The efficacy of diffusion optics technology spectacle lenses in slowing myopia progression: a 2-year retrospective real-world study

Purpose The aim of the study was to evaluate the 2-year real-world effectiveness of diffusion optics technology (DOT) spectacle lenses for pediatric myopia control in Chinese clinical practice. Methods This retrospective real-world comparative study analyzed patient records from children prescribed DOT or single-vision (SV) spectacle lenses. Sequential 1:1 propensity score matching (PSM) was performed for the year-1 and year-2 analyses, respectively: The first PSM matched baseline characteristics of the two groups; the second PSM re-matched the DOT group's year-1 characteristics against the SV group's baseline characteristics. Primary outcomes were changes in cycloplegic spherical equivalent (SE) and axial length (AL). Efficacy was quantified as between-group differences and retardation ratios, with subgroup analyses by age and myopia severity. Results A total of 420 subjects with DOT and 973 with SV spectacles were included. Both matching procedures achieved excellent covariate balance (all standardized mean differences <0.10). Significantly slower progression was seen in the DOT group at both year 1 (SE: DOT −0.14 ± 0.46 D, SV −0.76 ± 0.55 D, P < 0.001; AL: DOT 0.05 ± 0.22 mm, SV 0.38 ± 0.22 mm, P < 0.001) and year 2 (SE: DOT −0.24 ± 0.53 D, SV −0.73 ± 0.53 D, P < 0.001; AL: DOT 0.17 ± 0.16 mm, SV 0.34 ± 0.21 mm, P < 0.001). The retardation ratio was 81.5% for SE and 86.0% for AL at year 1, and 68.0% for SE and 49.7% for AL at year 2. Younger children and those with lower baseline myopia derived greater benefit from DOT lenses. Conclusions DOT spectacle lenses provided significant and clinically meaningful myopia control over 2 years in a clinical setting. Although the efficacy diminished in the second year, the treatment effect remained clinically significant, although residual confounding and responder selection inherent to the retrospective real-world design likely inflated the observed efficacy.