There is rapidly expanding interest in interventions to slow myopia progression in children and teenagers, with the intent of reducing risk of myopia-associated complications later in life. Despite many publications dedicated to the topic, little attention has been devoted to understanding ‘efficacy’ in myopia control and its application. Treatment effect has been expressed in multiple ways, making comparison between therapies and prognosis for an individual patient difficult. Available efficacy data are generally limited to two to three years making long-term treatment effect uncertain. From an evidence-based perspective, efficacy projection should be conservative and not extend beyond that which has been empirically established. Using this principle, review of the literature, data from our own clinical studies, assessment of demonstrated myopia control treatments and allowance for the limitations and context of available data, we arrive at the following important interpretations: (i) axial elongation is the preferred endpoint for assessing myopic progression; (ii) there is insufficient evidence to suggest that faster progressors, or younger myopes, derive greater benefit from treatment; (iii) the initial rate of reduction of axial elongation by myopia control treatments is not sustained; (iv) consequently, using percentage reduction in progression as an index to describe treatment effect can be very misleading and (v) cumulative absolute reduction in axial elongation (CARE) emerges as a preferred efficacy metric; (vi) maximum CARE that has been measured for existing myopia control treatments is 0.44 mm (which equates to about 1 D); (vii) there is no apparent superior method of treatment, although commonly prescribed therapies such as 0.01% atropine and progressive addition spectacles lenses have not consistently provided clinically important effects; (viii) while different treatments have shown divergent efficacy in the first year, they have shown only small differences after this; (ix) rebound should be assumed until proven otherwise; (x) an illusion of inflated efficacy is created by measurement error in refraction, sample bias in only treating ‘measured’ fast progressors and regression to the mean; (xi) decision to treat should be based on age of onset (or refraction at a given age), not past progression; (xii) the decreased risk of complications later in life provided by even modest reductions in progression suggest treatment is advised for all young myopes and, because of limitations of available interventions, should be aggressive.

人们对减缓儿童和青少年近视进展的干预措施的兴趣迅速扩大，目的是降低日后近视相关并发症的风险。尽管有许多关于该主题的出版物，但很少有人关注了解近视控制及其应用的“功效”。治疗效果已以多种方式表达，这使得对个体患者的治疗和预后进行比较变得困难。可用的疗效数据通常仅限于两到三年，因此长期治疗效果不确定。从基于证据的角度来看，疗效预测应该是保守的，不能超出经验确定的范围。使用这个原则，回顾文献，我们自己临床研究的数据，评估已证实的近视控制治疗并考虑到可用数据的局限性和背景，我们得出以下重要解释：（i）轴向伸长率是评估近视进展的首选终点；(ii) 没有足够的证据表明进展较快或较年轻的近视患者从治疗中获益更大；(iii) 近视控制治疗降低轴伸长的初始速度不持续；(iv) 因此，使用进展百分比减少作为描述治疗效果的指标可能会非常具有误导性，并且 (v) 轴向伸长的累积绝对减少 (CARE) 成为首选的疗效指标；(vi) 现有近视控制治疗测量的最大 CARE 为 0.44 mm（相当于约 1 D）；(vii) 没有明显优越的治疗方法，尽管常用的治疗方法如 0.01% 阿托品和渐进多焦镜片并不能始终如一地提供具有临床意义的效果；(viii) 虽然不同的治疗方法在第一年表现出不同的疗效，但在此之后它们只表现出很小的差异；(ix) 除非另有证明，否则应假设反弹；(x) 由于屈光测量误差、仅处理“测量的”快速进展者的样本偏差和回归均值而造成功效膨胀的错觉；(xi) 治疗决定应基于发病年龄（或特定年龄的屈光度），而不是过去的进展；(xii) 即使是轻度的进展减少也可以降低生命后期并发症的风险，这表明建议对所有年轻的近视患者进行治疗，并且，