Prevention of Myopia Progression with 0.05% Atropine Solution

Lee, Jong‐Jer; Fang, Po-Chiung; Yang, I-Hui; Chen, Chih-Hsin; Lin, Pei‐Wen; Lin, Sue-Ann; Kuo, Hsi-Kung; Wu, Pei-Chang

doi:10.1089/jop.2006.22.41

Cited by 84 publications

(58 citation statements)

References 15 publications

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“…Fan and colleagues (2007), who investigated the effect of 1% atropine ointment on myopia progression in children over a one year period, demonstrated that the rate of myopia progression was lower in children receiving atropine than in those using the placebo. A similar conclusion was also drawn by Lee et al (2006), Polling et al (2016) and Fang et al (2010) who evaluated the effectiveness of 0.5% and 0.025% atropine for slowing the development of myopia in Asian and Caucasian children after one year (Table 1.7.6.2).…”

Section: The Autonomic Innervation Of the Choroidsupporting

confidence: 76%

The Influence of the Autonomic Nervous System on the Human Choroid

Sander¹

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v AbstractThe impact of myopia is greater than just its optical consequences and in severe cases it can lead to a loss of vision. It is a highly prevalent eye disorder, with about one third of the population worldwide affected by this refractive error. Despite extensive research, the pathogenesis of myopia is still only partially understood. An improved knowledge of mechanisms underlying myopia is critical to developing new therapies to prevent myopia or to slow its progression.Although there is no fully effective and satisfactory myopia control treatment available, growing evidence has suggested that the choroid has a passive or active role in the regulation of eye growth and refractive error development. Numerous human and animal studies have shown that the retina can be moved forward or backward towards the image plane through changes in choroidal thickness, and these changes are likely to be associated in the longer term with eye growth and the development of refractive errors. As the choroid receives a rich innervation from the autonomic nervous system, many previous animal studies have utilized pharmacological agents and neurotoxins to elucidate the possible role of muscarinic signaling in the regulation of choroidal thickness, but only a few studies have investigated this issue in humans. An improved understanding of the mechanisms that control choroidal thickness may be important in developing new therapies for combating the development and progression of myopia.The research described in the thesis aimed to investigate the role of the autonomic nervous system in the control of choroidal thickness, axial length and the morphology In a series of experiments, we have confirmed that in humans under normal visual conditions, the parasympathetic nervous system is involved in the short-term regulation of subfoveal and parafoveal choroidal thickness, axial length and the morphology of the anterior sclera. The muscarinic blocker homatropine caused a significant subfoveal and parafoveal choroidal thickening, shortening of axial length, an enlargement of Schlemm's canal area and an increase in thickness of the conjunctival/episcleral complex. On the other hand, no notable changes in ocular parameters, except a decrease in the thickness of the conjunctival/episcleral tissues were found after instillation of the sympathomimetic drug phenylephrine.In an attempt to further improve our understanding of the myopigenic mechanisms influencing the thickness of the choroid in humans, we investigated the short-term influence of mixed interventions (positive and negative lens-imposed defocus / 2% homatropine) on choroidal thickness and axial length in emmetropic and myopic subjects. Homatropine prevented choroidal thinning in response to hyperopic defocus.This finding is consistent with the anti-myopia effects of muscarinic blockers and supports the potential importance of hyperopic defocus in the development of human myopia. By contrast, co-administration of homatropine with myopic defocus did not enhance the thicken...

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Section: The Autonomic Innervation Of the Choroidsupporting

confidence: 76%

The Influence of the Autonomic Nervous System on the Human Choroid

Sander¹

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“…22,23 The mechanism of action of atropine in myopia is suspected to include reduction of neuronal activity and increase in the general release of retinal neurotransmitters. 20 It has also been proven that pirenzepine and himbacine inhibit myopia in a dose-dependent manner, suggesting that these drugs mediate their effects via a receptoral mechanism.…”

Section: Discussionmentioning

confidence: 99%

“…[21][22][23] Because CNVs of different genes are related to many phenotypes, we identified CNVs of genes encoding mAChRs in an effort to determine a possible correlation with high myopia in the present study. Form-deprived myopic (FDM) animals were used to study the expression levels of mAChRs in myopic eyes before and after atropine treatment.…”

Section: -10mentioning

confidence: 99%

Muscarinic Acetylcholine Receptor 3 Is Dominant in Myopia Progression

Lin¹,

Wan

Chen

et al. 2012

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. Numerous studies have proven that the nonselective muscarinic acetylcholine receptor (mAChR) antagonist atropine prevents the axial elongation that leads to myopia. Five distinct receptor genes (CHRM1-CHRM5), each encoding a muscarinic receptor protein (M[1]-M[5]), have been cloned. Copy number variations (CNVs), which constitute a substantial portion of genetic variability and structural genetic variants, are increasingly being recognized as modulators of human diseases. In this study, CNVs of CHRMs were detected to determine the genes associated with myopia.METHODS. Participants were divided into three groups: high myopia group (myopia of 6-10 diopters [D]), severe high myopia group (myopia ‡10 D), and control group (myopia 0.5 D). The CNVs were detected, and the relative copy number was estimated using the comparative 2ÀDDCt method. Syrian hamsters with form-deprivation myopia (FDM) were used as animal models of myopia.RESULTS. The CNVs of CHRM2, CHRM3, and CHRM4 were significantly different among the groups, and the variations were most dominant in the CHRM3. The CNVs of CHRM3 showed significant differences among all 3 groups (P ¼ 0.005). A replication cohort was collected to further confirm the association of CHRM3 CNV with myopia (P ¼ 0.011). The expression of M(3) on the sclera of the FDM Syrian hamsters was upregulated and then downregulated after atropine administration.CONCLUSIONS. CHRM3 and M(3) were suggested to play important roles in the pathogenesis of myopia and in the arrested progression of myopia by atropine. (Invest Ophthalmol Vis Sci. 2012;53:6519-6525) DOI:10.1167/iovs.11-9031 C linically significant refractive errors are the most common visual disorders. Myopia affects more than half of young adults in the world. [1][2][3] In Asian countries, the prevalence of myopia has approached epidemic proportions.4 Animal studies of myopia have shown that the nonselective muscarinic acetylcholine receptor (mAChR) antagonist atropine effectively prevents the axial elongation that leads to myopia. [5][6][7] Human clinical trials have also shown the effectiveness of daily atropine administration in reducing the progression of myopia. The mAChR family proteins are a group of neurotransmitter proteins that belong to the 7-transmembrane superfamily of receptors. Five distinct receptor genes (CHRM1-CHRM5), each encoding a muscarinic receptor protein (M[1]-M[5]) with specific pharmacological properties, have been cloned. [8][9][10] Different studies have shown the diverse effects of M(1) to M(5) on myopia; moreover, M(1) to M(5) have been proposed to play various roles in the ''stop'' signal of myopic progression. [8][9][10] In vitro studies have shown that mAChR antagonists inhibited scleral proliferation and matrix synthesis. 8-10Many studies have suggested that myopia is a complex condition with multiple causes and develops as a result of interactions between multiple genes and environmental stimuli.11 This study detected CHRM1 to CHRM5 polymorphisms by using the copy number variation (CNV) metho...

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“…Indeed, the Atropine Treatment of Myopia 2 (ATOM2) study and related studies offer enticing evidence that doses as low as 0.01% atropine can quite effectively slow myopia progression in children with very low levels of pupil dilation, photophobia, cycloplegia, and allergy. [10][11][12] The findings from ATOM2 in particular have encouraged clinicians to consider lowdose atropine therapy, although there are difficulties in prescribing such doses as they are not easily available. The Cochrane group further suggests that corneal reshaping or orthokeratology and bifocal soft contact lenses are promising treatments, although still in need of more randomized controlled clinical trials.…”

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confidence: 99%

Clinical management of progressive myopia

Aller

2013

Eye

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Myopia has been increasing in prevalence throughout the world, reaching over 90% in some East Asian populations. There is increasing evidence that whereas genetics clearly have an important role, the type of visual environment to which one is exposed to likely influences the onset, progression, and cessation of myopia. Consequently, attempts to either modify the environment or to reduce the exposure of the eye to various environmental stimuli to eye growth through the use of various optical devices are well under way at research centers around the globe. The most promising of current treatments include low-percentage atropine, bifocal soft contact lenses, orthokeratology, and multifocal spectacles. These methods are discussed briefly and are then categorized in terms of their expected degree of myopia progression control. A clinical strategy is presented for selecting the most effective treatment for the appropriate type of patient at the optimal stage of refractive development to achieve the maximum control of myopia progression.

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Prevention of Myopia Progression with 0.05% Atropine Solution

Abstract: The results of this study demonstrate that, with regular instillation, topical 0.05% atropine is an effective agent for controlling myopia progression in a majority of school-aged children for at least a period of 1 year.

Cited by 84 publications

References 15 publications

The Influence of the Autonomic Nervous System on the Human Choroid

The Influence of the Autonomic Nervous System on the Human Choroid

Muscarinic Acetylcholine Receptor 3 Is Dominant in Myopia Progression

Clinical management of progressive myopia

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