Myopia control in Mendelian forms of myopia

Area of Science:

• Ophthalmology
• Genetics
• Pharmacology

Background:

• Myopia is a common refractive error, with Mendelian forms caused by single gene mutations.
• Understanding the genetic basis of myopia is crucial for developing targeted treatments.
• High-dose atropine has shown potential in slowing myopia progression.

Purpose of the Study:

• To evaluate the efficacy of high-dose atropine in reducing eye growth in children with Mendelian myopia.
• To investigate the effect of high-dose atropine on myopia progression in a mouse model of genetic myopia.

Main Methods:

• Children with and without Mendelian myopia were treated with high-dose atropine, and axial length (AL) progression was compared to population data.
• A mouse model (Lrp2 knockout) of Mendelian myopia was treated with atropine, and ocular biometry was assessed.
• Retinal dopamine and DOPAC levels were measured in mice post-treatment.

Main Results:

• Atropine reduced AL progression by 27% in children with Mendelian myopia and 23% in non-Mendelian myopes compared to untreated controls.
• High-dose atropine significantly reduced AL growth in both knockout and control mice.
• Retinal dopamine and DOPAC levels showed non-significant increases after atropine treatment.

Conclusions:

• High-dose atropine demonstrated comparable efficacy in reducing axial length progression in children with and without Mendelian myopia.
• Atropine effectively reduced myopia progression in a mouse model of severe Mendelian myopia.
• These findings suggest atropine's potential to manage myopia progression, irrespective of a strong monogenic cause.