Can we really distinguish 'responders' from 'non-responders' to myopia control interventions?

Publisher: Blackwell Publishers Country of Publication: England NLM ID: 8208839 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1475-1313 (Electronic) Linking ISSN: 02755408 NLM ISO Abbreviation: Ophthalmic Physiol Opt Subsets: MEDLINE

Publication: 2002- : Oxford : Blackwell Publishers
Original Publication: Oxford ; New York : Pergamon Press, c1981-

Atropine*/administration & dosage ; Myopia*/physiopathology ; Myopia*/diagnosis ; Disease Progression* ; Refraction, Ocular*/physiology ; Mydriatics*/administration & dosage; Humans ; Male ; Female ; Ophthalmic Solutions ; Adolescent ; Child ; Axial Length, Eye ; Treatment Outcome ; Adult ; Young Adult ; Double-Blind Method

Purpose: It is common to hear talk of 'responders' and 'non-responders' with respect to myopia control interventions. We consider the reality of distinguishing these sub-groups using data from the first year of the Low-concentration Atropine for Myopia Progression (LAMP) study.
Methods: The first year of the LAMP study was a robustly designed, placebo-controlled trial of three different low concentrations of atropine using a large sample size (N > 100 randomised to each group). The authors subsequently published mean axial elongation and myopia progression rates by age group. We used these data to calculate efficacy in terms of both absolute reduction in myopic progression and absolute reduction in axial elongation for each of the different atropine concentrations at each age group. We then compared these efficacy data to the overall progression for each of the two progression metrics.
Results: Plotting efficacy as a function of overall myopia progression and axial elongation for each of the different atropine concentrations demonstrates the invariant nature of efficacy, in terms of clinically meaningful reduction in progression, despite a substantial range of underlying overall progression. That is, faster progressors-the so-called non-responders-achieved similar reduction in axial elongation and myopia progression as the slower progressors-the so-called responders-within the various atropine treatment groups.
Conclusion: The use of the terms, responders and non-responders, during myopia progression interventions is not supported by evidence. Those designated as such may simply be slower or faster progressors, who, on average achieve the same benefit from treatment.
(© 2024 College of Optometrists.)

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Keywords: axial length; children; myopia; myopia control; myopia progression

7C0697DR9I (Atropine)
0 (Mydriatics)
0 (Ophthalmic Solutions)

Date Created: 20240904 Date Completed: 20241030 Latest Revision: 20241105

20241106

10.1111/opo.13379

39229644