DOT spectacle lenses reduce retinal contrast caused by environmental factors, thereby slowing axial elongation and myopia progression. Photo: Getty Images.
Abnormally high retinal contrast signaling between neighboring cones may be a driver of axial elongation. Based on this hypothesis, researchers recently investigated a novel therapy for myopia progression in children called diffusion optics technology (DOT) spectacle lenses, which are “designed to modulate retinal contrast by creating lower signal differences between adjacent cones,” according to the study authors. The authors, who have financial interest in the company and its CE-marked technology, noted in their paper that mutations in the L/M opsin gene array are responsible for the perceived high contrast in the environment and subsequent myopia development.
The 36-month Control of Myopia Using Peripheral Diffusion Lenses Efficacy and Safety Study is evaluating two investigational spectacle lenses vs. control in children aged six to 10. The primary endpoints are change from baseline axial length (AL) and spherical equivalent refraction (SER). The study is expected to conclude in late December.
A total of 256 children were enrolled (58% female, mean age at screening: 8.1 years, myopia between -0.75D and -4.50D) and given spectacles. Baseline average AL was 24.02mm, MRSE was -2.01D and cycloplegic autorefraction was -1.94D. At the 12-month interim analysis, the researchers reported the following significant mean differences in SER and AL progression vs. control for tests one and two:
- SER Test 1: -0.40D (74% reduction)
- SER Test 2: -0.32D (59% reduction)
- AL Test 1: 0.15mm
- AL Test 2: 0.10mm
The researchers concluded that the clinically and statistically significant reductions in myopia progression, as well as the low rate of adverse events, demonstrated the ability of DOT spectacle lenses to help myopic children six and older. “These findings support the hypothesis that high retinal contrast signals the eye to grow and that reducing contrast can slow axial growth and prevent myopia progression,” they wrote in their paper.
1. Rappon J, Chung C, Young G, et al. Control of myopia using diffusion optics spectacle lenses: 12-month results of a randomized controlled efficacy and safety study (CYPRESS). Br J Ophthalmol. September 1, 2022. [Epub ahead of print].