Single-vision spectacle use and myopia progression in children with low myopia, a propensity score matching study

PURPOSE: To investigate the impact of single-vision spectacle use on myopia progression in children with low myopia. METHODS: MYOSOTIS is a prospective myopia screening survey including all 46 primary and junior high schools in two districts of Hangzhou, China. After 1-to-1 propensity score matching (PSM), 1,685 pairs of students with low myopia were included. Group 1 was composed of 1,685 non-spectacle users at baseline, and group 2 consisted of 1,685 spectacle wearers at both survey rounds. Refraction was examined by noncycloplegic autorefraction and mean spherical equivalent refraction (SER) of both eyes was analyzed. Myopia progression was measured by average rate of change in SER (r∆SER) between two survey rounds and compared between the two groups. RESULTS: After PSM, no significant difference in age, sex ratio, SER, and uncorrected visual acuity (VA) between the two groups was found at baseline. For myopic progression, r∆SER showed no significant difference between the two groups (− 0.67 ± 0.97 versus − 0.69 ± 0.81 diopter/year, P = 0.448). After adjusting for age, sex, SER, and VA, the difference in r∆SER between the two groups was not significant (− 0.031, 95% CI − 0.089 ~ 0.028 diopter/year, P = 0.302). In the subgroup analyses stratified by age and SER, and in the sensitivity analyses by eye side, there was still no significant difference in myopia progression between the two groups. CONCLUSIONS: Our study indicates that single-vision spectacle use has no impact on myopia progression in children with low myopia. Spectacles are recommended in children with low myopia if their visual acuity has interfered with the daily life. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00417-021-05423-6.