Description

Pathological myopia (PM) is a major cause of irreversible visual impairment and blindness in adults, characterized by progressive axial elongation, choroidal thinning, impaired choroidal microcirculation, and subsequent retinal atrophy, which currently lacks effective therapeutic interventions. Against this clinical backdrop, this prospective randomized controlled trial is designed to systematically investigate the therapeutic efficacy and safety of repeated low-level red light (RLRL) therapy in adult patients with PM. The core research objectives are twofold: first, to verify whether RLRL can modulate choroidal microcirculatory function and thereby retard the progression of retinal atrophy in PM patients, and second, to comprehensively assess the safety profile of long-term RLRL administration by monitoring adverse events. To achieve these goals, the study will adopt a randomized controlled design, where eligible participants will be randomly assigned to either the active treatment group or the sham control group. The active treatment group will receive RLRL therapy, while the control group will be administered interventions using a sham RLRL device-this device is identical in appearance and operation mode to the active RLRL device but has an energy output of less than 10% of the original, aiming to exclude the placebo effect. The intervention regimen for both groups is standardized: participants will receive the assigned intervention twice daily, with each session lasting 3 minutes, 5 days per week, for a continuous 12-month course. During the study period, all participants will undergo regular follow-up visits at the clinic every 3 months, where a series of comprehensive assessments will be performed, including but not limited to visual acuity measurement, fundus examination, optical coherence tomography (OCT) for choroidal thickness and retinal structure evaluation, and choroidal blood flow dynamic detection to quantify microcirculatory changes. Additionally, participants will be instructed to maintain a detailed daily diary, recording the occurrence time, duration, and severity of any subjective symptoms (e.g., eye fatigue, photophobia) as well as changes in visual perception (e.g., contrast sensitivity, visual field changes), which will serve as supplementary data for safety monitoring and efficacy evaluation. Collectively, this study is expected to provide high-quality evidence for the clinical application of RLRL in the management of PM by clarifying its regulatory effect on choroidal microcirculation and its role in delaying retinal atrophy, while defining its safety boundaries.