SYSTEMATIC REVIEW article
Front. Med.
Sec. Ophthalmology
This article is part of the Research TopicThe Role of Light in MyopiaView all 5 articles
Effects of Repeated Low‑Level Red Light on Refractive Development During Childhood: A Systematic Review and Dose-Response Meta-Analysis Up to 12 Months
Provisionally accepted
- 1Department of Ophthalmology, the First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
- 2Department of Ophthalmology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- 3Eye Institute of Shandong First Medical University, Qingdao, China
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Objective: To systematically evaluate the effects of Repeated Low-Level Red Light (RLRL) intervention on refractive development in children over 12 months. Methods: A systematic search of PubMed, Embase, Web of Science, and Cochrane CENTRAL (inception to August 2024) identified randomized controlled trials (RCTs) comparing RLRL with non-phototherapeutic interventions in children. Independent data extraction and quality assessment were performed. Dose-response meta-analyses using random-effects models evaluated effects on anterior corneal curvature, axial length (AL), and spherical equivalent refraction (SER) at 1, 3, 6, and 12 months. Results: Twelve RCTs were included. For corneal curvature, evidence of flattening effects was inconclusive (SMD = -0.01, 95%CI -0.19 to 0.12; I² = 0%, P = 0.76). RLRL significantly reduced AL progression compared to controls at 1, 3, 6, and 12 months (SMD = 0.27, 0.06, 0.14, 0.19; 95%CI 0.20-0.33, 0.05-0.08, 0.11-0.17, 0.16-0.23; I² = 91%, 75%, 85%, 85%; all P < 0.01). Similarly, RLRL reduced SER progression at all timepoints (SMD = 0.62, 0.03, 0.18, 0.32; 95%CI 0.46-0.77, -0.03 to 0.08, 0.12-0.24, 0.24-0.40; I² = 91%, 75%, 85%, 85%; P = 0.05 at 6 months, P < 0.01 for others). Dose-response analysis revealed declining efficacy after 3 months. Regarding safety, all 12 RCTs explicitly reported adverse event monitoring with no treatment-related adverse events and zero safety-related withdrawals. Conclusions: RLRL treatment demonstrated non-linear efficacy in suppressing axial elongation and mitigating myopic progression, with peak effects observed within the first 3 months followed by declining efficacy. Evidence for corneal curvature flattening remains inconclusive. The favorable short-term safety profile supports RLRL as a promising myopia control intervention, though optimal dosing strategies and long-term outcomes warrant further investigation. PROSPERO registration: CRD42024575823.
Keywords: Repeated low-level red light, refractive development, Myopia, corneal curvature radius, Axial length, Spherical equivalent refractive error
Received: 01 Jul 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 Ren, Chu, Qiu and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Lin Liu, 15800285816@163.com
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