Alert to new myopia controls

A Danish ophthalmologist believes that, with so few options available to address the global myopia epidemic, the time has come to approve a caffeine metabolite that has shown promising results in trials.

Trier Research Laboratories myopia researcher, Dr Klaus Trier, has studied the compound 7-methylxanthine (7-MX) for close to two decades.

The body creates 7-MX when a person consumes caffeine or chocolate, but unlike the former, it cannot enter the brain. Therefore, it does not leave a person jittery and unable to sleep, Dr Trier highlighted.

He told OT that more than 800 children and adolescents have been taking the compound for a period of up to eight years. Over a one-year period, 400mg 7-MX pills taken twice a day reduced myopia progression by 44% compared to a control group.

Dr Trier explained that: “We also found that the myopia progression rate is significantly correlated with compliance. Thus, with full compliance, the myopia progression rate is reduced by around 50%.”

He added: “I think the relevant authorities should review the available data on safety and efficacy and allow 7-MX for myopia control. I am aware that the results we have found in Denmark need to be confirmed, and hopefully clinical trials will be initiated elsewhere.

“However, I see no reason why anyone outside Denmark who wishes to take 7-MX should not be allowed to do so already now, especially since few other treatment options exists,” he said.

Dr Trier pointed out that caffeine and its related compounds have been extensively studied and no long-term adverse effects have been found.

“Being a metabolite of caffeine and theobromine, which are present in substantial quantities in coffee and cacao, 7-MX has a history of human use dating back several thousand years and is consumed on a daily basis by billions of people,” he highlighted.

Analysing dark chocolate, Dr Trier found 7mg of 7-MX in a 50g serving, though the liver converts the chocolate’s caffeine and theobromide to 7-MX as well.

His studies have confirmed that 7-MX is most effective for low myopes, which led him to conclude that: “The treatment should be initiated as early as possible, before the myopia has reached a high degree.”

An Indian pharmaceutical company currently produces tablets of 7-MX, but the treatment is only available in Denmark, he said.

Dr Trier emphasised that: “More parents of myopic children should be made aware of this treatment option. Even in the greater Copenhagen area where this treatment option has existed for more than seven years, only a fraction of those children and adolescents who would benefit from the treatment actually take it.”

He hypothesised that the therapy could be used in combination with other myopia prevention treatments, such as ortho-k or dual-focus contact lenses, especially if they delayed the progression of the disease in different ways.

“Based on the available results, it is conceivable that if all children with low myopia start taking 7-MX, very few of them by the age of 18 years will have progressed to high myopia, defined as five dioptres or more. This would, later on, have a significant impact on the incidence of retinal detachments and other complications of high myopia,” he said.

Dr Trier also spoke of his work on 7-MX during the Joint World Health Organization-Brien Holden Vision Institute Global Scientific Meeting on Myopia.

Studies have shown that 7-MX binds to the adenosine receptors in the brain, Dr Trier explained, adding: “This is interesting, because there is a large body of evidence suggesting that dopamine is involved in the control of eye growth and myopia progression.

“It furthermore relates to the research showing that exposure to daylight may prevent myopia, because dopamine is liberated during light exposure, whereas adenosine accumulates during darkness,” he said.

Image credit: Ruben Alexander