CCOI Myopia Workshop: Michael X. Repka, MD, MBA, on building consensus and future directions

In advance of the upcoming CCOI Myopia Workshop, scheduled for September 8 in Paris, France, Michael X. Repka, MD, MBA—program co-chair of the event and current president of the American Academy of Ophthalmology—spoke about the challenges and opportunities facing the field of myopia control. The Collaborative Community on Ophthalmic Innovation (CCOI) workshop will bring together clinicians, researchers, regulators, and industry leaders to address critical questions in research design, regulatory guidance, and treatment development.

Repka emphasized that the workshop will not be about providing fixed answers, but rather fostering dialogue that can guide future decisions. “We propose possible answers and let the audience try and come to consensus now and in the next few months on what kind of guidelines should be offered to people doing clinical trials design or industry interested in entering this area, as well as hopefully influencing the regulators,” he explained.

A central question in clinical trial design is duration. Repka reflected on past assumptions: “Ten years ago, when we looked at this, we sort of said 2 or 3 years—that’s good enough. But I think we’re learning that we may need longer follow-up, maybe not in the initial trial, but in follow-up of those patients.” He pointed to data from Singapore suggesting that initial optimism about halting progression may have been premature.

Long-term studies in myopia face hurdles common to many areas of research. Funding is an ongoing concern, as is the diversity of patient populations. “This is a big population that is somewhat heterogeneous around the world, and it’s hard to develop clinical trials that necessarily will hit all of the end points for each of those subgroups,” Repka said. Beyond research, industry involvement and cost considerations are essential, since effective therapies ultimately must be brought to market and priced at levels acceptable to patients and health systems.

One way to streamline progress, he suggested, is harmonization of standards across regions. “The fastest way, of course, is to have your end points laid out… getting regulators around the world to have similar end points, not necessarily the same end point, but similar… That harmony could very well help all of us, the researchers, the investment community, and our patients.”

Accessibility will also vary country to country, depending on insurance structures and willingness of doctors to prescribe new treatments. Broad adoption, Repka noted, will depend on parental demand and movement away from niche or “boutique” treatments toward mainstream care.

Looking ahead, Repka highlighted both pharmacologic and device-based approaches. Atropine eye drops have shown “some effectiveness,” though optimal dosing remains under study. Novel lens designs and contact lenses also hold promise, but more outcome data is needed in Western populations. Extending their use safely to younger children will be an important next step.

Ultimately, the workshop is meant to accelerate consensus-building. As Repka put it, live discussion “can really distill a lot of, if you will, email conversations over years into an output of a few weeks.” He underscored the growing importance of myopia, long considered a “stepchild of medical eye care,” but increasingly linked to significant long-term complications. The goal, he said, is clear: “Show that you get a benefit now and probably that translates into a benefit decades from now.”

To register or learn more about the CCOI Myopia Workshop, click here.