Daily treatment with pirenzepine can slow the rate of progressive myopia in children, according to an article published on August 26, 2008 in the Journal of the American Association for Pediatric Ophthalmology and Strabismus (AAPOS).

When someone is myopic, or nearsighted, he is able to focus on objects that are close to the eye but objects that are more distant appear blurry. It is caused by a mismatch between the length of the eyeball and the curvature of the cornea, which must focus the image. The leading cause of vision loss in the world, at least 25% of adults in the United States are affected by myopia. In children, it often becomes progressively worse over time.

Myopia symptoms are usually corrected using glasses, though laser surgery is becoming more popular, especially in older people. Usually, new glasses are prescribed when myopia worsens by at least 0.75 diopters.

Treatment to actually prevent or delay myopia could reduce the risk of serious complications, such as a detached retina or glaucoma. This affects even children, and the risk of retinal detachment is much higher in children with moderate myopia is up to four times that of those without. Additionally, such treatments could improve quality of life for children, as -1.00 diopter children may only need glasses some of the time, while progression to -2.00 diopters indicates the need for glasses in all activities, including at school and in sports.

Previously, it has been shown that the medication atropine can delay myopia progression, but a related drug known as pirenzepine has fewer side effects with the same potential benefits. In order to discover the effects of pirenzepine on children with mypoia, a team led by Dr. R. Michael Stiatkowski of Dean McGee Eye Institute/University of Oklahoma Department of Ophthalmology, examined a total 84 young patients who continued a treatment regimen for two years. Each patient was randomized to receive pirenzepine gel (53) or a placebo (31.)

In both groups, myopia worsened. However, the rate of progression was slower for children treated regularly with pirenzepine. Initially, all of the children had “moderate” myopia, with an average refractive error of approximately -2.00 diopters. At the end of the two years, myopia worsened an average of 0.58 diopters in the test children, in contrast with 0.99 diopters for the children on the placebo. Over the course of the study, the cut off point for new glasses was reached by only 37% of the children using pirenzepine, while it was reached by 68% of the group treated with the placebo. Each child, with glasses, had 20/20 vision at the beginning and the end of the study.

Generally, the treatment with pirenzepine was safe, but 11% of the original population of children discontinued its use due to side effects, such as eye irritation. Additionally, subjects experienced mild dilation of the pupils. More research is necessary before pirenzepine can be recommended for the treatment of myopia. These further studies must examine the effects of the drug on the growth of the eye, the long term effects on vision, the optimal length and dose of treatment, and any practical methods of drug administration.

This article can be found published in the August issue of the Journal of AAPOS. Click Here For Journal

About Journal of AAPOS:

Journal of AAPOS presents expert information on children’s eye diseases and on strabismus as it impacts all age groups. Major articles by leading experts in the field cover clinical and investigative studies, treatments, case reports, surgical techniques, descriptions of instrumentation, current concept reviews, and new diagnostic techniques. The Journal is the official publication of the American Association for Pediatric Ophthalmology and Strabismus.

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Written by Anna Sophia McKenney