Presbyopia: a New Potential Pharmacological Treatment

Presbyopia occurs after 40 years of age in humans with a progressive loss of accommodation. Accommodation depends on the contraction of the ciliary muscle and iris, lens changes and convergence. The parasympathetic system regulates the degree of ciliary muscle and iris contraction necessary to modify the shape and position of the lens and its stimulation is effective through the activation of muscarinic receptors that are present in both structures. The hypothesis proposed here suggests the correction of accommodation in emmetropic presbyopic patients using a pharmacological treatment that includes a cholinergic agent combined with non-steroidal anti-inflammatory drugs (NSAIDs). This drug combination can restore near vision without affecting distance vision. It is important to note that the pharmaceutical form used was devoid of any inflammatory or other collateral effects.

[1]  J. Sivak,et al.  Age-Related Changes in Human Ciliary Muscle , 2000, Optometry and vision science : official publication of the American Academy of Optometry.

[2]  T. Wheeler,et al.  Side Effects and Ways to Avoid Them , 1982 .

[3]  T. Wheeler,et al.  Miotics: side effects and ways to avoid them. , 1982, Ophthalmology.

[4]  S. Mathews,et al.  Scleral expansion surgery does not restore accommodation in human presbyopia. , 1999, Ophthalmology.

[5]  R. Schalnus Topical Nonsteroidal Anti-Inflammatory Therapy in Ophthalmology , 2003, Ophthalmologica.

[6]  Lisa A. Ostrin,et al.  Effects of pharmacologically manipulated amplitude and starting point on edinger-westphal-stimulated accommodative dynamics in rhesus monkeys. , 2007, Investigative ophthalmology & visual science.

[7]  D. Jabs Treatment of ocular inflammation , 2004, Ocular immunology and inflammation.

[8]  Lisa A. Ostrin,et al.  Comparisons between pharmacologically and Edinger-Westphal-stimulated accommodation in rhesus monkeys. , 2005, Investigative ophthalmology & visual science.

[9]  P. Kaufman,et al.  Accommodation and presbyopia. , 2001, International ophthalmology clinics.

[10]  A. Glasser Accommodation: mechanism and measurement. , 2006, Ophthalmology clinics of North America.

[11]  P. Bhat,et al.  Nonsteroidal Anti-inflammatory Therapy and Recurrent Acute Anterior Uveitis , 2010, Ocular immunology and inflammation.

[12]  P. Kaufman,et al.  Accommodation and ciliary muscle muscarinic receptors after echothiophate. , 1991, Investigative ophthalmology & visual science.

[13]  Wolfgang Drexler,et al.  Comparison of pilocarpine-induced and stimulus-driven accommodation in phakic eyes. , 2005, Experimental eye research.

[14]  A. Glasser,et al.  Topical and intravenous pilocarpine stimulated accommodation in anesthetized rhesus monkeys. , 2010, Experimental eye research.

[15]  Aart C Kooijman,et al.  Polymer refilling of presbyopic human lenses in vitro restores the ability to undergo accommodative changes. , 2003, Investigative ophthalmology & visual science.

[16]  L. Garner,et al.  Changes in ocular dimensions and refraction with accommodation. , 1997, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.