Percorrer por autor "Repka, Michael X."
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- Controversies in myopia control treatment: what does it mean for future research?Publication . Lança, Carla; Repka, Michael X.; Grzybowski, AndrzejPurpose: Treatment of myopia has been informed by more than 3 decades of clinical trials and other observations. However, controversies regarding myopia control remain, such as when to stop treatment and what is the long-term efficacy of treatment. This perspective aims to describe clinically relevant and current controversies regarding myopia treatment. Design: Perspective. Methods: We reviewed clinical trial data and other studies regarding myopia control therapies. Results: Controversies in myopia treatment are related to the efficacy of low-dose atropine eyedrops and new lens design spectacles to reduce the progression of myopia substantially. In addition to efficacy, the safety of therapies including soft contact lenses, orthokeratology, and low-level red light remains a concern. The therapeutic role of outdoor time in reducing myopia progression also requires further investigation. More research is necessary to confirm treatment effectiveness, required treatment duration, tapering schedules, and when to begin and stop treatment. Conclusions: Myopia management is evolving and maintaining competency in the multiple approaches poses a challenge. Key challenges include identifying high-risk children who would benefit most from treatment, limited evidence supporting the effectiveness of myopia progression control treatments in certain populations, and concerns regarding the availability and cost of treatment, which may create socioeconomic barriers to access. The limitations of current methods to slow or stop myopia progression highlight the need for continuing rigorous investigation of new and improved strategies to reduce the burden of myopia.
- Myths in myopia epidemiology and treatmentPublication . Lança, Carla; Repka, Michael X.; Grzybowski, AndrzejPracticing evidence-based medicine requires constant effort to acquire, assess, and implement new knowledge that improves our care. Since 2013, more than 1000 publications per year have discussed myopia,1 many challenging existing medical beliefs. As in other areas of medicine, ophthalmologists are expected to translate new knowledge into their clinical practice as well as manage their demanding clinical schedule. However, practicing clinicians, including ophthalmologists, are sometimes slow to discard medical myths contradicted by available evidence. This is especially true in fields with rapidly evolving research, such as myopia. The goal of this viewpoint is to highlight examples of common beliefs about myopia epidemiology and control that are not evidence-based and to consider corrective educational strategies.
- Topical review: studies on management of myopia progression from 2019 to 2021Publication . Lança, Carla; Repka, Michael X.; Grzybowski, AndrzejMyopia is a common eye condition that increases the risk of sight-threatening complications. Each additional diopter increases the chance of complications. The purpose of this review is to make an overview of myopia control treatment options for children with myopia progression. In this non-systematic review, we searched PubMed and Cochrane databases for English-language studies published from 2019 through September 2021. Emphasis was given to a selection of randomized controlled trials. Nineteen randomized controlled trials and two retrospective studies were included. Topical atropine and orthokeratology remain the most used treatments, while lenses with novel designs are emerging treatments. Overall myopia progression in the treatment groups for low-dose atropine and orthokeratology were lower than in the control groups and their efficacy was reported in several randomized controlled trials and confirmed by various systematic reviews and meta-analysis. The findings of myopia progression and axial elongation for the MiSight, defocus incorporated multiple segments spectacle lens, highly aspherical lenslets and diffusion optics technology spectacle lens was comparable. Public health interventions to optimize environmental influences may also be important strategies to control myopia. The optimal choice of management of myopia depends on treatment availability, acceptability to the child and parents, and specific patient features such as age, baseline myopia, and lifestyle. Eye care providers need to understand the advantages and disadvantages of each therapy to best counsel parents of children with myopia.