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2005; 51, 2, 5-9

DAMIAN CZEPITA

FUNDAMENTALS OF MODERN TREATMENT OF MYOPIA

Katedra i Klinika Okulistyki Pomorskiej Akademii Medycznej
al. Powstańców Wlkp. 72, 70-111 Szczecin
Kierownik: prof. dr hab. n. med. Danuta Karczewicz

Summary
Purpose: The aim of this paper is to present and discuss modern concepts on the treatment of myopia.
Material and methods: Recent literature dealing with management of myopia has been reviewed.
Results: The history of experimental studies on myopia is presented. Anatomical and biochemical changes taking place in the eyeball during experimental induction of myopia are described. Additionally, the following substances inhibiting the progress of experimental myopia are discussed: atropine, oxyphenonium, pirenzepine, chlorpyrifos, apomorphine, reserpine, 6-hydroxy dopamine, dextromethorphan, MK-801, APV, bicuculline, SR95531, CACA, TPMPA, dextrorphanol, levorphanol, D- and L-naloxane, L-NAME, formoguanamine, β-xyloside, central and peripheral antagonists of VIP, and basic fibroblast growth factor. As the pathogenesis of experimental myopia is similar to progressive myopia, the above-mentioned substances can be treated as potential remedies inhibiting the process of myopia in man. Since 1991, apomorphine and pirenzepine continue to stir hope among researchers because it has been shown that apomorphine in the form of subconjunctival or intravitreal injections or topical preparation inhibits the progression of experimental myopia in primates and chickens. Apart from that it has been observed that pirenzepine administered subconjunctivally or intravitreally inhibits the progression of myopia in tree shrews and chickens. These observations led Siatkowski et al. [53] and Tan et al. [54] to undertake clinical studies in humans. Administration for one year of 2% pirenzepine ophthalmic gel in children resulted in reduction of myopia by 44–51% as compared with a control group. This result of Siatkowski et al. [53] and Tan et al. [54] represents a breakthrough in the treatment of myopia and clearly indicates that we will be able in the near future to slow down or even block the progression of this refractive anomaly.

K e y w o r d s: experimental myopia – treatment.

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