a one year follow up period. Statistical comparisons were made using independent t-tests and generalized linear models.

Results: After one year, the ATR group showed significantly greater SER progression (-0.38±0.14D) compared to the DIMS-ATR group (-0.15±0.09D) (p<0.001). After the same period of time, AXL elongation was also significantly higher in the ATR group (0.13±0.07 mm) compared to the DIMS-ATR group (0.06±0.04 mm) (p<0.001). Subgroup analysis indicated that a young initial age, high baseline SER, and longer initial AXL were associated with greater SER progression and AXL elongation in the ATR group (all p<0.05). In addition, in the DIMS-ATR group, higher initial SER and AXL were independently associated with SER progression and AXL elongation, respectively (both p<0.05).

Conclusion: The combined ATR plus DIMS spectacle lenses was more effective in slowing myopia progression than ATR monotherapy in children with high myopia. This combined approach may be a preferable strategy for managing high-risk pediatric myopia.

Keywords: High myopia; atropine; axial length; defocus incorporated multiple segments; spherical equivalent refraction.