Systemic 7-methylxanthine in retarding axial eye growth and myopia progression: a 36-month pilot study

The adenosine antagonist 7-methylxanthine (7-mx) works against myopia in animal models. In a clinical trial, 68 myopic children (mean age 11.3 years) received either placebo or 7-mx tablets for 12 months. All participants subsequently received 7-mx for another 12 months, after which treatment was stopped. Axial length was measured with Zeiss IOL-Master and cycloplegic refraction with Nikon Retinomax at −6, 0, 12, 24, and 36 months. Axial growth was reduced among children treated with 7-mx for 24 months compared with those only treated for the last 12 months. Myopia progression and axial eye growth slowed down in periods with 7-mx treatment, but when the treatment was stopped, both myopia progression and axial eye growth continued with invariable speed. The results indicate that 7-mx reduces eye elongation and myopia progression in childhood myopia. The treatment is safe and without side effects and may be continued until 18–20 years of age when myopia progression normally stops

Preclinical mouse models for BRCA1-associated breast cancer

A substantial part of all hereditary breast cancer cases is caused by BRCA1 germline mutations. In this review, we will discuss the insights into BRCA1 functions that we obtained from mouse models with conventional and conditional mutations in Brca1. The most advanced models closely resemble human BRCA1-related breast cancer and may therefore be useful for addressing clinically relevant questions

Photodynamic therapy with verteporfin for juxtafoveal choroidal neovascularization secondary to pathologic myopia - 1-year results of a prospective series

Purpose: To study the efficacy of photodynamic therapy (PDT) with verteporfin in the treatment of juxtafoveal choroidal neovascularization (CNV) secondary to pathologic myopia. Methods: Prospective, open label, two-centre, noncomparative, interventional case series. Consecutive patients with juxtafoveal CNV associated with pathologic myopia were recruited and treated with a standard regimen of PDT with verteporfin. Patients were being followed up every 3-monthly and retreatment was considered when there was evidence of angiographic leakage. Outcome measures included changes in the mean best-corrected visual acuity (BCVA) at the 1-year follow-up when compared with the baseline, the proportion of patients who had stable (within 1 line) and improved visions. Results: A total of 11 eyes from 11 patients with juxtafoveal CNV secondary to pathologic myopia were recruited and all completed the 1-year follow-up. The mean age at presentation was 44.8 years. The refractive error ranged from -6.0 to -15.0 D (± SD was -9.55 ± 3.04D). The logMAR BCVA improved from 0.57 to 0.39 at the 1-year follow-up (Wilcoxon signed-ranks test, P = 0.027). The mean improvement was 1.8 lines. Five eyes (45.4%) had BCVA improved by ≥3 lines. None of the treated patients had visual loss of ≥1 line. The mean number of treatments over the 12-month study period was 2.3 sessions. Conclusions: The results are encouraging, especially on considering the low retreatment rate, stable or improved BCVA in all treated eyes, and consistently good safety profile. Juxtafoveal myopic CNV may be an expanded indication for PDT with verteporfin. © 2005 Nature Publishing Group All rights reserved.link_to_subscribed_fulltex

Needling revision of glaucoma drainage device filtering blebs

Multiple letterslink_to_subscribed_fulltex

Use of atropine for prevention of childhood myopia progression in clinical practice: efficacy and safety during treatment and when tapering off medication

ARVO - The Association for Research in Vision and OphthalmologyPURPOSE: To assess the efficacy and safety of daily 0.125% topical atropine solution for the prevention myopia progression in children in the setting of a real life clinical practice. Study period was from July 1st 2011 to June 30th 2014. METHODS: This was a retrospective interventional case series. Patients aged 6-12 years old with spherical equivalent of -1.00D or more were offered treatment with daily 0.125% Atropine solution. Cyclopegic refraction was noted at baseline and then 6 monthly afterwards. If patients were shown to have slow myopic progression (less than -0.5D progression over 12 months), the frequency of application was reduced by one step (daily to alternate day to once weekly to off). In patients who were being tapered off atropine solution, those who demonstrated fast myopia progression (equal to or more than -0.25D progression over 6 months) at follow-up were resumed on their previous application frequency. The primary efficacy outcome measure was change in spherical error and primary safety outcome measure was occurrence of adverse effects or patient intolerance. For comparison between demographics and baseline data, continuous variables were evaluated with Student’s t test or Mann-Whitney U tests, while categorical variables were assessed using a chi-square or Fisher exact test. RESULTS: 27 patients with 54 eyes were treated with topical 0.125% atropine solution for at least one year during the study period. 14 of them were boys and 13 were girls. Average age upon starting treatment was 7.68 years (range 5 – 11) and the mean duration of follow-up during the study period was 19.6 months (range 12.1 – 28.9). Baseline spherical error was -4.07D (range -1.75 to -6.00) Mean myopia progression was -0.29±0.27(SD). There was no significant difference in myopia progression between genders or between age groups. There was also no significant difference in myopia progression between eyes with low baseline myopia and high baseline myopia. 10 patients were able to initiate weaning off treatment during the study period. Amongst them, only 1 patient required subsequent resumption of previous frequency due to fast disease progression on follow-up. There were no reported adverse effects related to the drug the study. CONCLUSIONS: Daily application of atropine 0.125% was well tolerated and effective in clinical practice. More than one-third of patients were able to able to begin reducing treatment frequency during the study period with only one patient having significant rebound effect

Different optineurin mutation pattern in primary open-angle glaucoma

PURPOSE. The optineurin gene (OPTN) is the second gene besides MYOC in which mutations have been identified to be associated with primary open-angle glaucoma (POAG). In this study, sequence alterations in the OPTN gene associated with POAG in Chinese subjects were investigated. METHODS. All the coding exons of OPTN were screened, including the intron-exon boundaries, for sequence alterations in a Chinese sample of 119 sporadic patients with POAG and 126 unrelated control subjects by polymerase chain reaction-conformation-sensitive gel electrophoresis and DNA sequencing. RESULTS. Sixteen sequence changes were identified: 3 had been reported (T34T, M98K, and R545Q) and 13 were novel (T49T, E103D, V148V, P199P, T202T, H486R, IVS6-5T→C, IVS6-10G→A, IVS7+24G→A, IVS8+20G→A, IVS13+21C→G, IVS15+10G→, and IVS15-48C→A). Among them, only E103D, H486R, V148V, and IVS13+21C→G were found exclusively in patients with POAG, whereas P199P, T202T, and IVS8+20G→A were present only in control subjects. The genotype of IVS7+24G→A showed a significant association with POAG (P = 0.02, Fisher two-tailed exact test) and with and increased cup-to-disc ratio in these patients (P = 0.005, Mann-Whitney test). CONCLUSIONS. The findings in the current study enrich the evidence on the OPTN gene as a causative gene for POAG and suggest a different mutation pattern of OPTN in Chinese than in whites. The wide spectrum of putative mutations detected in this study suggests that both structural and functional disruptions in OPTN may contribute to the pathogenesis of glaucoma.link_to_subscribed_fulltex