The Effect of Atropine on Human Global Flash mfERG Responses to Retinal Defocus

Acute Effects of Oral Caffeine Intake on Human Global-Flash mfERG Responses: A Placebo-Controlled, Double-Masked, Balanced Crossover Study

Purpose

To determine the acute effect of caffeine intake on the retinal responses as measured with a global-flash multifocal electroretinogram (gfmERG) protocol at different contrast levels.

Methods

Twenty-four young adults (age = 23.3 ± 2.4 years) participated in this placebo-controlled, double-masked, balanced crossover study. On two different days, participants orally ingested caffeine (300 mg) or placebo, and retinal responses were recorded 90 minutes later using a gfmERG at three contrast levels (95%, 50%, and 29%). The amplitude response density and peak time of the direct and induced components (direct component [DC] and induced component [IC], respectively) were extracted for five different eccentricities (1.3°, 5.0°, 9.6°, 15.2°, and 21.9°). Axial length, spherical equivalent refraction, habitual caffeine intake, and body weight were considered as continuous covariates.

Results

Increased IC amplitude response density was found after caffeine ingestion in comparison to placebo (P = 0.021, ƞp2 = 0.23), specifically for the 95% and 50% stimulus contrasts (P = 0.024 and 0.018, respectively). This effect of caffeine on IC amplitude response density was independent of the retinal eccentricity (P = 0.556). Caffeine had no effect on DC amplitude response density or DC and IC peak times.

Conclusions

Our results show that oral caffeine intake increases the inner electro-retinal activity in young adults when viewing stimuli of high- (95%) to medium-contrast (50%). Given the increasing evidence that the inner retinal function is involved in the emmetropization process, these results may suggest that caffeine or its derivatives could potentially play a role in the mechanisms involved in eye growth.

Frequency-dependent effects of 0.05% atropine eyedrops on myopia progression and peripheral defocus: a prospective study

BACKGROUND

Atropine, specifically 0.05% eyedrops, has proven effective in slowing myopia progression. This study aims to investigate peripheral refraction (PR) characteristics in myopic children treated with 0.05% atropine eyedrops at different frequencies.

METHODS

One hundred thirty-eight myopic children completed this one-year prospective study, randomly assigned to once daily (7/7), twice per week (2/7), or once per week (1/7) groups. Spherical equivalent (SE) and axial length (AL) were measured. PR was assessed using a custom-made Hartmann-Shack wavefront peripheral sensor, covering a visual field of horizontal 60° and vertical 36°. Relative peripheral refraction (RPR) was calculated by subtracting central from peripheral measurements.

RESULTS

After one year, SE increased more significantly in the 1/7 group compared to the 7/7 group (P < 0.001) and 2/7 group (P = 0.004); AL elongation was also greater in the 1/7 group compared to the 7/7 group (P < 0.001). In comparison with higher frequency groups, 1/7 group exhibited more myopic PR in the fovea and its vertical superior, inferior, and nasal retina; and less myopic RPR in the periphery retina after one-year (P < 0.05). Additionally, RPR in the 7/7 group demonstrated myopic shift across the entire retina, the 2/7 group in temporal and inferior retina, while the 1/7 group showed a hyperopic shift in the superior retina (P < 0.05). Moreover, myopic shift of RPR in the temporal retina is related to less myopia progression, notably in the 7/7 group (P < 0.05).

CONCLUSIONS

Atropine inhibits myopia progression in a frequency-dependent manner. The once-daily group showed the slowest myopia progression but exhibited more myopic shifts in RPR. Additionally, RPR in the temporal retina was related to myopia progression in all groups.

TRIAL REGISTRATION

Chinese Clinical Trial Registry, ChiCTR2100043506. Registered 21 February 2021, https://www.chictr.org.cn/showproj.html?proj=122214.

Mechanisms of emmetropization and what might go wrong in myopia

Studies in animal models and humans have shown that refractive state is optimized during postnatal development by a closed-loop negative feedback system that uses retinal image defocus as an error signal, a mechanism called emmetropization. The sensor to detect defocus and its sign resides in the retina itself. The retina and/or the retinal pigment epithelium (RPE) presumably releases biochemical messengers to change choroidal thickness and modulate the growth rates of the underlying sclera. A central question arises: if emmetropization operates as a closed-loop system, why does it not stop myopia development? Recent experiments in young human subjects have shown that (1) the emmetropic retina can perfectly distinguish between real positive defocus and simulated defocus, and trigger transient axial eye shortening or elongation, respectively. (2) Strikingly, the myopic retina has reduced ability to inhibit eye growth when positive defocus is imposed. (3) The bi-directional response of the emmetropic retina is elicited with low spatial frequency information below 8 cyc/deg, which makes it unlikely that optical higher-order aberrations play a role. (4) The retinal mechanism for the detection of the sign of defocus involves a comparison of defocus blur in the blue (S-cone) and red end of the spectrum (L + M-cones) but, again, the myopic retina is not responsive, at least not in short-term experiments. This suggests that it cannot fully trigger the inhibitory arm of the emmetropization feedback loop. As a result, with an open feedback loop, myopia development becomes "open-loop".

Contrast Sensitivity of ON and OFF Human Retinal Pathways in Myopia

The human visual cortex processes light and dark stimuli with ON and OFF pathways that are differently modulated by luminance contrast. We have previously demonstrated that ON cortical pathways have higher contrast sensitivity than OFF cortical pathways and the difference increases with luminance range (defined as the maximum minus minimum luminance in the scene). Here, we demonstrate that these ON-OFF cortical differences are already present in the human retina and that retinal responses measured with electroretinography are more affected by reductions in luminance range than cortical responses measured with electroencephalography. Moreover, we show that ON-OFF pathway differences measured with electroretinography become more pronounced in myopia, a visual disorder that elongates the eye and blurs vision at far distance. We find that, as the eye axial length increases across subjects, ON retinal pathways become less responsive, slower in response latency, less sensitive, and less effective and slower at driving pupil constriction. Based on these results, we conclude that myopia is associated with a deficit in ON pathway function that decreases the ability of the retina to process low contrast and regulate retinal illuminance in bright environments.

Dual-focus contact lenses for myopia control modify central retinal electrophysiology in humans

INTRODUCTION

Dual-focus contact lenses create two focal planes, one providing a clear retinal image while the other imposes myopic defocus on the retina to slow myopia progression. This study used global-flash multifocal electroretinogram (gmfERG) response amplitudes to compare central versus peripheral retinal responses under dual-focus conditions and to assess the optimal degree of myopic defocus compared with a single-vision control lens.

METHODS

Twenty participants each underwent three gmfERG trials, wearing a spectacle correction over dual-focus contact lenses with plano central power and peripheral secondary focal powers of either +2.00D, +4.00D or a plano single-vision lens. We compared amplitudes and latencies of the gmfERG direct and induced components (DC and IC) within participants, between the three different contact lens powers and at different retinal eccentricities (gmfERG ring).

RESULTS

We observed significant differences in the gmfERG responses between the single-vision and dual-focus contact lenses. Overall, DC amplitudes peaked between zero and +2.00D secondary power, while IC amplitudes were maximal between +2.00D and +4.00D. Compared with the single-vision control, the greatest increase in DC and IC amplitudes while wearing dual-focus lenses occurred within the central 10° of the retina. There was no interaction effect between gmfERG ring (eccentricity) and secondary power, and no difference in the latency of the gmfERG responses between different powers.

CONCLUSION

We found that dual-focus contact lenses with a +2.00D secondary power are close to that expected to induce the greatest increase in gmfERG responses relative to a single-vision lens. Dual-focus lenses produced the highest DC and IC response amplitudes relative to a single-vision lens in the central 10° of the retina. This suggests that dual-focus contact lenses slow myopia progression by modifying central rather than peripheral retinal activity.

Association between relative peripheral refraction and corresponding electro-retinal signals

PURPOSE

Considering the potential role of the peripheral retina in refractive development and given that peripheral refraction varies significantly with increasing eccentricity from the fovea, we investigated the association between relative peripheral refraction (RPR) and corresponding relative peripheral multifocal electroretinogram (mfERG) responses (electro-retinal signals) from the central to the peripheral retina in young adults.

METHODS

Central and peripheral refraction using an open-field autorefractor and mfERG responses using an electrophysiology stimulator were recorded from the right eyes of 17 non-myopes and 24 myopes aged 20-27 years. The relative mfERG N1, P1 and N2 components (amplitude density and implicit time) of a mfERG waveform were compared with the corresponding RPR measurements at the best-matched eccentricities along the principal meridians, that is at the fovea (0°), horizontal (±5°, ±10° and ± 25°) and vertical meridians (±10° and ± 15°).

RESULTS

The mean absolute mfERG N1, P1 and N2 amplitude densities (nV/deg² ) were maximum at the fovea in both non-myopes (N1: 57.29 ± 14.70 nV/deg² , P1: 106.29 ± 24.46 nV/deg² , N2: 116.41 ± 27.96 nV/deg² ) and myopes (N1: 56.25 ± 15.79 nV/deg² , P1: 100.79 ± 30.81 nV/deg² , N2: 105.75 ± 37.91 nV/deg² ), which significantly reduced with increasing retinal eccentricity (p < 0.01). No significant association was reported between the RPR and corresponding relative mfERG amplitudes at each retinal eccentricity (overall Pearson's correlation, r = -0.25 to 0.26, p ≥ 0.09). In addition, the presence of relative peripheral myopia or hyperopia at extreme peripheral retinal eccentricities did not differentially influence the corresponding relative peripheral mfERG amplitudes (p ≥ 0.24).

CONCLUSIONS

Relative peripheral mfERG signals are not associated with corresponding RPR in young adults. It is plausible that the electro-retinal signals may respond to the presence of absolute hyperopia (and not relative peripheral hyperopia), which requires further investigation.

Topical Review: Optometry in Nepal-Clinical Practice, Research Advances, and Challenges

SIGNIFICANCE

This article reviews educational standard, clinical practice, research advances, and challenges associated with optometry in Nepal and provides critical considerations for contemporary and new optometry programs in countries with similar socioeconomic status and health care systems.Optometry education started in Nepal in 1998 with the primary objective of addressing the unmet needs of eye health and vision care in the country. Over the last two decades, this program has made significant contributions to facilitating and improving the delivery of quality eye care and establishing the nation's eye health system as an exemplary model in South Asia. Despite the positive impact in a short time, optometry education and the profession continue to face several challenges, including a shortage of training resources and facilities, poor quality control and regulation of practice standards, lack of professional recognition, limited pathways for entry to governmental jobs via the national public service commission, and limited clinical and academic opportunities in existing eye care programs. This article reviews current education and clinical practice standards, highlights research advances, and discusses present and future challenges in sustaining and improving the quality of education and advancing the scope of practice of optometry in Nepal. Given the limited access to primary eye care services in Nepal, appropriate professional recognition and integration into the national health system, and initiatives targeted at improving the delivery of optometry education in alignment with successful international models may provide a long-sought solution to making eye care services accessible to all and lowering the burden of visual impairment in the country.

Electroretinogram responses in myopia: a review

The stretching of a myopic eye is associated with several structural and functional changes in the retina and posterior segment of the eye. Recent research highlights the role of retinal signaling in ocular growth. Evidence from studies conducted on animal models and humans suggests that visual mechanisms regulating refractive development are primarily localized at the retina and that the visual signals from the retinal periphery are also critical for visually guided eye growth. Therefore, it is important to study the structural and functional changes in the retina in relation to refractive errors. This review will specifically focus on electroretinogram (ERG) changes in myopia and their implications in understanding the nature of retinal functioning in myopic eyes. Based on the available literature, we will discuss the fundamentals of retinal neurophysiology in the regulation of vision-dependent ocular growth, findings from various studies that investigated global and localized retinal functions in myopia using various types of ERGs.

Short-term delay in neural response with multifocal contact lens might start at the retinal level

INTRODUCTION

Multifocal simultaneous imaging challenges the visual system to process the multiple overlaps of focused and defocused images. Retinal image processing may be an important step in neuroadaptation to multifocal optical images. Our aims are, firstly to evaluate the short-term effect of different multifocal contact lenses (MF) on retinal activity in young healthy subjects (Experiment#1) and secondly, to evaluate any changes in retinal activity in presbyopic patients fitted with MF over a 15-day period (Experiment#2).

METHODS

In Experiment-#1, 10 emmetropic healthy young subjects were included to evaluate the short-term effect of different MFs designs. In Experiment #2, 4 presbyopic subjects were included to wear MF for 15 days. Following the ISCEV Standards, multifocal electroretinograms (mfERGs) were recorded to evaluate different retinal regions under different conditions: with single vision contact lens (SVCL) and with center-distance and center-near MF.

RESULTS

In Exp#1 the peak time of N1, P1 and N2 were found to be delayed with the MF (p ≤ 0.040). There was a significant reduction for N1 amplitude in all retinal regions (p < 0.001), while for P1 and N2 amplitudes this reduction was more significant in the peripheral regions (p < 0.005, ring 5 to 6). With center-near MF the mean response density (nV/deg²) showed a significant decrease in all wave components of the mfERGs response, particularly from Ring 3 to Ring 6 (p < 0.001, all Rings). In Exp#2, the mean mfERG response is similar between SVCL and center-distance MF, while center-near MF showed an increase in implicit time N1 and P1 on day 1 that tends to recover to baseline values after 15 days of MF wear.

CONCLUSIONS

significant changes in the mfERGs responses were found with the MF lens, being most noticeable with the center-near MF lens design. The present results suggest that the observed delay in cortical response described during the adaptation to multifocality may partially begin at the retina level.

Short-Term Effects of Atropine 0.01% on the Structure and Vasculature of the Choroid and Retina in Myopic Chinese Children

Introduction

To explore the short-term effects of atropine 0.01% on the structure and vasculature of the choroid and retina in myopic Chinese children.

Methods

This study was a single-center randomized clinical trial. A total of 40 subjects with myopia < − 6.0 D were enrolled and randomized to receive atropine 0.01% once nightly with regular single-vision lenses or to simply wear regular single-vision lenses at an allocation ratio of 1:1. Follow-up visits were planned at 1 month and 3 months. Choroidal thickness (ChT) was obtained by optical coherence tomography (OCT). Retinal vessel density (RVD), retinal thickness (RT), foveal avascular zone (FAZ) and choriocapillaris flow (CCF) were measured by optical coherence tomography angiography (OCTA). The RVD and RT were measured at fovea, parafovea and perifovea area and four quadrants.

Results

Twenty-one subjects were allocated into the atropine group and 19 subjects into the control group. Over 3 months, the control group showed greater progression of myopia than those in the atropine group. ChT in the atropine group increased 11.12 ± 13.96 μm, which was not significant compared with that of the control group. None of the retinal sectors in atropine-treated eyes showed significant changes of RT and RVD compared with the control group. Besides, FAZ and CCF of the atropine group were not affected by atropine use over time, and there was no difference between the two groups.

Conclusion

Administration of atropine 0.01% eye drops demonstrated no effect on RVD, FAZ and CCF over 3 months, while a modest increase of ChT was observed in atropine-treated eyes.

Trial Registration Number

ChiCTR1800017154.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40123-022-00476-0.

Atropine Affects the Outer Retina During Inhibiting Form Deprivation Myopia in Guinea Pigs

PURPOSE

Atropine has been proven to be effective in retarding myopia progression. However, the underlying mechanism remains unknown. Our purpose was to detect morphological and functional changes caused by atropine during myopic inhibition.

METHOD

Twenty 2-week-old guinea pigs were randomly assigned to either the saline group (n = 10) or the atropine group (n = 10). Form-deprived myopia (FDM) and intravitreal injections were applied on the right eyes. The injections were given every 3 days, lasting for 2 weeks. The left eyes served as control. Ocular refraction, axial length, retinal, and choroidal thickness were collected at the start and the end of the experiment. Retinal function was evaluated via full-field electroretinogram (ERG) at the end of treatment.

RESULTS

The interocular differences (experimental eye minus control eye) of refraction error (RE), vitreous chamber depth (VCD), and axial length (AL) in the saline group were significantly greater than those in the atropine group (RE, VCD: P < .001, AL: P < .0001). The differences in choroidal thickness between the two groups did not reach statistical significance. However, a decreasing trend of choroidal thickness was observed in the saline group but not in the atropine group. Furthermore, the interocular differences of total retinal and outer retinal thickness in the atropine group were much thicker than in the saline group (P < .001 and P < .01, respectively). The treatment did not affect inner retinal thickness. In photopic ERG, the atropine-treated FDM eyes showed significantly greater a-wave amplitudes compared to the saline group.

CONCLUSION

During the process of inhibiting FDM, atropine showed an effect on the outer retina, most likely on the cones, in guinea pigs.

The Effect of Low-Dose Atropine on Alpha Ganglion Cell Signaling in the Mouse Retina

Low-dose atropine helps to control myopia progression with few side effects. However, the impact of atropine, a non-selective muscarinic Acetylcholine (ACh) receptor antagonist, on retinal ganglion cells (RGCs) remains unclear. After immersing the cornea and adjacent conjunctiva of enucleated eyes in 0.05% (approximately 800 μM) atropine solution for 30 min, the atropine concentration reached in the retina was below 2 μM. After direct superfusion of the retina with 1 μM atropine (considering that the clinical application of 0.05% atropine eye drops will be diluted over time due to tear flow for 30 min), no noticeable changes in the morphology of ON and OFF alpha RGCs (αRGCs) were observed. Atropine affected the light-evoked responses of ON and OFF αRGCs in a dose- and time-dependent fashion. Direct application of less than 100 μM atropine on the retina did not affect light-evoked responses. The time latency of light-induced responses of ON or OFF αRGCs did not change after the application of 0.05–100 μM atropine for 5 min. However, 50 μM atropine extended the threshold of joint inter-spike interval (ISI) distribution of the RGCs. These results indicated that low-dose atropine (<0.5 μM; equal to 1% atropine topical application) did not interfere with spike frequency, the pattern of synchronized firing between OFF αRGCs, or the threshold of joint ISI distribution of αRGCs. The application of atropine unmasked inhibition to induce ON responses from certain OFF RGCs, possibly via the GABAergic pathway, potentially affecting visual information processing.

IMI 2021 Yearly Digest

Purpose

The International Myopia Institute (IMI) Yearly Digest highlights new research considered to be of importance since the publication of the first series of IMI white papers.

Methods

A literature search was conducted for articles on myopia between 2019 and mid-2020 to inform definitions and classifications, experimental models, genetics, interventions, clinical trials, and clinical management. Conference abstracts from key meetings in the same period were also considered.

Results

One thousand articles on myopia have been published between 2019 and mid-2020. Key advances include the use of the definition of premyopia in studies currently under way to test interventions in myopia, new definitions in the field of pathologic myopia, the role of new pharmacologic treatments in experimental models such as intraocular pressure-lowering latanoprost, a large meta-analysis of refractive error identifying 336 new genetic loci, new clinical interventions such as the defocus incorporated multisegment spectacles and combination therapy with low-dose atropine and orthokeratology (OK), normative standards in refractive error, the ethical dilemma of a placebo control group when myopia control treatments are established, reporting the physical metric of myopia reduction versus a percentage reduction, comparison of the risk of pediatric OK wear with risk of vision impairment in myopia, the justification of preventing myopic and axial length increase versus quality of life, and future vision loss.

Conclusions

Large amounts of research in myopia have been published since the IMI 2019 white papers were released. The yearly digest serves to highlight the latest research and advances in myopia.

The Effects of 0.01% Atropine on Adult Myopes' Contrast Sensitivity

PURPOSE

Atropine at a low concentration is considered a safe and effective treatment to mitigate myopia progression. However, the potential unwanted side effects of administering atropine at a low dose on visual functions other than best corrected visual acuity has not been investigated. In this study, we investigate the short-term (12,16, and 20 h) and long-term (1, 2, and 4 weeks) effects of 0.01% atropine (i.e., 0.1 mg/ml) on contrast sensitivity (CS) in patients with myopia.

METHODS

Thirty adults (23.33 ± 2.93 years old) with myopia between -1.00 and -6.00 diopters (D), astigmatism of -1.50 D or less, and anisometropia of 1.00 D or less, participated in this prospective, masked, placebo-controlled, randomized study. The participants were randomly assigned to receive 0.01% atropine or polyvinyl alcohol eye drops once nightly to both eyes for four weeks. CS was measured binocularly at baseline and 12, 16, 20 h, 1, 2, and 4 weeks after the first use of the eye drops.

RESULTS

There was no statistically significant differences of CS found between atropine and placebo-controlled groups in both short-term and long-term. There was no statistically significant interaction effect found between the time and group.

CONCLUSION

We demonstrated no significant deleterious effect of 0.01% atropine on adult myopes' CS.

The acute effect of atropine eye drops on the human full-field electroretinogram

PURPOSE

Atropine eye drops are a common and effective treatment for slowing myopia progression, but the site and mode of action of atropine in controlling myopia are unclear. We investigated the early retinal sites of action of atropine by examining its effects on the human full-field electroretinogram (ffERG).

METHOD

Baseline ffERGs were recorded in both eyes of 24 healthy subjects (mean ± SD: 21.0 ± 2.3 years; spherical equivalent refraction, range: + 1.63 to - 0.75 D) using 6 standard ISCEV protocols, 30 min after bilateral pupil dilation with 1% Tropicamide. Atropine (1 drop, 0.1%) was then instilled into the non-dominant eye. 24 h later, ffERGs were again recorded in both eyes. Ratios (post-atropine: pre-atropine) of dark-adapted (DA) and light-adapted (LA) ffERGs were compared between atropine-treated and control eyes using multivariate repeated measures general linear models.

RESULTS

Atropine-treated eyes responded with 14% lower DA3.0 OP (oscillatory potential) amplitude (p = 0.003) and 4% delay in the DA10.0 a-wave peak time (p = 0.00099) compared with control eyes. Amplitudes and peak times were not different between atropine-treated and control eyes for DA0.01, LA3.0, and LA3.0 flicker ERGs. While atropine caused a small (1.26 mm², p = 0.03) extra increase in pupil area in the treated eye, atropine-induced changes in ffERG responses bore no relationship with changes in pupil area (R²= 2-5%, p > 0.05).

CONCLUSIONS

The observed changes in oscillatory potentials corroborate previous findings that atropine affects neural activity in the inner retina. However, observed changes to the a-wave suggest that atropine also affects activity in photoreceptors.

The effect of simultaneous dual-focus integration on the global flash multifocal electroretinogram in the human eye

PURPOSE

To investigate the effect of simultaneous dual-focus (DF) on retinal activities measured by global flash multifocal electroretinogram (mfERG).

METHODS

Thirty adults were recruited for mfERG measurement under three conditions: in-focus (i.e., no defocus), +2.50 D DF and +7.50 D DF, administered using single vision contact lenses and DF lenses. The direct component (DC) and the induced component (IC) of the mfERG were pooled into central macular (0-8°), para-macular (8-18°) and peri-macular (18-30°) regions, and then compared across the three conditions using two-way, repeated measures ANOVA.

RESULTS

Simultaneous DF had a significant effect on the IC amplitude, which was significantly stronger under +7.50 D DF (p < 0.01) than for the in-focus condition, which was mostly derived from the central and para-macular regions. No significant effect was observed for the +2.50 D DF condition.

CONCLUSION

Under the effect of relatively strong simultaneous DF integration, the retina showed an enhanced retinal response, which originated from the inner retina. Compared with the peri-macular region, central and para-macular responses appeared to be enhanced.

Probing the Potency of Artificial Dynamic ON or OFF Stimuli to Inhibit Myopia Development

Purpose

To determine whether equiluminant artificial dynamic ON or OFF stimuli on a computer screen can induce bidirectional changes in choroidal thickness (ChTh) in both humans and chickens, and whether such changes are associated with bidirectional changes in retinal dopamine release in chickens.

Methods

Experiment 1: Before and after ON or OFF stimulation for 1 hour, ChTh was measured with optical coherence tomography (OCT). Experiment 2: chicks (n = 14) were raised under ON or OFF stimulation for 3 hours. ChTh was determined by OCT. Experiment 3: chicks were raised for 7 days either under room light (500 lux, n = 11), dynamic ON stimulus (700 lux, n = 15), or dynamic OFF stimulus (700 lux, n = 7). In addition, negative lenses were attached to their right eyes. After experiments 2 and 3, retinal and vitreal dopamine (DA), and its metabolites, were measured by HPLC-electrochemical detection.

Results

Experiment 1: Dynamic ON stimuli caused thicker choroids (+5.3 ± 2.0 μm), whereas OFF stimuli caused choroidal thinning (-4.7 ± 0.5 μm) (right eye data only, P < 0.001). Experiment 2: After 3 hours, chickens developed thicker choroids with ON stimuli (+37.4 ± 12.4 μm) and thinner choroids with OFF stimuli (-11.3 ± 3.6 μm, difference P < 0.01). Vitreal DA, 3-methoxytyramine, and homovanillic acid levels were elevated after ON stimulation, compared with the OFF (P < 0.05). Experiment 3: After 7 days, chickens with lenses developed more myopia both with ON and OFF stimulation, compared with room light. ON stimulation increased vitreal DA compared with OFF.

Conclusions

Artificial dynamic ON or OFF stimuli had similar effects on ChTh in humans and chickens, but more work will be necessary to determine whether such stimuli can be used as novel interventions of myopia.

Short-Term Effect of Low-Dose Atropine and Hyperopic Defocus on Choroidal Thickness and Axial Length in Young Myopic Adults

Purpose

To examine the interaction between a short period of hyperopic defocus and low-dose atropine upon the choroidal thickness and ocular biometrics of healthy myopic subjects.

Methods

Twenty young adult myopic subjects had subfoveal choroidal thickness (ChT) and ocular biometry measurements taken before and 30 and 60 min following the introduction of optical blur (0.00 D and −3.00 D) combined with administration of 0.01% atropine or placebo. Each combination of optical blur and drug was tested on different days in a fixed order.

Results

The choroid exhibited significant thinning after imposing hyperopic defocus combined with placebo (mean change of −11 ± 2 μm, p < 0.001). The combination of hyperopic blur and 0.01% atropine led to a significantly smaller magnitude of subfoveal choroidal thinning (−4 ± 8 μm), compared to placebo and hyperopic defocus (p < 0.01). Eyes treated with 0.01% atropine with no defocus exhibited a significant increase in ChT (+6 ± 2 μm, p < 0.01). Axial length also underwent small but significant changes after treatment with hyperopic blur and placebo and 0.01% atropine alone (both p < 0.01), but of opposite direction to the changes in choroidal thickness. However, the 0.01% atropine/hyperopic blur condition did not lead to a significant change in axial length compared to baseline (p > 0.05).

Conclusion

Low-dose atropine does inhibit the short-term effect of hyperopic blur on choroidal thickness and, when used alone, does cause a slight thickening of the choroid in young healthy myopic adults.