Duration-Dependent Efficacy and Clinical Safety of Repeated Low-Level Red-Light Therapy for Paediatric Myopia: A Systematic Review and Meta-Analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 41846466 · doi:10.1111/ceo.70105
What was done
Authors searched PubMed, Embase, and Cochrane Library through August 2025 for randomized controlled trials evaluating repeated low-level red-light (RLRL) therapy versus control in children under 18 years old. The primary outcome was spherical equivalent refraction (SER); secondary outcomes included axial length (AL), choroidal thickness (ChT), anterior chamber depth, central corneal thickness, lens thickness, and uncorrected visual acuity (UCVA). Evidence certainty was rated using GRADE.
What was found
Twenty-eight RCTs with 3,573 participants met inclusion criteria. At 12 months, RLRL therapy showed duration-dependent control (p < 0.05) with pooled improvements versus control of +0.68 D in SER, -0.30 mm in AL, and +26.7 μm in ChT. Subgroup analysis showed greater efficacy in children with higher baseline myopia (p < 0.0001), with similar effects between 5-day and 7-day weekly regimens. UCVA was higher with RLRL, while anterior chamber depth, central corneal thickness, and lens thickness showed no change. Adverse events were described as mild and transient, without consistent structural or functional abnormalities.
Why it matters
This review provides pooled evidence that RLRL therapy produces duration-dependent slowing of myopia progression up to one year in children. It indicates comparable outcomes between 5- and 7-day weekly schedules and larger benefits in those with higher baseline myopia.
Limits
The maximum follow-up duration evaluated was 12 months, leaving long-term efficacy and potential rebound effects unaddressed. GRADE evidence certainty was moderate for SER and ChT but remained lower for axial length. Comprehensive long-term retinal safety assessments were noted as lacking in the available literature.
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