Medication Slows Progression of Myopia in Children

Pirenzepine gel may help to preserve vision in nearsighted kids, JAAPOS study finds

Philadelphia, PA, August 26, 2008 – Daily treatment with a medication called pirenzepine can slow the rate of progressive myopia, or nearsightedness, in children, reports a study in the August issue of the Journal of AAPOS (American Association for Pediatric Ophthalmology and Strabismus).

Led by Dr. R. Michael Stiatkowski of Dean McGee Eye Institute/University of Oklahoma Department of Ophthalmology, the researchers evaluated the effects of pirenzepine in children with myopia. Myopia—sometimes called nearsightedness—is a condition in which focus on near objects is good, but distant objects appear blurry. Caused by a problem with the length of the eyeball or the curvature of the cornea, myopia gets worse over time in many children.

In the study, children with myopia were randomly assigned to treatment with pirenzepine gel or an inactive placebo gel. After a year of treatment, the average increase in myopia was significantly less for children using pirenzepine. The new study presents the final results in 84 patients who continued treatment for a total of two years: 53 with pirenzepine and 31 with placebo.

Although myopia worsened in both groups of children, the rate of progression was slower with pirenzepine. At the end of two years, myopia increased by an average of 0.58 diopters in children using pirenzepine versus 0.99 diopters with placebo. (All children initially had "moderate" myopia, with an average refractive error of about -2.00 diopters.)

New glasses are generally prescribed when myopia worsens by at least 0.75 diopters. During the study, 37 percent of children using pirenzepine met this cut-off point compared with 68 percent of the placebo group. With glasses, all children had about 20/20 vision at both the beginning and end of the study.

Pirenzepine treatment was generally safe, although eleven percent of children stopped using it because of side effects such as eye irritation. The drug also caused mild dilation of the pupils. The amount of change in the length of the eyeball was not significantly different between groups, although more research is needed to determine whether pirenzepine affects the growth of the eyes.

Myopia is the leading cause of loss of vision worldwide, affecting at least 25 percent of U.S. adults. Effective treatments to prevent or delay progressive myopia may reduce the risk of serious complications such as detached retina and glaucoma—even for children with moderate myopia, the risk of retinal detachment is increased by up to four times.

Treatments to slow worsening myopia could also have important quality-of-life benefits. For example, while children with -1.00 diopter of myopia may need glasses only part-time, those with -2.00 diopters will probably need glasses for all activities, including school and sports.

Previous studies have suggested that a drug called atropine can delay progression of myopia. The new results show that pirenzepine—a related drug with fewer side effects—is also safe and effective for this purpose.

More research will be needed before pirenzepine can be widely recommended for children with myopia. Key questions include the long-term effects and optimal length of pirenzepine treatment. In addition, more convenient and practical methods of drug administration may help to overcome some of the disadvantages of pirenzepine gel.

# # #

Notes to Editors:
Full text of the article mentioned above is available upon request. Contact Jayne M. Dawkins at (215) 239-3674 or ja.dawkins@elsevier.com to obtain a copy or to schedule an interview. The article appears in the August Journal of AAPOS, published by Elsevier.

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.

About Elsevier

Elsevier is a world-leading provider of information solutions that enhance the performance of science, health, and technology professionals, empowering them to make better decisions, deliver better care, and sometimes make groundbreaking discoveries that advance the boundaries of knowledge and human progress. Elsevier provides web-based, digital solutions — among them ScienceDirect, Scopus, Elsevier Research Intelligence, and ClinicalKey — and publishes nearly 2,200 journals, including The Lancet and Cell, and over 25,000 book titles, including a number of iconic reference works.

The company is part of Reed Elsevier Group PLC, a world leading provider of professional information solutions in the Science, Medical, Legal and Risk and Business sectors, which is jointly owned by Reed Elsevier PLC and Reed Elsevier NV. The ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).

Media Contact:
Jayne Dawkins
Elsevier
+1 215 239 3674
ja.dawkins@elsevier.com