Clinical Engine v1.2-baseline

Clinical model, evidence, and limitations

MyopiaTracker is a clinical decision-support and communication tool. It uses axial-length norms, published treatment-effect estimates, and transparent model assumptions to help clinicians organize myopia-management discussions. It is not a diagnostic device, regulatory-cleared medical device, or prescribing guideline.

Important: Any age-18 projection, combination-therapy estimate, or composite score should be interpreted as a model estimate. Clinical judgment, measurement quality, patient adherence, local regulatory status, and patient-specific context remain essential.

What is evidence-backed versus modeled?

Evidence-backed inputs

Published axial-length norm sources and randomized-trial axial-elongation results are used where available.

Model assumptions

Long-range age-18 projections, combination therapy effects, and composite risk scores are labeled as model assumptions or heuristic communication scores.

Clinical boundary

The app supports clinical reasoning and family communication. It does not diagnose, prescribe, or replace professional judgment.

Treatment coefficients used by the app

ModalityCoefficientEvidence statusInterpretation
MiSight® 1 day52%RCTBased on reported reduction in axial elongation over 3 years versus control.
Stellest® / HAL51%RCTBased on Bao et al. 2022 overall 2-year axial-length result: 0.35 mm reduction from a 0.69 mm single-vision comparator. Full-time wearers had about 60% less axial elongation. The 67% figure in the paper refers to SER, not axial length, so it is intentionally not used in this AL-based projection model.
MiyoSmart® / DIMS62%RCTBased on reported axial-elongation reduction over 2 years versus single-vision spectacle lenses.
Ortho-K45%Evidence rangeSimplified midpoint within commonly reported meta-analysis ranges; not device-specific.
Atropine 0.01%12%Mixed evidenceConservative LAMP-derived model value; later placebo-controlled US evidence did not support 0.01% efficacy.
Atropine 0.025%29%RCTDerived from LAMP year-1 axial elongation compared with placebo.
Atropine 0.05%51%RCTDerived from LAMP year-1 axial elongation compared with placebo.
Combination therapy65%ModeledModeled combined-control estimate; not a single universal RCT coefficient.
Outdoor / behavioral counseling0%Prevention evidenceOutdoor time is important counseling, but the app does not model it as proven post-onset AL treatment reduction.

Normative curves

The app uses population-specific axial-length references where available. European/White, East Asian, and South Asian/Indian references are not interchangeable across all patients. South Asian/Indian values beyond age 12 require extra caution because the cited Indian percentile source is for children aged 6–12.

Current validation requirement: Hardcoded percentile tables should be maintained with a source worksheet showing every original, interpolated, or extrapolated value. Values outside a source population or age range should be labeled as approximations.

Risk and projection language

MyopiaTracker shows a primary low/moderate/high alert based on structural percentile, measured growth trajectory, and projected outcome. It also shows a composite communication score. The composite score is heuristic and should not be interpreted as a validated diagnostic instrument.

References

  1. McCullough SJ et al. Axial growth and refractive change in white European children and young adults. Scientific Reports. 2020;10:15189. Source
  2. He X, Sankaridurg P, Naduvilath T et al. Normative data and percentile curves for axial length and axial length/corneal curvature in Chinese children aged 4–18 years. British Journal of Ophthalmology. 2023;107:167–175. Source
  3. Gopalakrishnan A et al. Ocular biometry percentile curves and their relation to myopia development in Indian children. Journal of Clinical Medicine. 2024;13:2867. Source
  4. Chamberlain P et al. A 3-year randomized clinical trial of MiSight lenses for myopia control. Optometry and Vision Science. 2019;96:556–567. Source
  5. Bao J et al. Spectacle lenses with aspherical lenslets for myopia control. JAMA Ophthalmology. 2022;140:472–478. Source
  6. Lam CSY et al. Defocus incorporated multiple segments spectacle lenses slow myopia progression. British Journal of Ophthalmology. 2020;104:363–368. Source
  7. Yam JC et al. Low-concentration atropine for myopia progression (LAMP) study. Ophthalmology. 2019;126:113–124. Source
  8. Rose KA et al. Outdoor activity reduces the prevalence of myopia in children. Ophthalmology. 2008;115:1279–1285. Source
  9. PEDIG. Low-dose 0.01% atropine eye drops vs placebo for myopia control. JAMA Ophthalmology. 2023. Source