Control of refractive error through ionically driven fluid movements

近视影响着世界上大约一半的人口，最近的研究表明，近视在一些亚洲学童中呈流行病的比例，尽管我们在澳大利亚没有看到这种情况。与低度和高度近视的检测、监测和光学矫正相关的成本是巨大的。高度近视（6D的15%）在30至50岁之间由于与液体平衡受损相关的继发性疾病（视网膜和脉络膜水肿，黄斑水肿，视网膜脱离和青光眼）而失明的风险也大大增加。虽然我们在鸡身上的研究为潜在的治疗和专利提供了理论依据和实验数据，但目前还没有公认的近视药物治疗方法。该专利现在处于PCT阶段，并且证明视网膜下空间的离子丰度的变化控制穿过视网膜到脉络膜的流体运动，并且可以通过利尿剂进行治疗性调节以控制流体流动，从而控制轴向生长和近视。本申请旨在在猴临床前试验之前，将我们目前关于近视鸡液体控制的知识应用于哺乳动物模型。我们预计将需要1年的时间来建立利尿剂控制实验诱导的豚鼠近视屈光不正的可行性，以及最佳药物和最佳剂量范围。这些研究将有助于科学的理解，并使成人和儿童近视的拟议药物治疗达到完全商业化的程度。我们相信，在鸡身上发现的结果对人类早发性和迟发性近视具有重要意义，因为在整个生命过程中，眼睛生长调节的机制很可能是相同的。

Myopia affects about half the world's population with recent studies suggesting epidemic proportions among some Asian schoolchildren though we are not seeing this in Australia. Costs associated with detection, monitoring and optical correction of low and high myopia are huge. High myopes (15% with > 6D) also have a greatly increased risk of blindness between the ages of 30 and 50 years due to secondary disorders associated with impaired fluid balance (retinal and choroidal oedema, macula oedema, retinal detachment and glaucoma). Currently there is no accepted pharmaceutical treatment for myopia though our studies in chick have provided the theoretical rationale and experimental data for a potential therapy and patent. This patent is now at the PCT stage and attests that changes in the abundance of the ions of the subretinal space control fluid movements across the retina to choroid and can be modulated therapeutically by diuretics to control fluid flow and hence axial growth and myopia. This application aims to take our current knowledge about fluid control in myopic chick into a mammalian model prior to preclinical trials in monkey. We anticipate it will take 1 year to establish the feasibility of diuretic control of experimentally induced myopic refractive errors in guinea pigs and the best drug and best the dosage range. These studies will contribute to the scientific understanding and bring the proposed pharmaceutical therapy for myopia in adults and children to a point of full commercialization. We believe that the results found in chick will have significance for early and late-onset myopia in humans as it is highly likely that the same mechanisms of ocular growth regulation operate throughout life.