Efficacy of repeated low-level red-light therapy for myopia management in children and adolescents: a systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 41680682 · doi:10.1186/s12886-026-04645-8
What was done
A systematic review and meta-analysis of randomized controlled trials (searched through September 30, 2025 across PubMed, Embase, and Cochrane Library) evaluated repeated low-level red-light (RLRL) therapy versus single-vision spectacles (SVS) for controlling myopia progression in children and adolescents. Primary outcomes included changes in axial length (AL), spherical equivalent refraction (SER), and subfoveal choroidal thickness (SFCT) at 1, 3, 6, and 12 months, pooled as mean differences (MD) with 95% confidence intervals.
What was found
Across 14 RCTs involving 1,942 participants, RLRL significantly reduced axial elongation compared to controls at 1 month (MD: -0.07 mm, 95% CI: -0.09 to -0.06), 3 months (MD: -0.15 mm, 95% CI: -0.18 to -0.11), 6 months (MD: -0.22 mm, 95% CI: -0.26 to -0.17), and 12 months (MD: -0.33 mm, 95% CI: -0.39 to -0.27; all P < 0.00001). SER progression was also significantly slowed at 3 months (MD: 0.17 D, 95% CI: 0.13 to 0.21), 6 months (MD: 0.38 D, 95% CI: 0.26 to 0.49), and 12 months (MD: 0.67 D, 95% CI: 0.53 to 0.82; all P < 0.00001). SFCT increased significantly in the RLRL group at 1 month (16.72 µm), 3 months (19.46 µm), 6 months (28.21 µm), and 12 months (30.86 µm; all P < 0.00001). Heterogeneity was substantial for AL and SER outcomes.
Why it matters
This review demonstrates that RLRL therapy produces clinically meaningful reductions in axial elongation and refractive progression over 1 year compared to standard spectacles in pediatric populations.
Limits
Follow-up in the pooled trials did not extend beyond 12 months, leaving long-term safety, sustained efficacy, and rebound effects unknown. Substantial statistical heterogeneity was present for axial length and refractive outcomes, and specific optimal dosing parameters were not defined.
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