ABSTRACT
PURPOSE: To evaluate the long-term efficacy and safety of repeated low-intensity red light (RLRL) treatment for childhood myopia. DESIGN: Systematic review and meta-analysis METHODS: We searched PubMed, Web of Science, CNKI, and Wanfang from inception to February 8, 2023. We used the RoB 2.0 and ROBINS-I tools to assess the risk of bias and then used a random-effect model to calculate the weighted mean difference (WMD) and 95% CIs. The primary outcomes were WMD in spherical equivalent refractive error (SER), WMD in axial length (AL), and WMD in subfoveal choroid thickness (SFChT). Subgroup analyses were performed to investigate the sources of heterogeneity based on variation in follow-up and study design. The Egger and Begg tests were used to assess publication bias. Sensitivity analysis was used to verify the stability. RESULTS: This analysis included 13 studies (8 randomized controlled trials, 3 non-randomized controlled trials, and 2 cohort studies) involving 1857 children and adolescents. Eight studies met the meta-analysis criteria, and the WMD for myopia progression between RLRL and the control group was 0.68 diopters (D) per 6 months (95% CI = 0.38 to 0.97 D; I2 = 97.7%; P < .001) for SER change; -0.35 mm per 6 months (95% CI = -0.51 to -0.19 mm; I2 = 98.0%; P < .001) for AL elongation; and 36.04 µm per 6 months (95% CI = 19.61 to 52.48 µm; I2 = 89.6%; P < .001) for SFChT change. CONCLUSIONS: Our meta-analysis shows that RLRL therapy may be effective for delaying the progression of myopia. The evidence is low certainty, and larger and better randomized clinical trials with 2-year follow-ups are needed to improve the existing state of knowledge to inform medical guidelines more comprehensively.
Subject(s)
Myopia , Child , Adolescent , Humans , Myopia/therapy , Choroid , PhototherapyABSTRACT
BACKGROUND: There has been minimal research on the role of benevolent childhood experiences (BCEs) and how such events may offer protection from the insidious effects of adverse childhood experiences (ACEs) or later in life. OBJECTIVES: This research aims to learn how BCEs and ACEs interact to affect adolescents' psychological distress. METHODS: Cross-sectional survey was conducted in three cities (Xuzhou, Nanjing, and Wuhan) in China from March 2021 to May 2021. Latent class analysis (LCA) was used to classify the patterns of ACEs and BCEs. We adopted hierarchical multivariable regression to examine the influences of ACEs and BCEs on depression and suicidal ideation. RESULTS: To explore the relationship between childhood experience and suicidal ideation and depression, LCA revealed three patterns of ACEs: (1) emotional abuse (10.57%); (2) high ACEs (0.55%); and (3) low ACEs classes (88.88%). Adolescents with emotional abuse (depression: OR = 3.82, 95%CI = 2.80-5.22, P < 0.001; suicidal ideation: OR = 5.766, 95%CI = 3.97-8.38, P < 0.001) and high ACEs class (suicidal ideation: OR = 5.93, 95%CI = 1.19-29.66, P < 0.05) had an increased risk of psychological distress (reference: low ACEs). LCA revealed four patterns of BCEs: (1) relationship support (14.54%); (2) low BCEs (4.85%); (3) high BCEs (55.34%); and (4) high quality of life classes (25.28%). Adolescents with a high quality of life (depression: OR = 0.09, 95%CI = 0.05-0.16, P < 0.001; suicidal ideation: OR = 0.22, 95%CI = 0.12-0.40, P < 0.001) and high BCEs (depression: OR = 0.05, 95%CI = 0.03-0.09, P < 0.001; suicidal ideation: OR = 0.15, 95%CI = 0.09-0.26, P < 0.001) protected the mental health of adolescents (reference: low BCEs). CONCLUSIONS: High ACEs and emotional abuse classes were significantly associated with poorer mental health symptoms, including suicidal ideation and depression. In contrast, high BCEs and high quality of life classes were associated with better mental health. These findings point out that it is more necessary to identify and support victims of ACEs, and it is urgent to increase BCEs in early childhood.
