Myopic Control Using Defocus-Incorporated Multiple Segments Spectacle Lenses Plus Low-Concentration Atropine in Patients With Fast Myopia Progression: A Retrospective Cohort Study

Purpose The aim of this study is to evaluate the myopic control effect between defocus-incorporated multiple segments (DIMS) spectacle lenses plus 0.01% atropine (ATR), and 0.125% ATR, for patients with fast myopia progression. Methods A retrospective cohort study was conducted, and patients who had experienced myopic progression of more than -1.00 diopter (D) within a one-year period were enrolled. Then, the patients were divided according to the management they received. A total of 53 and 46 eyes were assigned to the ATR and DIMS groups, respectively. The primary outcomes were the progression of spherical equivalent refraction (SER) and axial length (AXL). The independent t-test and generalized linear model were used for statistical analysis. Results After the one-year follow-up period, the progression of SER was significantly greater in the ATR group (0.31 ± 0.11 D) than in the DIMS group (0.10 ± 0.07 D) (p < 0.001). On the other hand, the elongation of AXL was significantly larger in the ATR group (0.12 ± 0.06 mm) than in the DIMS group (0.03 ± 0.02 mm) (p < 0.001) at the final visit. In addition, the ATR group with low- or moderate-baseline myopia revealed more significant SER and AXL progression than the DIMS group (all p < 0.001). A young age at onset was correlated with greater SER and AXL progression in the ATR group (both p < 0.05). Still, no pre-treatment parameter was associated with increased SER or AXL progression in the DIMS group (all p > 0.05). Conclusions DIMS spectacle lenses plus 0.01% ATR management showed greater efficacy for SER and AXL control than 0.125% ATR management in the fast myopia progression population.