Association between contrast sensitivity and myopia control efficacy

This study compared central visual quality in myopic children wearing spectacles with highly aspherical lenslets (HAL) versus traditional single-vision spectacle lenses (SV) and examined the association between contrast sensitivity and myopia control efficacy. Myopic children aged 8 to 15 years were enrolled. All participants had worn either HAL or SV spectacles for at least six months and were classified into HAL and SV groups. Central visual quality was assessed using the quick contrast sensitivity function (qCSF) with both HAL and SV test lenses in randomized order. Axial length was measured at the qCSF visit and again after six months. Seventy participants completed all examinations, with 31 in the SV group and 39 in the HAL group. A significant main effect of test lenses was found, with HAL test lenses yielding lower contrast sensitivity than SV test lenses ( p = 0.002). A significant main effect of group was also observed ( p = 0.01), with the HAL group showing lower contrast sensitivity than the SV group (mean difference: 0.10). This difference in central visual quality was consistent regardless of the test lens used (interaction effect p = 0.67). Contrast sensitivity was positively associated with axial elongation in the HAL group ( p < 0.05) but not in the SV group. Satisfactory myopia control was defined as axial length progression of less than 0.055 mm over 6 months. A model with contrast sensitivity alone showed modest discriminative ability for myopia control (AUC = 0.63, p < 0.05). Adding covariates increased the AUC, but the improvement was not statistically significant ( p = 0.08). In this exploratory subgroup analysis, lower post-wear contrast sensitivity was associated with slower axial elongation among HAL wearers, but prospective baseline validation is needed before clinical prediction can be established.