Bullimore Mark A, Brennan Noel A
College of Optometry, University of Houston, Houston, Texas, USA.
Johnson & Johnson, New Brunswick, New Jersey, USA.
Ophthalmic Physiol Opt. 2025 Jan;45(1):100-110. doi: 10.1111/opo.13403. Epub 2024 Oct 8.
When myopia control treatment is discontinued, progression will increase, but does it revert to expected values based on the age and race of the child or does it accelerate further? The latter scenario is considered a rebound.
A PubMed search was conducted with the words 'rebound' and 'myopia control', identifying further papers from reviews. Inclusion was limited to prospective studies with ≥6 months of treatment, ≥3 months of data following cessation and with axial length data, which allowed calculation of rebound. Nineteen studies were identified, comprising 24 treatment groups. In 10 studies, untreated control children were followed both throughout the treatment and cessation periods, allowing for a concurrent comparison group. In three studies, a control group was followed for 1 or 2 years and thereafter received the treatment under evaluation. Later, treatment ceased in the originally treated children. Finally, six studies were cross-over designs. For these latter two study designs, initial axial elongation and myopia progression in the control group were extrapolated to the cessation period, accounting for annual slowing. Values from durations of <1 year were annualised.
The mean annualised rebound was +0.05 ± 0.10 mm and -0.09 ± 0.24 D for axial length and myopia progression, respectively, and these were correlated (r = 0.59, p < 0.001). Rebound was associated with 1-year treatment efficacy (r = 0.43, p < 0.001). The mean annualised rebound with optical corrections was -0.01 ± 0.03 mm. Five of the six highest rebound values (≥0.14 mm) were from red light therapy and atropine studies. Rebound ranged from +0.03 to +0.14 mm for overnight orthokeratology.
Consistent with previous statements, no evidence for rebound was found for myopia control spectacles and soft contact lenses. Future research should explore the influence of age and magnitude of treatment efficacy on rebound.
当近视控制治疗停止时，近视进展将会加快，但它是会恢复到基于儿童年龄和种族的预期值，还是会进一步加速？后一种情况被认为是反弹。
在PubMed上搜索“反弹”和“近视控制”，从综述中找出更多论文。纳入标准仅限于治疗时间≥6个月、停止治疗后有≥3个月数据且有眼轴长度数据的前瞻性研究，以便计算反弹情况。共确定了19项研究，包括24个治疗组。在10项研究中，未治疗的对照儿童在整个治疗期和停止治疗期均被随访，从而形成一个同期比较组。在3项研究中，对照组被随访1或2年，之后接受正在评估的治疗。随后，最初接受治疗的儿童停止治疗。最后，6项研究为交叉设计。对于后两种研究设计，对照组的初始眼轴伸长和近视进展被外推至停止治疗期，并考虑了每年的减缓情况。持续时间<1年的值进行了年化处理。
眼轴长度和近视进展的平均年化反弹分别为+0.05±0.10mm和-0.09±0.24D，且两者相关（r=0.59，p<0.001）。反弹与1年治疗效果相关（r=0.43，p<0.001）。光学矫正的平均年化反弹为-0.01±0.03mm。6个最高反弹值（≥0.14mm）中有5个来自红光疗法和阿托品研究。夜间角膜塑形术的反弹范围为+0.03至+0.14mm。
与之前的说法一致，未发现近视控制眼镜和软性隐形眼镜有反弹的证据。未来的研究应探讨年龄和治疗效果大小对反弹的影响。
