AAO Recap #3 - New research presented in Boston

The recent American Academy of Optometry (AAO) 2025 meeting in Boston, USA showcased an impressive range of new research advancing our understanding of myopia development, risk factors, and management strategies. From short-term physiological responses to innovative lens designs, to large-scale data on treatment efficacy and population trends, these studies reflected the depth and diversity of current global efforts in tackling childhood myopia. This article is the final instalment of a three-part series bringing together lecture and research presentations, along with a summary of Myopia Profile's contribution at AAO. Here, we look at some key research on myopia that were displayed during the poster sessions (pictured above). 

Authors: Alfredo Desiato (pictured)¹, Reena R. Anand¹, Inderjit Chahal¹, Nicola S. Logan¹, Amy L. Sheppard¹, James S. Wolffsohn¹, Deborah Laughton², Leon N. Davies¹

1. Optometry & Vision Science Research Group, School of Optometry, Aston University, Birmingham, UK
2. SightGlass Vision, San Jose, USA

This study investigated short-term changes in subfoveal choroidal thickness (SFCT) in myopic children (n = 38) aged 6–12 years after one week of wearing Diffusion Optics Technology™ (DOT), Defocus Incorporated Multiple Segments (DIMS), and single vision (SV) spectacle lenses. Both DOT and DIMS lenses significantly increased SFCT (13.18 µm and 8.72 µm, respectively), while SV lenses caused negligible thinning (−1.21 µm). Lens design was the primary factor influencing SFCT changes, with no significant effects from age or myopia level, although younger moderate myopes showed a more pronounced response to DOT lenses. Clinically, these findings suggest that DOT and DIMS lenses may elicit early choroidal thickening, which could serve as an indicator of their efficacy in slowing axial elongation and myopia progression. This highlights the potential for SFCT monitoring as a biomarker in evaluating the effectiveness of myopia control interventions. 

Authors: Pallavi Cherekar (pictured)¹, Anh Bui¹, Fuensata Vera-Diaz¹

1.  New England College of Optometry, Boston, MA

This retrospective study evaluated the effectiveness of different myopia control treatments (low-dose atropine; orthokeratology; multifocal soft contact lenses; atropine combined with ortho-k; and atropine combined with multifocal soft contact lenses) in slowing axial elongation among children (n=193) aged 4 to 16 years in clinical practice. Over a 12-month period, analysis suggested that there was no statistically significant difference in axial length progression between the treatment modalities, although ortho-k tended to show less elongation compared to multifocal soft contact lenses and low-dose atropine (concentration of atropine investigated in the study was unclear). Across the whole group, axial length growth was a mean of 0.12mm in the first six months, and 0.10mm in the second six months. Younger children and those with higher baseline myopia at the initial visit experienced faster axial growth regardless of treatment type, indicating those in need of the most proactive treatment.

Authors: Ryan Webster (pictured middle)¹, Josh Richards (pictured far right)¹, Pete Kollbaum (pictured far left)¹

1. Indiana University School of Optometry

This study evaluated whether lens material or manufacturing site influences the optical performance of SightGlass Vision Diffusion Optics Technology (DOT) spectacle lenses, which use light scattering micro diffusers to reduce contrast and slow myopia progression. Using polycarbonate and Trivex materials manufactured in China and the UK, respectively, the modulation transfer functions (MTFs) of DOT lenses were compared to standard single vision lenses. Results showed that DOT lenses consistently reduced contrast by about 35 to 40% across different materials and manufacturing locations, with consistent modulation properties in the treatment zones. The central zones behaved similarly to single vision lenses. Clinically, these findings suggest that DOT lens technology is robust and can be applied across various materials and manufacturing processes or locations, without compromising its optical properties, and hence efficacy in controlling myopia progression.

Authors: Hai-Yen Thi Nguyen (pictured left)¹, Neema Ghorbani-Mojarrad¹, Matthew Cufflin¹, Edward Mallen¹

1. University of Bradford, Bradford, UK
2. Wolfson Centre for Applied Health Research, Bradford, UK

This study developed age- and gender-specific axial length (AL) growth centile curves for Vietnamese children (n=1566) aged 4-16 years old with myopia and compared it with published Chinese reference data. Vietnamese children, both male and female, demonstrated longer ALs across all percentiles compared to their Chinese counterparts, particularly at younger ages. The centile curves show similarity in low percentiles (5th, 10th, 25th) and greater difference in higher percentiles (75th, 90th, 95th) between the two populations. Myopic children showed significantly faster AL growth compared to non-myopic children (1.98mm vs 0.46mm total growth over unspecified time period), with no gender differences observed. These findings highlight that AL data from one population, such as Chinese children, may not be directly applicable to other Asian populations like Vietnam, emphasizing the need for population-specific studies and caution when using growth centile curves in clinical practice.

Authors: Leo Ren¹, Drake Ren¹, Yi Pang ²

1. Whitney M. Young Magnet High School
2. Illinois College of Optometry

This study analysed medical records from 51,880 myopic children aged 3–18 years at the Illinois Eye Institute in Chicago to investigate changes in myopia magnitude from 2014 to 2024 amid shifts in children’s visual environments particularly after the COVID-19 pandemic. The average myopia magnitude increased significantly over the 11-year period, rising from -2.41 D in 2014 to -3.02 D in 2024 (-0.07 D/year). Preschoolers, elementary, and middle schoolers showed the largest increases in myopia magnitude (30–40%, or around -0.75D more myopia), while high schoolers experienced a smaller increase (10.5%, or around -0.30D). The findings highlight a trend of worsening myopia in younger age groups, which could be influenced by changes in visual environments and screen time. These results emphasize the need for early intervention and routine guidance on healthy visual habits as a key part of every myopia consultation.

Authors: Drake Ren (pictured left)¹, Leo Ren (pictured right)¹, Yi Pang ²

1. Whitney M. Young Magnet High School
2. Illinois College of Optometry

This retrospective study analysed medical records from 126,061 consultations from children aged 3 to 18 years attending a primary eyecare clinic Illinois Eye Centre between 2014 and 2024 to identify risk factors for myopia. Overall myopia prevalence increased from 37.6% in 2014 to 44.2% in 2024, with higher rates observed in females, Asian children, and older age groups. The  largest increase in myopia prevalence was observed in Black children (45.0%). Prevalence also rose across all age groups, particularly among children aged 3–11 years. Clinically, these findings highlight the growing burden of myopia and the importance of early intervention, particularly for high-risk groups such as younger children, females, and Asian populations.

Authors: Alex Nixon (pictured above)¹, Jie Xu¹, Augustine Nei¹, Xu Cheng¹

1. Johnson & Johnson MedTech, Jacksonville, USA

This study investigated how pupil size affects low-contrast (black-and-white desaturated), photopic (bright light) visual acuity in children wearing a novel non-coaxial focus (EE) soft contact lens designed for myopia control. Myopic children (n=99) with mean age of 10.3 years were randomized to wear either EE or single vision (SV) contact lenses over 12 weeks. Mean pupil diameter was around 6mm. At the 3-month follow-up, the mean binocular logMAR distance acuity in low contrast conditions was 0.16 (around 6/9⁺² or 20/32⁺²) for the EE lens group and 0.07 (slightly better than 6/7.5 or 20/25) for the SV lens group. While larger pupil size overall did have an effect on acuity, the interaction between pupil size and lens type was not significant, meaning that this effect was consistent across both lens types. These findings indicate that the EE lens maintained good visual performance not too far different to standard single vision lenses, suggesting it balances myopia control efficacy with acceptable visual quality.