Abstract
OBJECTIVES: To evaluate the efficacy and safety of repeated low-intensity red light (RLRL) therapy in slowing myopia progression and improving accommodative function in children. METHODS: This retrospective cohort study reviewed electronic medical records of 202 myopic children aged 6-12 years treated at Ganzhou People's Hospital between October 2022 and October 2024. Participants were assigned to an RLRL group (n = 101; 650 nm, 1600 lx, 3 min, twice daily) or a control group (n = 101; single-vision spectacles only). Primary outcomes included axial length and spherical equivalent refraction. Secondary outcomes were uncorrected and best-corrected visual acuity, macular choroidal thickness, accommodative amplitude and facility, intraocular pressure (IOP), and corneal endothelial cell density (ECD). RESULTS: Baseline demographics and ocular characteristics were comparable between groups (all P > 0.05). Up to 12 months, the RLRL group exhibited significantly less axial elongation and myopic refractive progression (P < 0.05 from 6 months onward), greater improvement in uncorrected visual acuity, thicker macular choroid, and enhanced accommodative function compared to controls (all P < 0.05). No significant between-group differences were observed in IOP or corneal ECD (both P > 0.05). CONCLUSION: RLRL therapy significantly slowed myopia progression and improved visual and accommodative function in children over 12 months, with no major safety concerns. These findings support RLRL as a promising, safe intervention for pediatric myopia control.