Significant Improvement in High Myopic Anisometropic Amblyopia Treated With Repeated Low-Level Red-Light (RLRL) Therapy: A Case Report.

BACKGROUND High myopic anisometropic amblyopia poses a significant therapeutic challenge, as traditional interventions (spectacles, occlusion, atropine) exhibit limited efficacy in reducing anisometropia and controlling myopia progression. This case report explores the novel application of repeated low-level red-light therapy, which has been previously validated for myopia control, in addressing both amblyopia and refractive imbalance. CASE REPORT A male child was diagnosed with anisometropic myopia at the age of 5 years. Cycloplegic retinoscopy showed a refractive error of -7.75/-1.25×155 diopters in the right eye and -1.75 diopters in the left eye, with best-corrected visual acuity of 20/67 and 20/25, respectively. The axial length was 27.79 mm in the right eye and 24.43 mm in the left eye. The patient was prescribed full correction spectacles combined with red light therapy. Over 3 years of follow-up, the refractive error of the highly myopic right eye improved to -4.75/-1.75×175 diopters, with best-corrected visual acuity recovering to 20/20 and axial length shortening to 26.78 mm. The left eye remained stable with minor refractive changes. Choroidal thickness changes or device-specific factors may have contributed to the observed reduction. CONCLUSIONS In this case of high myopic anisometropic amblyopia, repeated low-level red-light therapy simultaneously normalized visual acuity and produced an unprecedented 1.01 mm axial-length reduction. This single-case observation is hypothesis-generating and does not establish causality. Larger controlled trials are warranted to validate these findings and elucidate the mechanisms before the adoption of repeated low-level red-light therapy into routine clinical practice.