Treatment Adherence in Myopia Progression Management: A Monocentric Retrospective Study on Rates and Determinants

Purpose: To identify factors influencing good adherence when using different myopia management solutions, including low-dose atropine, defocus spectacle lenses (DIMS), defocus contact lenses, photobiomodulation with low-intensity red light, and combined approaches. Design: Retrospective, observational, single-center chart review. Patients and Methods: This single center retrospective study analyzed clinical and demographic data of myopic patients younger than 17 years. Exclusion criteria were presence of systemic and ocular pathologies, significant refractive (other than myopia) or binocular vision disorders, and follow-up less than 6 months. Data on age, sex, cycloplegic refraction, myopic progression, type of myopia control treatment, and patient-reported adherence to treatment (categorized as good, fair, poor) was obtained from the medical charts. Results: We analyzed 177 Caucasian pediatric patients (49.2% female; mean age 11.1 ± 2.78 years); 84.2% reported good adherence to treatment, 6.8% reported moderate adherence, and 9.0% reported poor adherence. In multivariate logistic regression analysis, DIMS spectacle lenses showed the strongest association with adherence (OR = 21.17, p = 0.003), followed by the combined use of DIMS spectacle lenses and atropine (OR = 4.02, p = 0.038). Higher myopia progression in spherical equivalent (SE) (OR = 0.31, p = 0.002), and older age (OR 0.78, p = 0.05) were significantly associated with lower adherence. Conclusion: These findings suggest that younger age and lower myopia progression are associated with better adherence to treatment. Among treatment options, DIMS spectacle lenses alone or combined with atropine, were the strongest predictors of adherence, while other approaches showed no significant associations. This favors optical-based strategies when adherence is a concern and calls for enhanced counseling strategies in adolescents.