Efficacy and Safety of Naked-Eye 3D Vision Training for Myopia Control
abstract
This abstract is available on the publisher's site.
Access this abstract nowIMPORTANCE
Early onset of myopia increases the risk of high myopia, which can lead to irreversible retinal damage and even loss of central vision.
OBJECTIVE
To investigate the efficacy and safety of naked-eye 3-dimensional vision training (NVT) in preventing the progression of myopia in children.
DESIGN, SETTING, AND PARTICIPANTS
This randomized clinical trial was conducted in 3 hospitals from May 25, 2022, to February 24, 2023. Participants were children (aged 6-18 years) who had a diagnosis of myopia with a spherical equivalent refraction of -0.75 to -6.00 diopters (D).
INTERVENTION
Children in the intervention group received 20 minutes of NVT treatment every day, whereas children in the control group lived as usual without vision training.
MAIN OUTCOME AND MEASURE
The primary outcome was the change in axial length at 6 months. Spherical equivalent refraction (SER) was included as a secondary outcome.
RESULTS
Among 263 participants, 125 (47.5%) were male and 138 (52.5%) were female; the mean (SD) age was 10.3 (1.9) years (range, 6.1-15.6 years). A total of 227 patients (86.3%) completed the 6-month follow-up, including 102 in the intervention group and 125 in the control group. In the intervention group, the changes in axial length and SER at 6 months were 0.18 mm (95% CI, 0.16 to 0.20 mm) and -0.25 D (95% CI, -0.31 to -0.19 D), respectively. In the control group, the changes in axial length and SER at 6 months were 0.23 mm (95% CI, 0.21 to 0.25 mm) and -0.35 D (95% CI, -0.41 to -0.30 D), respectively. The differences in AL and SER between the 2 groups were significant (AL difference: -0.06 mm; 95% CI, -0.09 to -0.03; P < .001; SER difference: 0.10 D; 95% CI, 0.02 to 0.19; P = .02). No study-related adverse reactions were reported during follow-up.
CONCLUSIONS AND RELEVANCE
NVT is a safe and promising means to control myopia progression in children with good adherence.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT05468775.
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Additional Info
Disclosure statements are available on the authors' profiles:
Naked-Eye 3-Dimensional Vision Training for Myopia Control: A Randomized Clinical Trial
JAMA Pediatr 2024 Apr 08;[EPub Ahead of Print], R Xie, F Zhao, J Yu, B Luo, Z Jiang, X Qiu, Y Cao, Y Yang, K Chen, Y Zhang, X Luo, Z Wang, Y Zhu, Y ZhuoFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
Xie et al described their study's findings on the safety and efficacy of a novel myopia control intervention involving naked-eye three-dimensional vision training (NVT). They conducted a prospective multicentric randomized clinical trial that included 227 children with myopia (age, 6–18 years) with a spherical equivalent refraction (SER) of −0.75 to −6.00 D. Children randomized to the intervention group (n = 102) received 20 minutes of NVT daily for 6 months, whereas those in the control group (n = 125) received no vision training. Axial length, SER, visual acuity, and any adverse reactions were assessed at 1-month, 3-month, and 6-month follow-up visits.
The mean increase in axial length was significantly less in the intervention group (0.176 mm) than in the control group (0.232 mm). The mean change in SER at 6 months was −0.25 D in the intervention group and −0.35 D in the control group. The subgroup analysis showed better myopia control with NVT in children with a baseline SER of less than −3.0 D and with increased adherence to training.
NVT uses stereoscopic visual targets, which may promote eye movements, improve ciliary muscle spasms, and reduce the accommodative lag associated with prolonged near work. This approach has the advantages of requiring no additional eyewear, providing a variety of content, and being convenient. The authors showed that, after 6 months of NVT, axial length progression reduced by 35.86% and SER progression reduced by 36.68%. Additionally, there were no adverse events reported. This study provides preliminary evidence supporting the use of NVT as a safe and effective myopia control strategy; however, studies with long-term follow-up and on a larger scale are required before widespread clinical application.