Programm                 "Degeneration und Regeneration– Grundlagen, Diagnostik und Therapie"

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Pharmacology and molecular biology of myopia - possibilities for pharmacological intervention

Feldkaemper M.
Section of Neurobiology of the Eye, University Eye Hospital, Dept. II, Tübingen

Purpose: Since retinal image processing determines the release of growth controlling messengers from the retina to the underlying sclera, the search for agents that could lead to an inhibition of scleral expansion during myopia development is a promising research direction.
Method: Drugs were applied intravitreally (chicks) or by an ophthalmic gel (children). Myopia was induced by deprivation or defocus and eye growth was compared in saline-treated and drug-treated eyes (chicks). Differential Display (DD-RT-PCR, chicks) was used to search for retinal genes that are controlled by imposed defocus. The search for areas in the genome that affect eye size was done by quantitative trait loci (QTL) mapping (mice) or transmission disequilibrium testing (TDT) (humans).
Results: Atropine, an unspecific muscarinic antagonist that has been tested in animal models and children, is currently the most successful drug for myopia inhibition. At least four potential routes for atropine action are known although it is still uncertain whether it acts through muscarinic receptors at all. Pirenzepine, a preferential M1/M4 antagonist is in clinical phase II studies and is said to reduce progression by 50%, although only in the first year of application (applied twice a day, as an ophthalmic gel). Moreover, dopamine agonists, opiate and VIP antagonists can inhibit myopia but these drugs and neuro

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