IS REPEATED LOW LEVEL RED LIGHT (RLRL) EFFECTIVE FOR PREMYOPIC CHILDREN? A SYSTEMIC REVIEW AND META ANALYSIS
Published 2025 - 29th ESCRS Winter Meeting
Reference: PO225 | Type: Presented Poster & Poster | DOI: 10.82333/62sg-8f80
Authors: Ahmed Sermed Al Sakini* 1 , Aya Saad 2 , Muhammad M. Elsharkawy 3 , Ajay Kumar 4 , Ahmad Alkheder 5 , Lava Abdullah 6 , Sandra Thair Al aish 1 , Ahmed Ibrahim 7 , May Ameri 8 , Mohammed A. Fenjan 9 , Mohamed Hosny 10
1University of baghdad, college of Medicine,Baghdad,Iraq, 2Al-Mustansiriyah University, College of Medicine,Baghdad,Iraq, 3Alexandria Main University Hospital,Alexandria,Egypt, 4Isra University Hyderabad Faculty of Medicine and Allied Medical Sciences,Hyderabad, Sindh,Pakistan, 5Department of Head and Neck Surgery,Al Mouwasat University Hospital, Faculty of Medicine, Damascus University,Damascus,Syrian Arab Republic;Faculty of Medicine, Syrian Private University,Damascus,Syrian Arab Republic, 6Farah Fertility Center,Damascus,Syrian Arab Republic, 7Faculty of medicine, Alexandria university,Alexandria,Egypt, 8Department of ophthalmology,Baylor College of Medicine, Cullen Eye Institute,Houston,United States, 9Department of ophthalmology,Ibn Al Haitham Teaching Eye Hospital,Baghdad,Iraq, 10Department of ophthalmology, Refractive and Cornea Service,Cairo University Hospitals,Cairo,Egypt
Purpose
To determine if Repeated Low-Level Red Light (RLRL) treatment is beneficial for premyopic children, assessing two pivotal metrics; axial length (AL), and spherical equivalent refraction (SER).
Setting
This systemic review and meta analysis was conducted in University of Baghdad, College of Medicine and Department of ophthalmology, Cairo University Hospitals.
Methods
We searched PubMed, Scopus, Web of Science, Embase and Cochrane databases to conduct this meta analysis according to PRISMA guidelines up to 8th September. Randomized clinical trials were included and their quality was assessed through ROB-2. Analyses were conducted using Revman (v 5.4). The fixed- or random-effect model was used based on the extent of heterogeneity to pool the mean difference (MD) and its corresponding 95% confidence interval (CI) across included studies. Heterogeneity was quantified using I2 statistics and explored by sensitivity analysis.
Results
4 RCTs including 551 children were meta-analyzed. Across all outcomes, RLRL significantly showed consistently greater improvements in premyopic children at both 6-month and 12-month follow-ups. After 6-month follow-up, the effect of RLRL on SER showed a statistically significant MD of 0.26 D (95% CI: 0.22 to 0.30), favoring the RLRL group over controls (p < 0.00001, I² = 0%). Similarly, by 12 months, the effect was more pronounced, with a pooled MD of 0.45 D (95% CI: 0.25 to 0.66; p < 0.0001); however, substantial heterogeneity was observed (I² = 87%). To address this high heterogeneity, the leave-one-out sensitivity analysis was done. The adjusted meta-analysis showed a statistically significant pooled MD of 0.36 D (95% CI: 0.27 to 0.46; p < 0.00001,I²= 0%). Regarding AL outcome, at 6-month follow-up, the analysis demonstrated a statistically significant reduction favoring (RLRL). The pooled MD was -0.13 mm (95% CI: -0.16 to -0.09; p < 0.00001, I² = 46%). Similarly, 12 months also showed a significant reduction in the RLRL group compared to the control. The pooled MD was -0.21 mm (95% CI: -0.30 to -0.12; p < 0.00001). Heterogeneity was substantial (I² = 88%, p < 0.00001). However, on solving the heterogeneity, the leave-one-out method was done. The adjusted analysis demonstrated that AL reduction remained statistically significant in favor of (RLRL) pooled MD was -0.17 mm (95% CI: -0.21 to -0.13; p < 0.00001) with I² = 0% indicating consistency in effect size across studies after excluding one outlier study.
Conclusion
This is the first meta-analysis to investigate the effectiveness of RLRL for premypoic children in the short term. RLRL treatment demonstrated significant improvements for both AL and SER suggesting a novel alternative therapeutic approach. Further, larger RCTs with longer follow-up durations should be conducted.