Highlights from Johnson & Johnson MedTech at ARVO 2025

The Association for Research in Vision and Ophthalmology (ARVO) 2025 meeting was held in Salt Lake City, USA from May 4-8 and hosted thousands of experts in optometry and ophthalmology to share the latest findings in ocular science. The RingBoost™ soft contact lenses are an innovative addition to the suite of available myopia management options and offer a novel approach to slowing myopia progression. Soft contact lenses are a valuable option for pediatric patients as they offer numerous benefits including improved self-perception and enhanced self-esteem in young wearers.¹  

As the prevalence of myopia continues to rise globally,²  the demand for effective, evidence-based interventions and management has never been greater—nor has the importance of clear, effective clinician-to-patient communication. This article reviews the latest research from Johnson & Johnson MedTech presented at this year’s ARVO meeting. 

The RingBoost™ soft contact lens is a novel optical design specifically engineered to control myopia progression while maintaining good visual performance. Unlike traditional dual-focus or concentric ring designs, RingBoost™ Technology uses non-coaxial ring focus zones that deliver +7 D plus power with a “boost” in the center, a +10 D coaxial zone. This approach allows the lens to incorporate higher-powered myopia control zones into the lens design while limiting the impact on vision performance.³  The uniqueness of this design lies in how the treatment zones focus light around the visual axis, which enables it to deliver the signal to slow myopia progression while limiting the impact on vision quality.

Authors: Xu Cheng¹, Jie Xu¹, Alex Nixon¹, Noel A. Brennan¹, Weizhong Lan²˒³

1. Johnson & Johnson Vision, Jacksonville, Florida, United States
2. Aier Eye Hospital in the Hainan Boao Lecheng International Medical Tourism Pilot Zone, China
3. Aier Academy of Ophthalmology, Central South University, China

A 12-month real-world study involving 70 Chinese children aged 7–12 years found that the enhanced efficacy (EE) RingBoost™ soft contact lens for myopia management was safe, well-tolerated, and effective. No serious adverse events occurred, and all participants who completed the 12-month follow-up visit met lens wear requirements with high compliance. Myopia progression at 12 months was substantially lower than expected in the treated children with a mean axial length increase of 0.09 mm and refractive progression of -0.24 D, significantly less than the expected progression of +0.39 mm and -0.80 D in untreated Asian children aged 10.3 years old (age-matched to the mean age of the study participants).^4,5  Participants also had good visual acuity with the contact lenses, with 95.3% achieving binocular distance VA of 0.00 logMAR (20/20 or 6/6) or better at 12 months. At six months, average wear time reached 12.8 hours per day over 6.5 days per week, and 98.5% of participants met the recommended minimum of 8 hours per day and 5 days per week—reinforcing the lens’s practicality and wearability in real-world pediatric settings.

Purpose: Safety and performance of a soft contact lens for myopia control (EE, Cheng et al. Ophthalmol Sci. 2022 Oct 18;3(1):1002323 ) are being evaluated in Chinese children at the Aier Eye Hospital in the Boao Lecheng International Medical Tourism Pilot Zone (Hainan, China). Here we report outcomes of this real-world study after participants completed 12 months of lens wear.

Methods: This is a single-site, prospective, single-arm, open-label, real-world evidence study with a minimum of 1-year study duration. Eligible participants were followed post lens fit at 1 week and 1, 3, 6, and 12 months for evaluating potential adverse events (AEs), vision performance, lens fit, and lens wear compliance. Further, myopia progression was evaluated every 6 months via measuring changes in spherical equivalent cycloplegic autorefraction (SECAR by Topcon KR-1) and axial length (AL by IOLMaster 700).

Results: A total of 70 participants aged 7–12 years with a mean (SD) baseline myopia of -2.21 (0.97) D were fitted with the EE lens, of which 64 completed the 12-month follow-up. No participants were discontinued due to unacceptable lens vision, comfort, fit, or AEs. No serious or significant AEs occurred to date. At 12 months, mean (SD) changes from baseline in AL and SECAR were 0.09 (0.18) mm and -0.24 (0.41) D, respectively. Monocular distance visual acuity (VA) with the EE lens was 0.00 (0.05) and -0.01 (0.06) logMAR at initial lens fitting and 12 months, respectively—neither was significantly different from baseline best-sphere corrected VA (-0.01 [0.05] logMAR). Binocular distance VA at 12 months was 0.00 logMAR or better in 95.3% of participants. The mean (SD) lens wear time reported at 12 months was 13.5 (1.8) hours/day and 6.7 (0.6) days/week. All 64 participants met or exceeded the lens wear time requirements.

Conclusions: The 12-month outcomes of the real-world study demonstrated excellent safety, vision, and fit performance of the EE lens. Minimal axial elongation and myopia progression were observed within the 12 months of treatment (compared to an expected 0.39 mm / 0.80 D progression in untreated, 10.3-year-old Asian children).^4,5 Safety and performance of the EE lens in slowing myopia progression in this cohort of Chinese children will continue to be evaluated for another year.

Authors: Noel A. Brennan¹, Xu Cheng¹, Monica Jong¹, Alex Nixon¹, Mark A. Bullimore²

1. Johnson & Johnson MedTech, New Brunswick, New Jersey, United States
2. Optometry, University of Houston, Houston, Texas, United States

This analysis estimated the proportion of children treated for myopia progression who still exhibit axial elongation greater than the mean progression in an untreated control group. Using data from 32 treated cohorts and accounting for age-adjusted pooled variance, the model predicted that even with treatments demonstrating 0.10 mm, 0.15 mm, 0.20 mm, and 0.25 mm axial elongation efficacy over one year, 26%, 17%, 11%, and 7% of children respectively would exceed the control mean. This suggests that progression above the control average is likely due to the natural variability in progression rates among children.

Purpose: A reasonable goal of any myopia control intervention is that it reduces axial elongation to less than the average elongation in a control group. Here, we estimate the proportion of children undergoing treatments of varying efficacy for myopia control that demonstrate greater axial elongation than the mean value observed for age-matched controls.

Methods: To determine an appropriate age-adjustment to pooled variance data, three papers providing individual control and treatment group 1-year progression data by age were used. Data from relevant graphs were digitized as necessary. Prediction intervals for the treated groups across age were considered as a proportion of overall pooled variance. To estimate the proportion of subjects in treated groups whose axial elongation exceeded the mean elongation of the control group, studies of myopia control interventions with statistically adjusted 1-year efficacy values and measures of variance for progression in the treated group were selected from our databank of controlled clinical trials. Conversions to standard deviations were made as appropriate and these were age-adjusted. A normal distribution of progression and equal efficacy across the age range was assumed. An unweighted logit function was used to linearly model the data.

Results: To appropriately adjust for age, pooled standard deviations were reduced by 8.2%. From the databank, 32 cohorts of treated subjects satisfied our inclusion criteria. Standard deviations (median 0.17 mm, IQR 0.16–0.20) were remarkably consistent in treated groups after 1 year, despite widely varying progression. The model (r = 0.99) predicts that 26%, 17%, 11% and 7% of treated individuals exhibit greater elongation than the mean of the control group for treatments with 0.10, 0.15, 0.20 and 0.25 mm 1-year efficacy, respectively.

Conclusions: This analysis provides estimates for clinicians of the proportion of treated individuals that exhibit undesirable axial elongation for a given treatment efficacy. The likely source of greater elongation than the mean of the control group is the absolute nature of myopia control efficacy and the large variance in underlying myopia progression rates of children rather than unresponsiveness to treatment.

Authors: Mark A. Bullimore¹, Xu Cheng², Monica Jong², Alex Nixon², Noel A. Brennan²

1. College of Optometry, University of Houston, Houston, Texas, United States
2. Johnson & Johnson MedTech, Jacksonville, Florida, United States

Axial length centile growth curves developed in context of the rising prevalence of myopia have not yet been evaluated in detail with regards to how well they represent emmetropic and myopic eye growth. A literature review identified 6 published centile growth charts and compared them with modelled trajectories for emmetropic and myopic eyes using a representative set of baseline axial lengths. While centile curves reflected emmetropic growth at lower percentiles, they underestimated axial elongation in myopic eyes - even at higher percentiles.

Purpose: In 1952, Hirsch published a table of refractive error percentiles by sex and age for children. More recently, interest in the rising prevalence of myopia has prompted researchers to revisit centile curves and several axial length growth curves have been developed. Here, we assess whether axial length centile growth curves accurately represent emmetropic and myopic growth, and consider the suitability of their application for assessing the impact of myopia control therapy.

Methods: In order to identify published axial length centile growth curves, PubMed was searched using the following terms: (myopi* OR refract*) AND (percentile OR centile OR growth) AND axial AND (curve OR chart). For comparison, axial length values for a representative selection of baseline values (21 to 24 mm at 6 years) were calculated as a function of age and race using published myopic⁵  and emmetropic⁶  models. The relevant axial length values from the functions were superimposed on each set of centile growth curves for comparison.

Results: Six published percentile growth curves were identified: three for European children, two for Chinese children and one for Indian children. A representative set of percentile curves are shown in the Figure (for European boys redrawn from Truckenbrod et al.⁷ ). As might be expected, at lower percentiles (shorter axial lengths and predominantly non-myopic eyes), the trajectory of the centile growth curves is generally similar to that for the emmetropic eye model. In contrast, trajectory of the centile growth curves is flatter than that for the myopic eye model, even at higher percentiles. Only in centile growth curves for Chinese children with a higher prevalence of myopia did the curves reflect myopic eye growth, and then only for older children and at higher percentiles.

Conclusions: Centile growth curves underestimate the average rate of axial elongation in myopic children, probably due to conflation of myopes and emmetropes, even at higher percentiles. Consequently, centile growth curves will underestimate the benefits of myopia control treatment, potentially contributing to mismanagement. Treatment efficacy should be based on comparison with published models of myopic eye growth.

Authors: Monica Jong¹˒², Michelle Waugh¹, Pinar Ozmizrak¹, Ian Flitcroft³˒⁴

1. Johnson & Johnson Vision, Jacksonville, Florida, United States
2. Optometry and Vision Science, University of New South Wales Medicine & Health, Sydney, NSW, Australia
3. Technological University Dublin, Dublin, Ireland
4. Children's University Hospital, University College Dublin, Dublin, Ireland

This cross-sectional study assessed the readability of freely available online patient education materials for myopia management treatments and products with regulatory approval. The top 10 Google search results were reviewed across five treatment categories and eight product names, totalling 120 websites. Readability was evaluated using five standard indices (FRES, FKGL, GFI, SMOG, CLI) and scored against the Journal of the American Medical Association (JAMA) benchmarks. None of the websites met the recommended sixth-grade reading level across all indices, and only 13 websites met at least one readability index, 10 being product-related. Most websites also failed to meet multiple JAMA benchmarks. Statistical analysis showed only weak associations between search ranking and readability or benchmark adherence. These findings highlight the poor readability of online myopia management content available to patients and families.

Objectives: Patients are turning to the internet to access educational materials to help them make healthcare decisions, making readability an important factor. This cross-sectional study assessed readability of online patient education materials for myopia management treatments that have regulatory approval.

Methods: The top 10 Google search results from May 2024 for freely available online patient information on myopia management modalities and regulatory-approved products in Canada and Australia were analyzed for readability. The modalities included: orthokeratology, myopia control spectacle lenses, myopia control soft contact lenses, atropine, and repeated low-level red-light therapy. The products included MiyoSmart [by Hoya] (spectacles), Stellest® [by Essilor®] (spectacles), MyoCare® [by Zeiss] (spectacles), MiSight® 1 day [by CooperVision®] (soft contact lenses), ACUVUE® Abiliti® 1-Day [by Johnson & Johnson] (soft contact lenses), NaturalVue® (soft contact lenses), ACUVUE® Abiliti® Overnight [by Johnson & Johnson] (orthokeratology), and Eikance (atropine). These searches gave 120 results. Readability was assessed with Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Gunning Fog Index (GFI), Simple Measure of Gobbledygook Index (SMOG), and Coleman-Liau Index (CLI). Additionally, websites were scored on Journal of American Medical Association (JAMA) benchmark criteria. Statistical analysis was performed with two-tailed tests.

Results: Of 120 websites, none met the recommended sixth-grade reading level across all readability indices. There were 13 websites meeting at least one readability index, 10 being product-related. There were 7 websites satisfying all four JAMA benchmarks, while the majority met one. There was a weak positive relationship between product search rank and readability (SMOG p=0.016, GFI p=0.021) and a weak negative relationship between JAMA benchmarks and readability for both modality (CLI p=0.045) and product (CLI p=0.049).

Conclusions: Online information about myopia management is generally written above the recommended sixth-grade reading level and does not meet all JAMA benchmarks. Websites that appear as top search results do not necessarily have easier readability. The readability of online patient education materials may influence access to treatment and outcomes.          

The Johnson & Johnson MedTech research presented at ARVO 2025 highlights the growing sophistication of evidence in myopia management. From new clinical data on RingBoost™ lenses to critical analyses of treatment benchmarking and patient communication, these findings equip us with deeper insights to support effective, personalised care. Key messages include: 

• RingBoost™ Soft Contact Lenses showed strong safety, excellent visual performance, and effective myopia control in a 12-month real-world study of Chinese children. It also offers good visual performance, with 95.3% achieving binocular visual acuity of 0.00 logMAR (20/20 or 6/6) or better.
• Modelling shows that some children may still progress more than average, even with effective treatment—highlighting the importance of setting expectations. 
• Centile growth curves may underestimate axial elongation in myopic eyes; validated eye growth models offer a more accurate way to track progression and treatment outcomes.

Alongside these outcomes, effective clinician-to-patient communication remains essential: verifying understanding, addressing misconceptions, and reinforcing key messages supports informed decision-making and encourages long-term adherence. As the prevalence of myopia continues to grow, so does the opportunity to make a meaningful difference in children's lives through evidence-based treatment and effective patient engagement.