An intervention trial on efficacy of atropine and multi‐focal glasses in controlling myopic progression

Shih, Yung‐Feng; Hsiao, Chuhsing Kate; Chen, C. J.; Chang, Ching‐Yao; Hung, Por‐Tying; Lin, Li-Chun

doi:10.1034/j.1600-0420.2001.790304.x

Cited by 189 publications

(166 citation statements)

References 10 publications

(11 reference statements)

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“…Liu et al (54) demonstrated that muscarinic antagonists acted directly on the sclera to prevent myopia development induced by form deprivation in guinea pigs in which myopia progression was accompanied by overexpression of muscarinic acetylcholine receptors (M1 and M4). Furthermore, atropine, a nonselective muscarinic antagonist, and pirenzepine, an antagonist specific for M1, have been found to be effective in clinical trials to prevent myopia progression (55)(56)(57)(58). In experimentally induced myopia, including chicks and tree shrews, several muscarinic antagonists have been applied to control ocular growth in different species, although the mechanism of drug effects against myopia remain unclear (59 -61).…”

Section: Discussionmentioning

confidence: 99%

Knockdown of Zebrafish Lumican Gene (zlum) Causes Scleral Thinning and Increased Size of Scleral Coats

Yeh

Liu

Kao

et al. 2010

Journal of Biological Chemistry

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The lumican gene (lum), which encodes one of the major keratan sulfate proteoglycans (KSPGs) in the vertebrate cornea and sclera, has been linked to axial myopia in humans. In this study, we chose zebrafish (Danio rerio) as an animal model to elucidate the role of lumican in the development of axial myopia. The zebrafish lumican gene (zlum) spans ϳ4.6 kb of the zebrafish genome. Like human (hLUM) and mouse (mlum), zlum consists of three exons, two introns, and a TATA box-less promoter at the 5-flanking region of the transcription initiation site. Sequence analysis of the cDNA predicts that zLum encodes 344 amino acids. zLum shares 51% amino acid sequence identity with human lumican. Similar to hLUM and mlum, zlum mRNA is expressed in the eye and many other tissues, such as brain, muscle, and liver as well. Transgenic zebrafish harboring an enhanced GFP reporter gene construct downstream of a 1.7-kb zlum 5-flanking region displayed enhanced GFP expression in the cornea and sclera, as well as throughout the body. Downregulation of zlum expression by antisense zlum morpholinos manifested ocular enlargement resembling axial myopia due to disruption of the collagen fibril arrangement in the sclera and resulted in scleral thinning. Administration of muscarinic receptor antagonists, e.g. atropine and pirenzepine, effectively subdued the ocular enlargement caused by morpholinos in in vivo zebrafish larvae assays. The observation suggests that zebrafish can be used as an in vivo model for screening compounds in treating myopia.Myopia is a very common ocular disorder, which is characterized by excessive elongation of the eyeball. In Taiwan, the prevalence of myopia is about 84% of schoolchildren aged 16 -18, and the prevalence of high myopia (less than Ϫ6.0 D) at 18 years of age is 24% in girls and 18% in boys (1). In contrast, the prevalence of high myopia is much lower in Western countries, about 1% of the general population (2). These studies imply that genetic susceptibility of ethnic differences may account for the high prevalence of myopia in Taiwanese.The sclera contains a collagen-rich extracellular matrix that undergoes significant biochemical and biomechanical remodeling during the development of myopia (3). Linkage studies of high myopia have identified potential loci MYP1 (Xq28) and MYP3 (12q21-23); these loci are within and/or near the loci of the human genome containing several genes that encode small leucine-rich proteoglycans (SLRP), 3 i.e. biglycan (Xq27ter), decorin (12q21-22), lumican (12q21.3-22), and DSPG3 (12q21) (4 -9). Our previous study showed that certain variations (rs3759223 (C3 T)) of single nucleotide polymorphism in the lumican regulatory region may influence the promoter activities of lumican and affect fibrillogenesis in myopic eyes (10). Furthermore, Majava et al. (11) found that a novel single nucleotide polymorphism (c.893-105G3 A) of the lumican gene was associated with high myopia. Recently, our prospective case control study also showed that genetic variation in the regulatory domai...

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Section: Discussionmentioning

confidence: 99%

Knockdown of Zebrafish Lumican Gene (zlum) Causes Scleral Thinning and Increased Size of Scleral Coats

Yeh

Liu

Kao

et al. 2010

Journal of Biological Chemistry

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“…Although in most clinical studies atropine is used to treat 6-13-year-old children, [11][12][13][14][15] in Taiwan, 41.6% of 13-15-year-old children (junior high school students) and 28.5% of 16-18-year-old children (senior high school students) were still being prescribed atropine during 2007. The present study shows that atropine remains being prescribed to a certain portion of 13-18-year-old children, indicating that doctors are still concerned about myopia progression in these age groups.…”

Section: Discussionmentioning

confidence: 99%

“…Atropine has become part of routine eye care in Taiwan ever since the suggestion by the Taiwan Ophthalmology Association in the year 2000. Although evidences from many clinical trials on the use of atropine eye drops support a statistically significant reduction in myopia progression between experimental and control groups, [9][10][11][12][13][14][15][16] the clinical significance of the results of these trials are controversial. The routine use of atropine among children with myopia is not recommended in other countries.…”

Section: Introductionmentioning

confidence: 99%

Prescription of atropine eye drops among children diagnosed with myopia in Taiwan from 2000 to 2007: a nationwide study

Yt¹,

Yj²,

Chen³

et al. 2013

Eye

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Purpose This study was conducted to examine the atropine eye drop prescription trend for children diagnosed with myopia, and to determine the factors associated with the prescription of atropine eye drops. Design This was a population-based cross-sectional study. Methods This study was conducted using a national representative sample from the National Health Insurance (NHI) claims data. All school children between 4 and 18 years of age who had visited an ophthalmologist and were diagnosed with myopia between 2000 and 2007 were included herein. The main outcome measure was the proportion of subjects who were prescribed atropine eye drops in each year. Logistic regression was used to identify the factors associated with atropine eye drops being prescribed. Results The prescription of atropine eye drops for children diagnosed with myopia increased significantly from the school years 2000 (36.9%) to 2007 (49.5%). There was also a shift from prescribing high concentrations (0.5 and 1%) of atropine eye drops to lower concentration ones (0.3, 0.25, and 0.1%) within this period. Atropine eye drops were more frequently prescribed to 9-12-year-old children (OR ¼ 1.26-1.42, compared with those 7-8 years old), and to children from families with a high socioeconomic status (OR ¼ 1.19-1.25); however, they were less prescribed to those living in mid to low urbanized areas . Conclusions This study revealed an increasing trend of atropine eye drop prescription for children with myopia in Taiwan. Our study provides eye-care professionals worldwide a reference for the potential integration of atropine eye drops into their clinical practice toward children with myopia.

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“…Subsequent studies have shown some clinical effect on the progression of myopia in children. [68][69][70] In addition, atropine inhibits myopia in tree shrew and monkey myopia models and blocks form deprivation myopia or lens induced myopia in chicks. [71][72][73][74] In contrast to the mammalian eye, the avian eye contains striated intraocular muscle and atropine has neither mydriatic nor cycloplegic effect in birds, indicating a non accommodative mechanism for anti-myopia activity of atropine in chick.…”

Section: Medication Atropine Eyedropsmentioning

confidence: 99%

139: An evidence-based update on myopia and interventions to retard its progression

Leo¹,

Young²

2009

Journal of American Association for Pediatric Ophthalmology and

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SummaryMyopia is the most common human eye disorder. With its increasing prevalence and earlier ageof-onset in recent birth cohorts, myopia now affects almost 33% of adult individuals in the United States, and epidemic proportions of 85% to 90% adult individuals in Asian cities. Unlike children in Western populations, where the prevalence of myopia is very low (less than 5%), Asian children have prevalences as high as 29% in 7-year-olds. In addition to the direct economic and social burdens of myopia, associated ocular complications may lead to substantial vision loss. This workshop summarizes the current literature regarding myopia epidemiology, genetics, animal model studies, risk factors, and clinical treatments. Published treatment strategies to retard the progression of myopia in children, such as pharmacologic agents, progressive addition lenses, neural adaptation programs are outlined.Myopia, or near-sightedness, is the state of refraction in which parallel rays of light are brought to focus in front of the retina of a resting eye. 1 It is measured by the spherical power in diopters of the diverging lens needed to focus light onto the retina, which can be expressed as the spherical equivalent (SE), that is, sphere + half negative cylinder. Most commonly used definitions of myopia in epidemiologic studies include SE of at least −0.50D, −0.75D, and −1.0D. 2 Myopia is the most common human eye disorder in the world, affecting 85% to 90% of young adults in some Asian countries such as Singapore and Taiwan,3,4 and between 25% and 50% of older adults in the United States and Europe. [5][6][7] Epidemiological studies in Western populations have collectively shown the prevalence of myopia to be low (<5%) in children aged 8 years or younger. [8][9][10][11][12][13][14] However, studies in Asian children suggest a significantly higher prevalence of myopia, affecting 9% to 15% of preschool children 15,16 and 29% of primary school children in Singapore. 17 A study of 10,000 Taiwanese school children found that the prevalence of myopia was 6% in 6-yearolds, with the prevalence increasing to more than 70% by age of 15 years. 18

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An intervention trial on efficacy of atropine and multi‐focal glasses in controlling myopic progression

Cited by 189 publications

References 10 publications

Knockdown of Zebrafish Lumican Gene (zlum) Causes Scleral Thinning and Increased Size of Scleral Coats

Knockdown of Zebrafish Lumican Gene (zlum) Causes Scleral Thinning and Increased Size of Scleral Coats

Prescription of atropine eye drops among children diagnosed with myopia in Taiwan from 2000 to 2007: a nationwide study

139: An evidence-based update on myopia and interventions to retard its progression

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