Early changes in choroidal thickness and ocular biometry in predicting who will achieve full myopia control with repeated low-level red light therapy

Purpose: To evaluate the early predictors for achieving full myopia control with repeated low-level red light (RLRL) therapy based on two independent randomized clinical trials (RCTs). Methods: Myopic children undergoing RLRL therapy from a multi-center RCT (training set) and a single-center RCT (va...

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Main Authors: Yanxian Chen, Mingge Li, Xianwen Shang, Guangyu Li, Ziwei Zhao, Pengju Li, Yanjun Liu, Ruilin Xiong, Mengying Lai, Yueye Wang, Mingguang He, Zhuoting Zhu
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Photodiagnosis and Photodynamic Therapy
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Online Access:http://www.sciencedirect.com/science/article/pii/S1572100025002042
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author Yanxian Chen
Mingge Li
Xianwen Shang
Guangyu Li
Ziwei Zhao
Pengju Li
Yanjun Liu
Ruilin Xiong
Mengying Lai
Yueye Wang
Mingguang He
Zhuoting Zhu
author_facet Yanxian Chen
Mingge Li
Xianwen Shang
Guangyu Li
Ziwei Zhao
Pengju Li
Yanjun Liu
Ruilin Xiong
Mengying Lai
Yueye Wang
Mingguang He
Zhuoting Zhu
author_sort Yanxian Chen
collection DOAJ
description Purpose: To evaluate the early predictors for achieving full myopia control with repeated low-level red light (RLRL) therapy based on two independent randomized clinical trials (RCTs). Methods: Myopic children undergoing RLRL therapy from a multi-center RCT (training set) and a single-center RCT (validation set) were included. Full myopia control was defined as axial elongation <0.1mm/year. Variables included age, sex, baseline refraction, ocular parameters at baseline, 1 and 3 months (axial length [AL] and subfoveal choroidal thickness [sChT]), as well as their rates of change over the first 3 months. Four random forest models to predict full myopia control after 1 year and a logistic regression was used to estimate 2-year outcome. Results: A total of 148 children were analyzed. The proportions of 1-year full myopia control was 54.2 % of eyes in the training set and 55.0 % in the validation set. Random forest models incorporating the rate of change in AL and sChT showed high predictive accuracy (AUC: 0.97 to 0.98) in external validation. The rate of change in AL contributed the most for model accuracy. For 2-year control, the rate of AL change had an AUC of 0.99 while the rate of change in sChT achieved only 0.69. Conclusions: The rate of change in AL during the first three months emerged as the most important predictor for treatment outcomes at both 1-year and 2-year, rather than the change in sChT. Early monitoring of AL changes could be a valuable tool for identifying children most likely to benefit from this intervention.
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spelling doaj-art-cf38390cced44523beec36a31ba1fa472025-08-20T04:00:40ZengElsevierPhotodiagnosis and Photodynamic Therapy1572-10002025-08-015410467210.1016/j.pdpdt.2025.104672Early changes in choroidal thickness and ocular biometry in predicting who will achieve full myopia control with repeated low-level red light therapyYanxian Chen0Mingge Li1Xianwen Shang2Guangyu Li3Ziwei Zhao4Pengju Li5Yanjun Liu6Ruilin Xiong7Mengying Lai8Yueye Wang9Mingguang He10Zhuoting Zhu11School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong; Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong KongDepartment of Ophthalmology, Shenzhen Nanshan People’s Hospital, Shenzhen, ChinaSchool of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong; Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong KongSchool of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong KongSchool of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong; Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong KongSchool of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong KongSchool of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong KongState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, ChinaSchool of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong KongSchool of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong; Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong KongSchool of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong; Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong; Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong; Corresponding authors at: Experimental Ophthalmology, The Hong Kong Polytechnic University, Hong Kong, China.Centre for Eye Research Australia, Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia; Corresponding authors at: Centre for Eye Research Australia, Department of Surgery, University of Melbourne, Melbourne, Australia.Purpose: To evaluate the early predictors for achieving full myopia control with repeated low-level red light (RLRL) therapy based on two independent randomized clinical trials (RCTs). Methods: Myopic children undergoing RLRL therapy from a multi-center RCT (training set) and a single-center RCT (validation set) were included. Full myopia control was defined as axial elongation <0.1mm/year. Variables included age, sex, baseline refraction, ocular parameters at baseline, 1 and 3 months (axial length [AL] and subfoveal choroidal thickness [sChT]), as well as their rates of change over the first 3 months. Four random forest models to predict full myopia control after 1 year and a logistic regression was used to estimate 2-year outcome. Results: A total of 148 children were analyzed. The proportions of 1-year full myopia control was 54.2 % of eyes in the training set and 55.0 % in the validation set. Random forest models incorporating the rate of change in AL and sChT showed high predictive accuracy (AUC: 0.97 to 0.98) in external validation. The rate of change in AL contributed the most for model accuracy. For 2-year control, the rate of AL change had an AUC of 0.99 while the rate of change in sChT achieved only 0.69. Conclusions: The rate of change in AL during the first three months emerged as the most important predictor for treatment outcomes at both 1-year and 2-year, rather than the change in sChT. Early monitoring of AL changes could be a valuable tool for identifying children most likely to benefit from this intervention.http://www.sciencedirect.com/science/article/pii/S1572100025002042Myopia controlPredictionRed lightChoroidal thicknessAxial lengthLow level light
spellingShingle Yanxian Chen
Mingge Li
Xianwen Shang
Guangyu Li
Ziwei Zhao
Pengju Li
Yanjun Liu
Ruilin Xiong
Mengying Lai
Yueye Wang
Mingguang He
Zhuoting Zhu
Early changes in choroidal thickness and ocular biometry in predicting who will achieve full myopia control with repeated low-level red light therapy
Photodiagnosis and Photodynamic Therapy
Myopia control
Prediction
Red light
Choroidal thickness
Axial length
Low level light
title Early changes in choroidal thickness and ocular biometry in predicting who will achieve full myopia control with repeated low-level red light therapy
title_full Early changes in choroidal thickness and ocular biometry in predicting who will achieve full myopia control with repeated low-level red light therapy
title_fullStr Early changes in choroidal thickness and ocular biometry in predicting who will achieve full myopia control with repeated low-level red light therapy
title_full_unstemmed Early changes in choroidal thickness and ocular biometry in predicting who will achieve full myopia control with repeated low-level red light therapy
title_short Early changes in choroidal thickness and ocular biometry in predicting who will achieve full myopia control with repeated low-level red light therapy
title_sort early changes in choroidal thickness and ocular biometry in predicting who will achieve full myopia control with repeated low level red light therapy
topic Myopia control
Prediction
Red light
Choroidal thickness
Axial length
Low level light
url http://www.sciencedirect.com/science/article/pii/S1572100025002042
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