Comparative Effectiveness of Feasible Myopia Control Interventions for Children in Indonesia
A Systematic Review and Network Meta-Analysis
DOI:
https://doi.org/10.32734/scripta.v7i1.21206Keywords:
Axial length, control interventions, efficacy, myopia progression, network meta-analysisAbstract
Background: : Myopia in children is a growing public health concern in Indonesia, leading to long-term visual impairment and economic burden. Early intervention is crucial, yet no study has comprehensively compared axial length (AL) changes among feasible interventions for Indonesian children. Objectives: This study aims to evaluate and compare the efficacy of feasible myopia control strategies for children in Indonesia using a systematic review and network meta-analysis (NMA), focusing on AL changes. Methods: Following the PRISMA-NMA guideline, systematic searches up to 8 April 2025 were carried out in four online databases, including Europe PMC, PubMed, Sage Journals, and Wiley. Randomized studies measuring the AL of different myopia control interventions to placebo or each other were included. A total of 1266 titles and abstracts were screened, and 18 studies were included in the analysis. A Bayesian NMA was conducted using the “gemtc” package in RStudio, with mean difference (MD) and 95% credible interval (CrI) as summary measures. Results: Eighteen randomized studies involving 2145 children were included. The combination of low-dose atropine 0.01% and orthokeratology (ACO) showed the most effective reduction in axial elongation (SUCRA: 0.078). SVS alone ranked lowest in effectiveness (SUCRA: 0.9986). ACO consistently outperformed monotherapies and control interventions in slowing myopia progression. Conclusion: ACO is the most effective intervention for controlling myopia progression in children and holds promising applicability in Indonesia. These findings support its recommendation in clinical and public health settings, though further research involving Indonesian populations and safety outcomes is warranted.
Keyword: Axial length, control interventions, efficacy, myopia progression, network meta-analysis
Latar Belakang: Miopia pada anak-anak merupakan masalah kesehatan masyarakat yang terus berkembang dan semakin mengkhawatirkan di Indonesia, karena menyebabkan gangguan penglihatan jangka panjang dan beban ekonomi bagi penderitanya. Intervensi dini menjadi sangat penting, namun belum ada penelitian yang secara komprehensif membandingkan perubahan axial length (AL) di antara intervensi yang layak digunakan oleh anak-anak di Indonesia. Tujuan: Penelitian ini bertujuan untuk mengevaluasi dan membandingkan efektivitas strategi pengendalian miopia yang layak untuk anak-anak di Indonesia menggunakan tinjauan sistematis dan network meta-analysis (NMA), dengan fokus utama pada perubahan AL. Metode: Mengikuti pedoman PRISMA-NMA, pencarian sistematis hingga 8 April 2025 dilakukan di empat basis data daring, termasuk Europe PMC, PubMed, Sage Journals, dan Wiley. Penelitian acak yang mengukur AL dari berbagai intervensi pengendalian miopia terhadap plasebo atau satu sama lain disertakan. Sebanyak 1266 judul dan abstrak disaring, dan 18 penelitian disertakan dalam analisis. NMA Bayesian dilakukan menggunakan paket "gemtc" di RStudio, dengan mean difference (MD) dan 95% credible interval (CrI) sebagai ukuran ringkasan. Hasil: Delapan belas studi acak yang melibatkan 2145 anak-anak disertakan. Kombinasi atropin dosis rendah 0,01% dan orthokeratology (ACO) menunjukkan pengurangan paling efektif dalam pemanjangan aksial (SUCRA: 0,078). SVS sendiri memiliki peringkat terendah dalam efektivitas (SUCRA: 0,9986). ACO secara konsisten mengungguli monoterapi dan intervensi kontrol dalam memperlambat perkembangan miopia. Kesimpulan: ACO adalah intervensi paling efektif untuk mengendalikan perkembangan miopia pada anak-anak dan memiliki peranan yang menjanjikan di Indonesia. Temuan ini mendukung rekomendasinya dalam pengaturan klinis dan kesehatan masyarakat, meskipun penelitian lebih lanjut yang melibatkan populasi Indonesia dan hasil keamanan diperlukan.
Kata Kunci: hiperplasia prostat jinak, LUTS, tamsulosin, tadalafil, terapi kombinasi Axial length, control interventions, efficacy, myopia progression, network meta-analysis
Downloads
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Sabrina Brigitta Valerie Setiono, Richella Miranda Wynne Setiono
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with SCRIPTA SCORE Scientific Medical Journal agree to the following terms:
- Authors retain copyright and grant SCRIPTA SCORE Scientific Medical Journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial License that allows others to remix, adapt, build upon the work non-commercially with an acknowledgment of the work’s authorship and initial publication in SCRIPTA SCORE Scientific Medical Journal.
- Authors are permitted to copy and redistribute the journal's published version of the work non-commercially (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in SCRIPTA SCORE Scientific Medical Journal.
