IMI 2023 Digest
Myopia research is rapidly advancing, led by the International Myopia Institute (IMI), which published key papers in 2019 and updated evidence in 2021. Recent findings from animal studies reveal how light wavelength and intensity impact eye growth, along with exploring new pharmacological and scleral cross-linking methods for myopia control. The concept of "premyopia" necessitates early intervention in children. Clinical trials confirm the effectiveness of various myopia control approaches, including innovative spectacle lens designs, soft multifocal contact lenses, orthokeratology, and topical atropine. Lower atropine concentrations and optical interventions mitigate rebound effects, with minimal impact on visual function. Extended use and combination therapies yield the best results. Light-based therapies, such as low-level red light from desk devices, show promise but need more safety data. Ethical dilemmas arise regarding control arms in clinical trials due to the success of myopia control strategies. Clear definitions and classifications for high and pathologic myopia are essential. Animal studies shed light on the role of visual feedback and growth pathways. In summary, myopia control treatments offer substantial benefits, outweighing the risks. Future trials should inform clinical practice, uncover mechanisms of action, and emphasize unbiased trial design and collaboration among researchers, industry, clinicians, and regulators.