Repeated low-level red light shows greater 12-month efficacy than 1% atropine in myopia control trial

Repeated low-level red light (RLRL) therapy slowed myopia progression more than 1% atropine over 12 months, but showed slightly greater rebound in axial length after treatment stopped.

The prospective, single-blinded study enrolled 136 myopic children aged 6-12 years who were randomly assigned to receive RLRL therapy or 1% atropine in a 1:1 ratio. Treatment continued for 12 months, followed by a 3-month washout period. Outcomes included changes in axial length (AL), spherical equivalent refraction (SER), subfoveal choroidal thickness (SFChT), and safety.

A total of 116 children completed at least 1 follow-up visit, including 65 in the RLRL group and 51 in the HCA group.

At 12 months, AL regressed slightly in the RLRL group but increased in the HCA group (P = 0.005). SER decreased by 0.24 D with RLRL and increased by 0.035 D HCA (P = 0.008). SFChT increased by 26.0 μm in the RLRL group compared with 12.761 μm in the HCA group (P = 0.032).

During the 3-month washout period, AL elongation was greater in the RLRL group than in the HCA group (0.163 mm vs 0.115 mm; P = 0.014). Higher compliance with RLRL (≥75%) was associated with greater efficacy at 12 months (AL change −0.064 mm vs 0.084 mm; P = 0.011), but also greater rebound during washout (0.183 mm vs 0.122 mm; P = 0.02).

No severe adverse events were reported.

Reference
Xie J, Zhang Z, Zhang T, et al. Efficacy and Rebound Effects of Repeated Low-Level Red Light versus High-Concentration Atropine for Myopia Control in Children: A Randomized Controlled Trial. Clin Exp Ophthalmol. 2026 Mar 8. doi: 10.1111/ceo.70101. Epub ahead of print. PMID: 41796439.