Caffeine Metabolite Slows Progress of Myopia in Children

Myopia can increase the risk of vision loss, and the condition been on the rise in the children over the past few years, exacerbated by increased screen use during the pandemic. However, caffeine metabolite 7-methylxanthine may be used to slow down the rate of myopia progression. A study in British Journal of Ophthalmology examined the progression of myopia in a cohort of children taking this treatment.

Researchers used all longitudinal data from children with myopia who were seen at an ophthalmology unit in Denmark from June 2000 to January 2021 (n=711). For the majority of children, the measurement of axial length and cycloplegic refraction were done as part of routine ophthalmologic care.

Within the study cohort, 87 children were not taking 7-methylxanthine, while614 children were.. Over the course of the study, participants were encouraged to return for measurements with no more than 1 year between visits. Most participants had over 700 days of follow-up, with 11 aging out of the age requirements; 23 having a last appointment less than a year before the data cutoff; and 97 choosing to discontinue study participation.

Median participant age was 11.1 years. Participants received follow-up care for 3.6 years;over the course of this care, the progression of myopia was 1.34 diopters (D) (range, −6.50 to +0.75 D). Treatment with 7-methylxanthin was linked to both a reduced rate of axial elongation (p<0.002) and myopia progression (p<0.001).Results of a model created by researchers suggested that a child aged 11 years who took 1000 mg of 7-methylxanthin would develop −1.43 D of myopia over 6 years. In contrast, a child who received no treatment would see a progression of −2.27 D during the same 6-year period. The model also predicted that axial length would increase by 0.84 mm in a child receiving treatment over 6 years, whereas it would be 1.01 mm in a child who was untreated. Participants reported no adverse events from the 7-methylxanthine treatment.

Further study—in particular, randomized controlled trials—were recommended to determine whether the link between 7-methylxanthine treatment and reduction in myopia progression was causal.

Reference

1. Trier K, Cui D, Ribel-Madsen S, Guggenheim J. Oral administration of caffeine metabolite 7-methylxanthine is associated with slowed myopia progression in Danish children. Br J Ophthalmol. Published online August 22, 2022 doi: 10.1136/bjo-2021-320920. Online ahead of print.