The Effect of Repeated Low-Level Red Light (RLRL) Therapy on Myopia Outcomes in Children Aged 6 - 14: A Systematic Review

Abstract Introduction: Myopia, or nearsightedness, is a significant public health concern, affecting billions worldwide. In particular, school-aged children demonstrate alarming increases in myopia rates. Despite various interventions including atropine eye drops, orthokeratology, and single vision spectacles (SVS), no intervention has fully stopped or prevent myopia progression in children. Repeated Low-Level Red-Light (RLRL) therapy, exposing eyes to red light, offers a potential intervention to control myopia in children. Objective: This protocol outlines our approach to evaluate RLRL therapy's effectiveness in myopia control in children age 6 – 14 years by comparing RLRL with SVS to SVS alone. The effectiveness will be measured by the mean difference in Spherical Equivalent Refraction (SER) and axial length (AL). Methods and Analysis: Our systematic review will adhere to the PRISMA guidelines. We will search MEDLINE, Embase, Web of Science, Scopus, China National Knowledge Infrastructure, and Wanfang Data Knowledge Service Platform, and various trial registries to identify potentially relevant articles. Articles will be screened according to a pre-defined criterion, and relevant articles will be evaluated using the Cochrane Risk of Bias Tool 2 (RoB 2) criteria. If possible, a meta-analysis and/or subgroup analyses will be performed. Implications: Findings from this review will contribute to evidence-based strategies for myopia control, potentially benefiting millions of children worldwide. Dissemination plans include publication in a peer-reviewed journal and presentation at relevant seminars and conferences.