Myopi-X lenses vs. low-dose atropine in myopia control: a Turkish retrospective study : Study design: retrospective observational study.

Background: The global prevalence of myopia is rising rapidly, with projections indicating that by 2050, half of the world's population will be affected. High myopia is associated with an increased risk of sight-threatening complications, contributing to a substantial public health burden. Atropine 0.01% has been widely used for myopia control in non-Asian populations, supported by evidence demonstrating its efficacy. Myopi-X^® lenses, designed to induce myopic defocus, represent an optical alternative to pharmacological intervention. Given that atropine requires monthly preparation, long-term adherence, and may cause mild side effects, (Myopi-X^® Novax^®) lenses offer a non-pharmacological option that may be preferable for some patients. This study compares the effectiveness of these two treatment strategies in comparison with single vision lenses to provide further insights into their role in myopia management.

Methods: This retrospective observational study was conducted at Acıbadem Hospital, Ankara, between September 2022 and September 2023. A total of 128 patients aged 5 to 16 years with myopia were included and divided into three groups: peripheral progressive addition lenses (Myopi-X^® Novax^®), atropine 0.01%, and single vision lenses. Baseline characteristics, including age, gender, and axial length, were recorded. Cycloplegic autorefraction and axial length measurements were performed, and statistical analyses were conducted to assess changes in spherical equivalent refraction and axial length over 12 months. Additionally, the potential effects of baseline axial length, gender, and age group on spherical equivalent progression and axial length elongation were evaluated.

Results: Significant differences were observed among the treatment groups in changes in spherical equivalent refraction and axial length (p < 0.001). Both the Myopi-X^® lenses and atropine 0.01% groups exhibited significantly less myopia progression compared to the single vision lenses group (p < 0.001 for both). However, no significant difference was observed between the Myopi-X^® lenses and atropine 0.01% groups at 12 months (p = 0.79), and axial length changes remained comparable between these two groups (p = 0.76). Regarding potential confounding factors, age had a significant effect on spherical equivalent refraction progression, with older children experiencing less myopic progression (p = 0.02), whereas no significant effect was observed on axial length change (p = 0.11). Gender was not significantly associated with changes in spherical equivalent (p = 0.21) or axial length (p = 0.32). Similarly, baseline axial length showed no significant association with changes in spherical equivalent (p = 0.17) or axial length (p = 0.36).

Conclusion: Both Myopi-X^® lenses and atropine 0.01% effectively slowed myopia progression over 12 months compared to single vision lenses. Spherical equivalent progression and axial length elongation were comparable between these two treatment groups. Gender and baseline axial length did not significantly affect the outcomes, whereas older children exhibited less myopic progression in terms of spherical equivalent change. This study aimed to compare the clinical effectiveness of these two treatment strategies. Further studies with longer follow-up periods are required to evaluate the long-term sustainability of these effects.