Publication

Effect of publication bias on the evidence supporting the use of myopia control interventions

Rizzo, G.C.
; 
Scotti, L.
; 
Recchioni, A.
; 
Ponzini, E.
; 
Zeri, F.
; 
Tavazzi, S.
; ; 
Cheloni, R.
Publication Date
2025
End of Embargo
Supervisor
Keywords
Myopia, Myopia control, Randomised control trial, Publication bias, Systematic review, Meta-analysis
Rights
(c) 2025 Elsevier. Reproduced in accordance with the publisher's self-archiving policy. This manuscript version is made available under the CC-BY-NC-ND license (https://creativecommons.org/licenses/by-nc-nd/4.0/)
cb
Peer-Reviewed
Yes
Open Access status
embargoedAccess
Accepted for publication
2025-06-04
Institution
Department
Awarded
Embargo end date
2026-06-20
Collections
Life Sciences Publications
Show all metadata
Files
rizzo_et_al_2025.pdf
Adobe PDF, 796.17 KB
Additional title
Abstract
Purpose Publication bias exists when studies with negative results are less likely to be published, resulting in over-estimation of treatment efficacy. This study aimed to assess the impact of publication bias on current evidence supporting myopia control interventions. Methods A systematic literature search was conducted to retrieve systematic-reviews (SRs) and meta-analyses (MAs) assessing myopia control interventions. From eligible SRs & MAs randomised controlled trials (RCTs) evaluating myopia control treatments (spectacle-based, contact lenses (CL), pharmacological) were included. Outcomes were mean changes in axial-length and refractive error. Pooled estimates of efficacy were computed with random effects meta-analysis. Publication bias was evaluated with funnel plots and Egger’s test. Results This study included 27 SRs and MAs, reporting on 49 eligible RCTs. Considering axial length outcomes, there were 41 RCTs, assessing CL (n = 16, 39 %), spectacles (n = 13, 31.7 %), and pharmacological treatments (n = 12, 29.3 %). Egger’s test was significant only for pharmacological treatments (p = 0.045), but trim and fill analysis indicated that that treatment efficacy was not over-estimated. Of 46 RCTs considering refractive error outcomes, 13 (28.3 %), 14 (30.4 %), and 19 (41.3 %) examined CL, pharmacological and spectacle treatments, respectively. Egger’s test showed significant asymmetry only for CL (p = 0.006), but there was not over-estimate of treatment efficacy. Among specific treatments, only atropine (refractive outcomes) and multifocal CL (axial length and refractive outcomes) had sufficient RCTs for analysis, and all Egger’s test were not significant (all p > 0.05). Conclusions This study did not find evidence of publication bias affecting the current literature supporting myopia control treatments, suggesting that the effect of different interventions is unlikely to be overestimated.
URI
https://bradscholars.brad.ac.uk/handle/10454/20486
Version
Accepted manuscript
Citation
Rizzo GC, Scotti L, Recchioni A et al (2025) Effect of publication bias on the evidence supporting the use of myopia control interventions. Contact Lens and Anterior Eye. 102463. Accepted for publication.
Link to publisher’s version
Link to published version
Link to Version of Record
https://doi.org/10.1016/j.clae.2025.102463
Type
Article
Qualification name
Notes
The full-text of this article will be released for public view at the end of the publisher embargo on 20 Jun 2026.