Cochrane · systematic review · CD014758
Interventions for myopia control in children: a living systematic review and network meta‐analysis
Lawrenson, JG, Shah, R, Huntjens, B, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
Eyes and VisionAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
39
current version
GRADE rated
39
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 12 · 30.8%Low 17 · 43.6%Moderate 10 · 25.6%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Summary of findings 1: change in refractive error at 1 year
Population: children with progressive myopia (38 studies, 6525 participants in analyses) Interventions: optical and pharmacological Comparator: control (36 studies, 2846 participants). Control arms for optical interventions are either single vision spectacles or contact lenses. Placebo eyedrops were the usual comparator for pharmacological interventions Outcome: progression of myopia (difference in change in spherical equivalent refraction (SER)) at 1 year (dioptres)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
High‐dose atropine (≥ 0.5%) | no estimate extracted | 3 studies · 512 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Moderate‐dose atropine (0.1% to < 0.5%) | no estimate extracted | 2 studies · 254 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Low‐dose atropine (< 0.1%) | no estimate extracted | 4 studies · 497 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Pirenzepine | no estimate extracted | 2 studies · 210 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
7‐methyxanthine | no estimate extracted | 1 study · 77 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Multifocal soft contact lenses | no estimate extracted | 8 studies · 712 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Rigid gas‐permeable contact lenses | no estimate extracted | 2 studies · 178 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Peripheral plus spectacle lenses | no estimate extracted | 5 studies · 480 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Multifocal spectacle lenses | no estimate extracted | 9 studies · 729 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Undercorrected single vision spectacles | no estimate extracted | 2 studies · 72 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Summary of findings 2: change in refractive error at 2 years
Population: children with progressive myopia (26 studies, 4949 participants in the analysis) Interventions: optical and pharmacological Comparator: control (24 studies, 2282 participants). Control arms for optical interventions are either single vision spectacles or contact lenses. Placebo eyedrops were the usual comparator for pharmacological interventions Outcome: progression of myopia (difference in change in spherical equivalent refraction (SER)) at 2 years (dioptres)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
High‐dose atropine (≥ 0.5%) | no estimate extracted | 2 studies · 428 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Moderate‐dose atropine (0.1% to < 0.5%) | no estimate extracted | 2 studies · 247 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Low‐dose atropine (< 0.1%) | no estimate extracted | 2 studies · 249 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Pirenzepine | no estimate extracted | 1 study · 53 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Multifocal soft contact lenses | no estimate extracted | 5 studies · 540 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Rigid gas‐permeable contact lenses | no estimate extracted | 2 studies · 154 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Peripheral plus spectacle lenses | no estimate extracted | 2 studies · 188 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Multifocal spectacle lenses | no estimate extracted | 8 studies · 696 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Undercorrected single vision spectacles | no estimate extracted | 2 studies · 122 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Summary of findings 3: change in axial length at 1 year
Population: children with progressive myopia (36 studies, 6263 participants) in the analysis Interventions: optical and pharmacological Comparator: control (35 studies, 2732 participants). Control arms for optical interventions are either single vision spectacles or contact lenses. Placebo eyedrops were the usual comparator for pharmacological interventions
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
High‐dose atropine (≥ 0.5%) | no estimate extracted | 3 studies · 512 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Moderate‐dose atropine (0.1% to < 0.5%) | no estimate extracted | 1 study · 155 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Low‐dose atropine (< 0.1%) | no estimate extracted | 4 studies · 497 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Pirenzepine | no estimate extracted | 2 studies · 210 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
7‐methylxanthine | no estimate extracted | 1 study · 35 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Orthokeratology | no estimate extracted | 7 studies · 402 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Multifocal soft contact lenses | no estimate extracted | 8 studies · 712 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Rigid gas‐permeable contact lenses | no estimate extracted | 2 studies · 176 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Peripheral plus spectacle lenses | no estimate extracted | 3 studies · 340 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Multifocal spectacle lenses | no estimate extracted | 4 studies · 445 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Undercorrected single vision spectacles | no estimate extracted | 1 study · 47 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Summary of findings 4: change in axial length at 2 years
Population: children with progressive myopia (21 studies, 4169 participants in the analysis) Interventions: optical and pharmacological Comparator: control (20 studies, 1894 participants). Control arms for optical interventions are either single vision spectacles or contact lenses. Placebo eyedrops are the usual comparator for pharmacological interventions. Outcome: median change in axial length in control arms at 2 years
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
High‐dose atropine (≥ 0.5%) | no estimate extracted | 2 studies · 428 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Moderate‐dose atropine (0.1% to < 0.5%) | no estimate extracted | 1 study · 144 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Low‐dose atropine (< 0.1%) | no estimate extracted | 2 studies · 249 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Orthokeratology | no estimate extracted | 2 studies · 49 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Multifocal soft contact lenses | no estimate extracted | 5 studies · 540 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Rigid gas‐permeable contact lenses | no estimate extracted | 2 studies · 154 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Peripheral plus spectacle lenses | no estimate extracted | 2 studies · 188 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Multifocal spectacle lenses | no estimate extracted | 3 studies · 404 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Undercorrected single vision spectacles | no estimate extracted | 2 studies · 122 participants | Low Downgraded: risk of bias, imprecision, inconsistency |