{"id":"https://openalex.org/W4412379741","doi":"https://doi.org/10.3389/fpubh.2025.1556199","title":"Prophylactic treatment of childhood myopia: a game-changer in combating the scourge of myopia?","display_name":"Prophylactic treatment of childhood myopia: a game-changer in combating the scourge of myopia?","publication_year":2025,"publication_date":"2025-07-14","ids":{"openalex":"https://openalex.org/W4412379741","doi":"https://doi.org/10.3389/fpubh.2025.1556199","pmid":"https://pubmed.ncbi.nlm.nih.gov/40726936"},"language":"en","primary_location":{"id":"doi:10.3389/fpubh.2025.1556199","doi":"https://doi.org/10.3389/fpubh.2025.1556199","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fpubh.2025.1556199","pdf_url":"https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1556199/pdf","source":{"id":"https://openalex.org/S2595931848","display_name":"Frontiers in Public Health","issn_l":"2296-2565","issn":["2296-2565"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","medline","norway-1"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Public Health","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1556199/pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5019408175","display_name":"Deborah Mei Xuan Lee","orcid":"https://orcid.org/0000-0001-9173-797X","observed_orcids":["https://orcid.org/0000-0001-9173-797X"]},"institutions":[{"id":"https://openalex.org/I2251586001","display_name":"Singapore General Hospital","ror":"https://ror.org/036j6sg82","country_code":"SG","type":"healthcare","lineage":["https://openalex.org/I2251586001"]}],"countries":["SG"],"is_corresponding":false,"raw_author_name":"Deborah M. X. Lee","raw_affiliation_strings":["Department of Cardiothoracic Surgery, Singapore General Hospital, Singapore, Singapore"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Cardiothoracic Surgery, Singapore General Hospital, Singapore, Singapore","institution_ids":["https://openalex.org/I2251586001"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5031646437","display_name":"Jonathan T W Au Eong","orcid":"https://orcid.org/0000-0003-0531-0318","observed_orcids":["https://orcid.org/0000-0003-0531-0318"]},"institutions":[{"id":"https://openalex.org/I2251586001","display_name":"Singapore General Hospital","ror":"https://ror.org/036j6sg82","country_code":"SG","type":"healthcare","lineage":["https://openalex.org/I2251586001"]}],"countries":["SG"],"is_corresponding":false,"raw_author_name":"Jonathan T. W. Au Eong","raw_affiliation_strings":["Department of General Surgery, Singapore General Hospital, Singapore, Singapore"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of General Surgery, Singapore General Hospital, Singapore, Singapore","institution_ids":["https://openalex.org/I2251586001"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5012654939","display_name":"Kah\u2010Guan Au Eong","orcid":"https://orcid.org/0000-0002-7373-8925","observed_orcids":["https://orcid.org/0000-0002-7373-8925"]},"institutions":[{"id":"https://openalex.org/I172675005","display_name":"Nanyang Technological University","ror":"https://ror.org/02e7b5302","country_code":"SG","type":"education","lineage":["https://openalex.org/I172675005"]},{"id":"https://openalex.org/I2800542734","display_name":"Mount Elizabeth Hospital","ror":"https://ror.org/019z9dk17","country_code":"SG","type":"healthcare","lineage":["https://openalex.org/I2800542734"]},{"id":"https://openalex.org/I2802424189","display_name":"Khoo Teck Puat Hospital","ror":"https://ror.org/05wc95s05","country_code":"SG","type":"healthcare","lineage":["https://openalex.org/I2802424189"]}],"countries":["SG"],"is_corresponding":true,"raw_author_name":"Kah-Guan Au Eong","raw_affiliation_strings":["Department of Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, Singapore, Singapore","International Eye Cataract Retina Center, Mount Elizabeth Medical Center and Farrer Park Medical Center, Singapore, Singapore","Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, Singapore, Singapore","institution_ids":["https://openalex.org/I2802424189"]},{"raw_affiliation_string":"International Eye Cataract Retina Center, Mount Elizabeth Medical Center and Farrer Park Medical Center, Singapore, Singapore","institution_ids":["https://openalex.org/I2800542734"]},{"raw_affiliation_string":"Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore","institution_ids":["https://openalex.org/I172675005"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":4,"corresponding_author_ids":["https://openalex.org/A5012654939"],"corresponding_institution_ids":["https://openalex.org/I172675005","https://openalex.org/I2800542734","https://openalex.org/I2802424189"],"apc_list":{"value":3150,"currency":"CHF","value_usd":3801},"apc_paid":{"value":3150,"currency":"CHF","value_usd":3801},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.1918458,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"13","issue":null,"first_page":"1556199","last_page":"1556199"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10381","display_name":"Ophthalmology and Visual Impairment Studies","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10381","display_name":"Ophthalmology and Visual Impairment Studies","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12006","display_name":"Ergonomics and Musculoskeletal Disorders","score":0.0,"subfield":{"id":"https://openalex.org/subfields/3207","display_name":"Social Psychology"},"field":{"id":"https://openalex.org/fields/32","display_name":"Psychology"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T10250","display_name":"Glaucoma and retinal disorders","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2731","display_name":"Ophthalmology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/childhood-myopia","display_name":"childhood myopia","score":0.9660000205039978},{"id":"https://openalex.org/keywords/myopia-progression","display_name":"myopia progression","score":0.8740000128746033},{"id":"https://openalex.org/keywords/atropine","display_name":"atropine","score":0.8190000057220459},{"id":"https://openalex.org/keywords/myopia-control","display_name":"myopia control","score":0.8029999732971191},{"id":"https://openalex.org/keywords/axial-elongation","display_name":"axial elongation","score":0.7289999723434448},{"id":"https://openalex.org/keywords/muscarinic-receptors","display_name":"muscarinic receptors","score":0.8510000109672546},{"id":"https://openalex.org/keywords/myopia-prevention","display_name":"myopia prevention","score":0.41100001335144043}],"concepts":[{"id":"https://openalex.org/C119767625","wikidata":"https://www.wikidata.org/wiki/Q618211","display_name":"Optometry","level":1,"score":0.5874199271202087},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.5687302350997925},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.3371954560279846},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.334008127450943}],"mesh":[],"locations_count":4,"locations":[{"id":"doi:10.3389/fpubh.2025.1556199","doi":"https://doi.org/10.3389/fpubh.2025.1556199","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fpubh.2025.1556199","pdf_url":"https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1556199/pdf","source":{"id":"https://openalex.org/S2595931848","display_name":"Frontiers in Public Health","issn_l":"2296-2565","issn":["2296-2565"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","medline","norway-1"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Public Health","raw_type":"journal-article"},{"id":"pmid:40726936","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/40726936","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in public health","raw_type":"Journal Article"},{"id":"pmh:oai:pubmedcentral.nih.gov:12301354","doi":null,"is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/12301354","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Front Public Health","raw_type":"Text"},{"id":"pmh:oai:doaj.org/article:af174c07e3a3429987ddfa32daa837ed","doi":null,"is_oa":true,"landing_page_url":"https://doaj.org/article/af174c07e3a3429987ddfa32daa837ed","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-sa","license_id":"https://openalex.org/licenses/cc-by-sa","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Frontiers in Public Health, Vol 13 (2025)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.3389/fpubh.2025.1556199","doi":"https://doi.org/10.3389/fpubh.2025.1556199","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fpubh.2025.1556199","pdf_url":"https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1556199/pdf","source":{"id":"https://openalex.org/S2595931848","display_name":"Frontiers in Public Health","issn_l":"2296-2565","issn":["2296-2565"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","medline","norway-1"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Public Health","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","score":1.0,"id":"https://metadata.un.org/sdg/3"}],"sustainable_development_goals_aurora":[{"display_name":"Zero hunger","score":0.6499999761581421,"id":"https://metadata.un.org/sdg/2"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4412379741.pdf","grobid_xml":"https://content.openalex.org/works/W4412379741.grobid-xml"},"referenced_works_count":36,"referenced_works":["https://openalex.org/W1886115468","https://openalex.org/W2026604531","https://openalex.org/W2032805099","https://openalex.org/W2263395847","https://openalex.org/W2263495255","https://openalex.org/W2611968166","https://openalex.org/W2807926487","https://openalex.org/W2912460416","https://openalex.org/W2920381415","https://openalex.org/W2925021245","https://openalex.org/W2947782382","https://openalex.org/W2981852339","https://openalex.org/W2995569484","https://openalex.org/W2997374461","https://openalex.org/W3000589485","https://openalex.org/W3033484759","https://openalex.org/W3090771571","https://openalex.org/W3128562820","https://openalex.org/W3148490085","https://openalex.org/W3159823987","https://openalex.org/W3195325911","https://openalex.org/W3211232292","https://openalex.org/W3215419349","https://openalex.org/W4296988146","https://openalex.org/W4320710104","https://openalex.org/W4322719426","https://openalex.org/W4367833874","https://openalex.org/W4381598607","https://openalex.org/W4384120011","https://openalex.org/W4386607357","https://openalex.org/W4388219729","https://openalex.org/W4388698517","https://openalex.org/W4391387827","https://openalex.org/W4392455551","https://openalex.org/W4399046352","https://openalex.org/W4401932170"],"related_works":["https://openalex.org/W2899084033","https://openalex.org/W2748952813","https://openalex.org/W3031052312","https://openalex.org/W4389568370","https://openalex.org/W3032375762","https://openalex.org/W1995515455","https://openalex.org/W2080531066","https://openalex.org/W3108674512","https://openalex.org/W1506200166","https://openalex.org/W1489783725"],"abstract_inverted_index":{"The":[0,154,249,375],"global":[1],"prevalence":[2,1305],"of":[3,26,34,41,74,82,96,127,149,160,334,341,408,499,505,512,600,626,656,694,713,739,754,786,798,823,890,914,916,961,975,994,1005,1015,1026,1100,1112,1125,1178,1202,1293,1306,1391,1435,1455],"myopia":[4,35,68,84,116,152,232,264,274,353,373,437,506,514,601,627,638,657,682,726,742,817,1017,1055,1094,1149,1238,1257,1308,1322,1341,1392,1404,1436,1442],"has":[5,85,364,661,1397],"been":[6,86,365,420,634,662,1399],"increasing":[7],"in":[8,23,112,139,168,182,220,286,337,425,435,449,464,497,541,602,608,645,664,672,681,703,708,731,746,775,808,844,904,919,934,946,954,980,997,1022,1032,1216,1228,1331,1347,1378,1402,1411,1437,1451],"the":[9,20,24,72,80,94,97,121,125,147,158,177,212,215,369,401,427,453,465,500,528,598,624,646,653,752,762,768,965,992,1003,1012,1024,1108,1167,1198,1203,1291,1304,1328,1453],"last":[10],"few":[11,1241],"decades":[12],"and":[13,56,107,131,184,191,198,204,206,294,306,313,347,357,382,391,400,445,474,486,538,583,630,684,716,734,792,816,839,907,948,1009,1089,1159,1173,1189,1200,1233,1268,1309,1340,1367,1386,1413],"is":[14,36,62,162,175,326,532,560,572,766,777,832,1062,1107,1224,1250],"projected":[15],"to":[16,66,70,114,230,262,303,323,367,388,422,429,451,456,596,636,827,853,876,901,978,1060,1064,1154,1183,1214,1261,1283,1289,1301,1353,1382,1421],"reach":[17],"50%":[18],"by":[19,491,527,640,728,1002,1039,1070,1357,1406],"year":[21,188],"2050":[22],"absence":[25],"effective":[27,424,1401],"intervention":[28,709,1235],"measures.":[29],"Each":[30],"additional":[31],"diopter":[32],"(D)":[33],"associated":[37,76,1311],"with":[38,228,260,283,412,469,543,614,691,820,837,849,867,887,971,1044,1240,1296,1393],"increased":[39,548],"risk":[40,544,567,610,753,1360],"ocular":[42,169,650],"pathologies":[43],"such":[44,119,546,1130,1336],"as":[45,120,525,547,825,1131,1161,1248,1265,1337],"open-angle":[46],"glaucoma":[47],"(20%),":[48],"posterior":[49],"subcapsular":[50],"cataract":[51],"(21%),":[52],"retinal":[53,447,740],"detachment":[54],"(30%),":[55],"myopic":[57,417,443,488,550,811,1033,1409],"maculopathy":[58],"(58%).":[59],"Hence,":[60],"there":[61],"a":[63,331,533,668,677,722,778,796,920,935,972,981,1020,1048,1081,1226,1245,1274,1285,1375,1448],"pressing":[64],"need":[65],"control":[67,507,704,982,1029,1045,1150,1342,1443],"progression":[69,240,275,903],"reduce":[71,751,1065,1303],"burden":[73,1264],"its":[75,432,744,806,1310],"sight-threatening":[77,1312],"complications.Until":[78],"now,":[79],"prevention":[81,511,781,1323,1390],"childhood":[83,218,513,1016],"largely":[87],"focused":[88],"on":[89,151,157,163,224,246,352,516,593,1166,1315,1327,1425],"secondary":[90,1297],"prevention,":[91,1239,1298],"i.e.,":[92],"reducing":[93,729,809,1407],"severity":[95,1201],"condition":[98],"for":[99,124,134,146,193,200,208,214,372,415,483,1092,1236,1320,1350,1362,1364],"those":[100],"who":[101,518,1219],"already":[102],"have":[103,142,419,522,633,1080,1220],"myopia.":[104,523,1027,1294,1456],"Various":[105],"pharmacologic":[106,618,1232],"optical":[108,620,1090,1211,1234],"interventions":[109,411,621,1030,1091,1212],"are":[110,404,563,985,1000,1096],"currently":[111,767,986,1225],"use":[113,824,993],"retard":[115],"progression.":[117,354,438],"Studies":[118],"landmark":[122],"Atropine":[123,133,213],"Treatment":[126,216],"Myopia":[128,135,219,530,1028],"2":[129],"(ATOM2)":[130],"Low-Concentration":[132],"Progression":[136],"(LAMP)":[137],"trials":[138,790],"East":[140,342],"Asia":[141],"provided":[143],"robust":[144],"evidence":[145,1429],"effect":[148,174,245,724,1111],"atropine":[150,164,237,270,362,765,774,1087,1113,1117,1140,1318,1339,1396],"control.":[153,374],"prevailing":[155],"theory":[156],"mechanism":[159],"action":[161],"modulating":[165],"muscarinic":[166],"receptors":[167],"tissues":[170],"during":[171,461,1170],"development.":[172,658],"This":[173,659],"dose-dependent:":[176],"weighted":[178],"mean":[179,931],"differences":[180],"(WMD)":[181],"refraction":[183,239,289],"axial":[185,247,277,307,651,864,908,932,1037,1066,1414],"elongation":[186,278,865,909,933,1038,1067],"per":[187,698,892,1176],"was":[189,340,885,939],"0.73D":[190],"-0.26mm":[192],"high-concentration":[194],"(0.5%-1%)":[195],"atropine,":[196],"0.65D":[197],"-0.37mm":[199],"moderate":[201,231,263],"concentration":[202,371,1330],"(0.1%-0.25%),":[203],"0.35D":[205],"-0.11mm":[207],"low-concentration":[209,764,773,1086,1338,1395],"(0.005%-0.05%).":[210],"Interestingly,":[211],"Of":[217],"India":[221],"(I-ATOM)":[222],"trial":[223,339,671],"100":[225],"Indian":[226],"children":[227,259,395,517,542,562,801,857,927,1034,1180,1218,1351,1439],"mild":[229,383],"found":[233,265],"that":[234,266,329,607,835,1011,1074,1431],"topical":[235,268,361,772,1085,1317,1394],"0.01%":[236,269],"reduced":[238,392],"but":[241,604],"had":[242,1191],"no":[243,556,987],"significant":[244],"elongation.":[248,1415],"Pediatric":[250],"Eye":[251],"Disease":[252],"Investigator":[253],"Group":[254],"(PEDIG)":[255],"trialon":[256],"187":[257],"American":[258],"low":[261,1116],"nightly":[267],"did":[271],"not":[272,520,1097,1120,1251],"slow":[273,430],"or":[276,349,552,1076,1138,1164],"after":[279],"two":[280],"years":[281,690,804,860],"compared":[282,826,875,977,1043],"placebo.":[284],"Change":[285],"spherical":[287],"equivalent":[288],"(SER)":[290],"were":[291,310,898,1205],"-0.82D":[292],"(atropine)":[293,312],"-0.80D":[295],"(placebo;":[296,315],"adjusted":[297,316],"difference":[298,317],"-0.02D;":[299],"95%":[300,320],"CI,":[301,321],"-0.19":[302],"+0.15D;":[304],"p=0.83)":[305],"length":[308],"(AL)":[309],"0.44mm":[311],"0.45mm":[314],"-0.002":[318],"mm;":[319],"-0.106":[322],"0.102mm).":[324],"It":[325],"worth":[327],"noting":[328],"only":[330],"small":[332],"proportion":[333],"participants":[335],"(11%)":[336],"this":[338,502,613,1147,1332,1379],"Asian":[343],"descent,":[344],"suggesting":[345,1073],"genetic":[346],"cultural":[348],"environmental":[350,553],"influences":[351],"Balancing":[355],"effectiveness":[356,807],"potential":[358],"side":[359,378,402,1110],"effects,":[360],"0.05%":[363],"deemed":[366],"be":[368,423,842,1019,1284,1447],"optimal":[370,1329],"commonly":[376],"reported":[377,1181],"effects":[379,403],"include":[380],"photophobia":[381],"blurry":[384],"near":[385,714],"vision":[386,460,485,878,1249],"due":[387],"pupil":[389],"dilation":[390],"accommodation.":[393],"Most":[394],"adapt":[396],"well":[397],"over":[398,688,911],"time,":[399],"reversible":[405],"upon":[406],"cessation":[407],"treatment.":[409],"Optical":[410],"lenses":[413,468,836,869,879,897,963,996,1344],"designed":[414],"peripheral":[416,446,487],"defocus":[418,448,489],"proven":[421,663,1400],"signaling":[426],"eye":[428,1141,1192],"down":[431],"growth,":[433],"resulting":[434],"slower":[436,863],"For":[439],"example,":[440],"orthokeratology":[441,995],"uses":[442],"shift":[444,812,1410],"addition":[450],"reshaping":[452],"cornea":[454],"temporarily":[455],"achieve":[457],"good":[458,1221],"unaided":[459,1222],"lens-free":[462],"periods":[463],"daytime.":[466],"Spectacle":[467],"highly":[470],"aspherical":[471],"lenslets":[472],"(HAL)":[473],"Defocus":[475],"Incorporated":[476],"Multiple":[477],"Segments":[478],"(DIMS)":[479],"provide":[480],"refractive":[481,534,570],"correction":[482],"distance":[484],"simultaneously":[490],"converging":[492],"some":[493],"incoming":[494],"light":[495,1424],"rays":[496],"front":[498],"retina.to":[501],"new":[503,1380],"generation":[504],"spectacle":[508,1343],"lenses.":[509],"Primary":[510],"focuses":[515],"do":[519,1119],"yet":[521,1098],"Premyopia,":[524],"defined":[526],"International":[529],"Institute,":[531],"state":[535],"between":[536],"+0.75":[537],"-0.50":[539],"D":[540,574,579,585],"factors":[545,1208],"AL,":[549],"parents,":[551],"influences.":[554],"While":[555,1416],"strict":[557],"age":[558,576,1058],"cutoff":[559],"given,":[561],"considered":[564],"at":[565,575,580,586,949,1143,1187,1244,1273],"higher":[566,1354],"if":[568],"their":[569,1184],"error":[571],"<+0.75":[573],"6,":[577],"\u2264+0.50":[578],"ages":[581,587],"7-8,":[582],"\u2264+0.25":[584],"9-10.":[588],"Current":[589],"practices":[590],"rely":[591],"solely":[592],"behavioral":[594],"modification":[595],"delay":[597,1290],"onset":[599,727,745,1056,1078,1292],"premyopes":[603,747,776],"we":[605,1371,1417],"posit":[606],"high":[609,1307],"groups,":[611],"supplementing":[612],"prophylactic":[615,1013,1093,1256,1280,1426,1433],"treatment":[616,1014,1095,1243,1258,1281,1335,1434],"using":[617,1135,1194],"and/or":[619],"may":[622,841,1079,1259],"increase":[623],"efficacy":[625],"control.Outdoor":[628],"time":[629],"sunlight":[631],"exposure":[632],"hypothesized":[635],"prevent":[637],"development":[639],"stimulating":[641],"light-sensitive":[642],"dopamine":[643],"release":[644],"retina.":[647],"Dopamine":[648],"inhibits":[649],"elongation,":[652],"anatomical":[654],"basis":[655],"relationship":[660,884],"several":[665],"studies,":[666],"including":[667],"3-year":[669],"clusterrandomized":[670],"Guangzhou,":[673],"China,":[674],"which":[675],"demonstrated":[676,861],"9.1%":[678],"absolute":[679],"reduction":[680,687],"incidence":[683,702,818,1405],"23%":[685],"relative":[686],"three":[689,787,912],"40":[692],"minutes":[693],"outdoor":[695],"activity":[696],"added":[697],"school":[699],"day":[700],"(39.5%":[701],"group":[705],"vs":[706],"30.4%":[707],"group,":[710],"p<0.001).":[711],"Reduction":[712],"work":[715],"longer":[717],"viewing":[718],"distances":[719],"also":[720,899],"exert":[721],"protective":[723],"against":[725],"variation":[730],"accommodative":[732],"demand":[733],"promote":[735],"more":[736,1423],"uniform":[737],"levels":[738],"focus.Treating":[741],"before":[743],"can":[748,1145,1152,1209,1324,1345,1372],"potentially":[749,1446],"further":[750],"myopia-associated":[755],"morbidities":[756],"than":[757,1041],"current":[758,1428,1441],"preventive":[759],"strategies.":[760],"Among":[761],"modalities,":[763],"most":[769],"evidence-supported":[770],"intervention.Using":[771],"novel":[779,1287],"primary":[780,1237,1321],"strategy.":[782],"A":[783,847,882],"recent":[784,1007],"meta-analysis":[785],"randomized":[788],"controlled":[789],"(RCT)":[791],"one":[793],"non-RCT":[794],"involving":[795,923],"total":[797],"644":[799],"premyopic":[800,925,998,1179,1217,1246,1438],"aged":[802,858,928],"4-12":[803],"highlighted":[805],"rapid":[810,1408],"(\u22650.5":[813],"D/year,":[814],"p<0.04)":[815],"(p=0.03)":[819],"12-24":[821],"months":[822,913,960],"placebo":[828],"(Table":[829],"1).":[830],"Evidence":[831],"now":[833],"emerging":[834],"HAL":[838,868],"DIMS":[840,896,962,1195],"useful":[843],"treating":[845],"premyopes.":[846],"RCT":[848],"108":[850],"low-hyperopic":[851],"(0":[852],"+2.00":[854],"D)":[855],"Chinese":[856,937],"6-9.9":[859],"significantly":[862,1121],"(p<0.001)":[866],"(0.11mm;":[870],"interquartile":[871],"range":[872],"[IQR]:":[873],"0.05-0.17mm)":[874],"single":[877],"(0.27mm;":[880],"0.21-0.33mm).":[881],"dose-response":[883],"observed,":[886],">30":[888],"hours":[889],"wear":[891],"week":[893],"proving":[894],"efficacious.":[895],"shown":[900],"stabilize":[902],"SER":[905,968,1412],"(+0.04D)":[906],"(+0.06mm)":[910],"usage":[915],"\u226510":[917],"hours/day":[918],"pilot":[921],"study":[922,1050],"24":[924],"Taiwanese":[926],"5-6.":[929],"Comparatively,":[930],"6-year-old":[936],"population":[938],"0.58mm/year":[940],"(99%":[941,951],"confidence":[942],"interval":[943],"[CI]":[944],"0.56-0.59mm/year)":[945],"myopes":[947],"0.65mm/year":[950],"CI":[952],"0.62-0.67mm/year)":[953],"incident":[955],"myopes.":[956],"31":[957],"Over":[958],"nine":[959],"use,":[964],"average":[966],"cycloplegic":[967],"remained":[969],"stable":[970],"yearly":[973],"change":[974],"+0.06D":[976],"-0.15D":[979],"group.":[983],"There":[984],"published":[988],"studies":[989,1008,1314],"specifically":[990],"evaluating":[991],"children.We":[999],"excited":[1001],"findings":[1004],"these":[1006,1278],"believe":[1010],"could":[1018,1445],"game-changer":[1021],"combating":[1023,1452],"scourge":[1025,1454],"employed":[1031],"typically":[1035],"reduces":[1036],"less":[1040],"0.4mm":[1042],"groups":[1046],"within":[1047],"2-year":[1049],"period.":[1051],"In":[1052],"contrast,":[1053],"delaying":[1054,1077,1403],"from":[1057],"9":[1059],"10":[1061],"estimated":[1063],"into":[1068,1440],"adulthood":[1069],"around":[1071],"0.5mm,":[1072],"preventing":[1075,1383],"greater":[1082,1262],"long-term":[1083,1388],"impact.Currently,":[1084],"therapy":[1088],"part":[1099],"routine":[1101],"clinical":[1102],"practice.":[1103],"One":[1104],"possible":[1105],"concern":[1106],"main":[1109],"use-photophobia,":[1114],"although":[1115,1197],"concentrations":[1118,1319],"affect":[1122],"vision-related":[1123],"quality":[1124],"life":[1126],"(p>0.05).":[1127],"Simple":[1128],"measures":[1129],"wearing":[1132],"sunglasses":[1133],"outdoors,":[1134],"photochromic":[1136],"lenses,":[1137,1196],"administering":[1139],"drops":[1142],"bedtime":[1144],"ameliorate":[1146],"symptom.Wearing":[1148],"spectacles":[1151],"lead":[1153,1260],"concerns":[1155],"about":[1156,1231],"appearance,":[1157],"discomfort,":[1158],"inconvenience-such":[1160],"slipping,":[1162],"fogging,":[1163],"pressure":[1165],"nose":[1168],"bridge":[1169],"daily":[1171,1185],"activities":[1172,1186],"sports.":[1174],"Seventeen":[1175],"cent":[1177],"inconvenience":[1182],"home":[1188],"8.3%":[1190],"strain":[1193],"frequency":[1199],"complaints":[1204],"mild.":[1206],"These":[1207],"make":[1210],"challenging":[1213],"adopt":[1215],"vision.There":[1223],"gap":[1227],"public":[1229,1369],"awareness":[1230],"seeking":[1242],"stage":[1247],"problematic":[1252],"yet.":[1253],"Additionally,":[1254],"starting":[1255],"financial":[1263],"treatment,":[1266],"follow-up":[1267],"opportunity":[1269],"costs":[1270],"start":[1271],"accumulating":[1272],"younger":[1275],"age.":[1276],"Despite":[1277],"caveats,":[1279],"appears":[1282],"promising":[1286],"strategy":[1288],"Combined":[1295],"they":[1299],"aim":[1300],"ultimately":[1302],"complications.Further":[1313],"different":[1316],"guide":[1325],"clinicians":[1326],"population.Investigating":[1333],"synergistic":[1334],"aid":[1346],"proposing":[1348],"solutions":[1349],"intolerant":[1352],"doses.":[1355],"Lastly,":[1356],"developing":[1358],"multifactorial":[1359],"scores":[1361],"premyopia":[1363],"patient":[1365],"selection":[1366],"better":[1368],"education,":[1370],"hopefully":[1373],"see":[1374],"large":[1376],"benefit":[1377],"approach":[1381],"myopia-related":[1384],"complications":[1385],"improving":[1387],"outcomes.Primary":[1389],"recently":[1398],"await":[1418],"future":[1419],"research":[1420],"shed":[1422],"interventions,":[1427],"suggests":[1430],"incorporating":[1432],"strategies":[1444],"game":[1449],"changer":[1450]},"counts_by_year":[],"updated_date":"2026-08-25T07:29:55.448023","created_date":"2025-10-10T00:00:00"}
