NEW RESEARCH ON HALTING MYOPIA

[John C Hagan III, MD, FACS, FAAO]

Several people have posted frustation about the lack of things that can be done to stop myopia from progressing. There is much research being done on this in asian countries as myopia-high myopia is much more common in asians more than 50% in some groups.

This is a promsing PRELIMINARY STUDY  that appeared in Ocular surgery News November 10, 2008 "Pirenzepine gel slows myopia progression in children". The medication is not available except by research studies but I hope many will find it heartening that such research is being done.

Thes are the two published studies in peer reviewed journals:

Siatkowski RM and others  US Pirenzepine study group. Two year multicenter, randomized, double masked, placebo controlled parallel safety and efficacy study of 2% pirenzepins ophthalmic gel in children with myopia:  JAAPOS 2008;12(4):332-339

AND

Tan DT and others  Asian Pirenzepine study group. One year multicenter, double masked, placebo controlled, parallel safety and efficacy study of 2% pirenzepine ophthalmic gel in children with myopia.  Ophthalmology 2005;112(1):84-91

JCH MD

[kg17]

Thank you, Dr. Hagan, for providing updates on new research.  With an extensive family history of high myopia and myopic degeneration, I am anxious for my children.  I welcome any hope.

[dukey]

Actually, I take it back....a little!

There is some good studies out there on this in animal models showing it's mode of action and it seems pretty interesting. My problem is that there is still myopic progression and I am concerned that it will not be effective in the pathologic type, which is almost a separate disease characterised by the staphyloma. For people like me, who has advancing staphyloma, this is probably useless as it does not look strong enough to stop the progression. The good news is that if you have young kiddies that are myopic and progressing, I would get hold of this compound ASAP, or get them in a trial.  

Kg17, your comments on diabetes are mostly correct, but unfortunately people do not want to eat right and exercise so we have to deal with it!

[kg17]

bump

[John C Hagan III, MD, FACS, FAAO]

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[nickppatel]

dukey - why don't you see it being a long-term solution? (I respect your opinion!)

[John C Hagan III, MD, FACS, FAAO]

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[kg17]

Just a note....Diabetes does render substantial and life-altering damage.  However, it is well-known that diabetes type II is for the most part, a "life-style" disease that most folks could avoid if they take care of their health.  We know what factors (e.g., diet, exercise) can prevent the disease for the majority of people.  Prevention yields the most "bang for the buck." (Of course, this generalization does not apply to type I)

Myopia is different in that lifestyle factors have not been identified as causative.  The money problem is quite directly tied to the lack of advocacy.  Because no one believes myopia is a problem (in fact, in the U.S. it bodes as a great money-maker for optometrists), there is no money for basic research.  However, this does not mean that one person cannot make a difference.

[dukey]

Well it is something I have thought about seriously. My home town, London, has a number of excellent research departments, most of which are associated with Moorefields eye hospital. It would be "relatively" easy to transfer my training to the study of myopia, at least at the molecular level. However, it is not as easy as that as the problem with myopia research is funding I think. In general, where there is money available for research, scientists will swoop in and start working. They will abandon an area if funding becomes scarce. Most do not have an emotional connection to the research (sadly) and so will switch fields on a whim. It appears to me that this is exactly what has happened.  

On that note, I could never abandon diabetes research. When you put it in perspective, diabetes kills people (and early), myopia does not. Diabetes is a life full of horrific complications involving the kidneys, heart, nerves and even the eyes. The media paints diabetes as a relatively benign and treatable condition, but that is very, very far from the truth.  

[John C Hagan III, MD, FACS, FAAO]

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[walkietalkie]

Dukey, why don’t you switch from diabetes to eye research? I’m sure the eye community would welcome a dedicated scientist like you looking for a 'long term solution'.

[John C Hagan III, MD, FACS, FAAO]

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[dukey]

The reduction in axial elongation is particularly impressive in the earlier studies I think, but the latest papers seem to dispute this a little. I just can't see it being a long term solution. I think phase III trials will expose it, they usually do! It is, of course, great to see some current research though. I would like to see much more basic science into myopia though.