Effects of Monocular Atropinization on Refractive Error and Eye Growth in Infant New World Monkeys

Whatham, Andrew; Lunn, Daniel; Judge, S. J.

doi:10.1167/iovs.18-24490

Cited by 8 publications

(4 citation statements)

References 36 publications

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“…While the use of atropine "penalization" treatment to reduce the strength of input from the fellow, nonamblyopic eye as an alternative to patching had fallen out of favor, it has been revived of late and is now more commonly used as one of the standard treatment options (5). However, 2 noteworthy studies in nonhuman primates suggest that atropine use can cause the development of amblyopia (56) and exert effects on the natural process of emmetropization of the eye (57). It is hoped that this work will serve as a caution and lead to tempering the use of this approach.…”

Section: Implications For Clinical Practicementioning

confidence: 94%

Understanding the development of amblyopia using macaque monkey models

Kiorpes

2019

Proc. Natl. Acad. Sci. U.S.A.

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Amblyopia is a sensory developmental disorder affecting as many as 4% of children around the world. While clinically identified as a reduction in visual acuity and disrupted binocular function, amblyopia affects many low- and high-level perceptual abilities. Research with nonhuman primate models has provided much needed insight into the natural history of amblyopia, its origins and sensitive periods, and the brain mechanisms that underly this disorder. Amblyopia results from abnormal binocular visual experience and impacts the structure and function of the visual pathways beginning at the level of the primary visual cortex (V1). However, there are multiple instances of abnormalities in areas beyond V1 that are not simply inherited from earlier stages of processing. The full constellation of deficits must be taken into consideration in order to understand the broad impact of amblyopia on visual and visual–motor function. The data generated from studies of animal models of the most common forms of amblyopia have provided indispensable insight into the disorder, which has significantly impacted clinical practice. It is expected that this translational impact will continue as ongoing research into the neural correlates of amblyopia provides guidance for novel therapeutic approaches.

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Section: Implications For Clinical Practicementioning

confidence: 94%

Understanding the development of amblyopia using macaque monkey models

Kiorpes

2019

Proc. Natl. Acad. Sci. U.S.A.

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“…Atropine has been shown to be clinically effective at reducing myopia progression in clinical trials (Upadhyay & Beuerman, 2020) and in avian and mammalian animal models of myopia, although the mechanism of action is poorly understood (McBrien, Moghaddam et al, 1993, Whatham, Lunn et al, 2019). Therefore, we examined the effect of atropine on choroidal IL-6 transcription in chicks undergoing form deprivation myopia ( Figure 8 ).…”

Section: Resultsmentioning

confidence: 99%

Visually Induced Changes in Cytokine Production in the Chick Choroid

Summers¹,

Martínez²

2021

Preprint

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Postnatal ocular growth is regulated by a vision-dependent mechanism which acts to minimize refractive error through coordinated growth of the ocular tissues. Of great interest is the identification of the chemical signals that control visually-guided ocular growth. Here we provide evidence that the pro-inflammatory cytokine, Interleukin-6 (IL-6), may play a pivotal role in the control of ocular growth using a chicken model of myopia. Microarray, real time RT-qPCR, and ELISA analyses identified IL-6 upregulation in the choroids of chick eyes under two visual conditions that introduce myopic defocus and slow the rate of ocular elongation (recovery from induced myopia and compensation for positive lenses). Intraocular administration of atropine, an agent known to slow ocular elongation, also resulted in an increase in choroidal IL-6 gene expression. Nitric oxide appears to directly or indirectly upregulate choroidal IL-6 gene expression, as administration of the non-specific nitric oxide synthase inhibitor, L-NAME, inhibited choroidal IL-6 gene expression, and application of a nitric oxide donor stimulated IL-6 gene and protein expression in isolated chick choroids. Considering the pleiotropic nature of IL- 6 and involvement in many biological processes, these results suggest that IL-6 may mediate many aspects of the choroidal response in the control of ocular growth.

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“…Evidence of axial elongation should therefore be regarded as a prerequisite for any myopia control intervention in a child with a history of prematurity. Animal studies involving infant primates have also raised the possibility that topical atropine may lead to arrested development of the anterior segment, 106 suggesting caution over the use of high concentrations of atropine for myopia control in the first year or two of life until further clinical data are available. This presents a particular challenge in ROP, because myopic progression appears to be most rapid in the first 3 or 4 years of life in eyes with ROP.…”

Section: Management Of Myopia Progressionmentioning

confidence: 99%

IMI—Management and Investigation of High Myopia in Infants and Young Children

Flitcroft

Ainsworth

Chia

et al. 2023

Invest. Ophthalmol. Vis. Sci.

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Purpose The purpose of this study was to evaluate the epidemiology, etiology, clinical assessment, investigation, management, and visual consequences of high myopia (≤−6 diopters [D]) in infants and young children. Findings High myopia is rare in pre-school children with a prevalence less than 1%. The etiology of myopia in such children is different than in older children, with a high rate of secondary myopia associated with prematurity or genetic causes. The priority following the diagnosis of high myopia in childhood is to determine whether there is an associated medical diagnosis that may be of greater overall importance to the health of the child through a clinical evaluation that targets the commonest features associated with syndromic forms of myopia. Biometric evaluation (including axial length and corneal curvature) is important to distinguishing axial myopia from refractive myopia associated with abnormal development of the anterior segment. Additional investigation includes ocular imaging, electrophysiological tests, genetic testing, and involvement of pediatricians and clinical geneticists is often warranted. Following investigation, optical correction is essential, but this may be more challenging and complex than in older children. Application of myopia control interventions in this group of children requires a case-by-case approach due to the lack of evidence of efficacy and clinical heterogeneity of high myopia in young children. Conclusions High myopia in infants and young children is a rare condition with a different pattern of etiology to that seen in older children. The clinical management of such children, in terms of investigation, optical correction, and use of myopia control treatments, is a complex and often multidisciplinary process.

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Effects of Monocular Atropinization on Refractive Error and Eye Growth in Infant New World Monkeys

Cited by 8 publications

References 36 publications

Understanding the development of amblyopia using macaque monkey models

Understanding the development of amblyopia using macaque monkey models

Visually Induced Changes in Cytokine Production in the Chick Choroid

IMI—Management and Investigation of High Myopia in Infants and Young Children

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