Background: Myopia is a common visual disorder with increasing prevalence. Halting progression of myopia is\ncritical, as high myopia can be complicated by a number of vision-compromising conditions.\nMethods: Literature search was conducted in the following databases: Medical Literature Analysis and Retrieval\nSystem Online (MEDLINE), Excerpta Medica dataBASE (EMBASE), Cochrane Database of Systematic Reviews (CDSR),\nDatabase of Abstracts of Reviews of Effects (DARE) and Centre for Reviews and Dissemination (CRD) Health\nTechnology Assessment (HTA) database. Systematic reviews and meta-analyses investigating the efficacy and safety\nof multiple myopia interventions vs control conditions, were considered. Methodological quality and quality of\nevidence of eligible studies were assessed using the ROBIS tool and GRADE rating. The degree of overlapping of\nindex publications in the eligible reviews was calculated with the corrected covered area (CCA).\nResults: Forty-four unique primary studies contained in 18 eligible reviews and involving 6400 children were\nincluded in the analysis. CCA was estimated as 6.2% and thus considered moderate. Results demonstrated the\nsuperior efficacy of atropine eyedrops; 1% atropine vs placebo (change in refraction: -0.78D, [- 1.30 to - 0.25] in 1\nyear), 0.025 to 0.05% atropine vs control (change in refraction: -0.51D, [- 0.60 to - 0.41] in 1 year), 0.01% atropine vs\ncontrol (change in refraction: -0.50D, [- 0.76 to - 0.24] in 1 year). Atropine was followed by orthokeratology (axial\nelongation: - 0.19 mm, [- 0.21 to - 0.16] in 1 year) and novel multifocal soft contact lenses (change in\nrefraction: -0.15D, [- 0.27 to - 0.03] in 1 year). As regards adverse events, 1% atropine induced blurred near\nvision (odds ratio [OR] 9.47, [1.17 to 76.78]) and hypersensitivity reactions (OR 8.91, [1.04 to 76.03]).\nConclusions: Existing evidence has failed to convince doctors to uniformly embrace treatments for myopic\nprogression control, possibly due to existence of some heterogeneity, reporting of side effects and lack of\nlong-term follow-up. Research geared towards efficient interventions is still necessary.
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