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Oral administration of caffeine metabolite 7-methylxanthine is associated with slowed myopia progression in Danish children
  1. Klaus Trier1,
  2. Dongmei Cui2,
  3. Søren Ribel-Madsen1,
  4. Jeremy Guggenheim3
  1. 1 Trier Research Laboratories, Ojenlage Klaus Trier ApS, Hellerup, Denmark
  2. 2 Shenzhen Eye Hospital, Jinan University, Guangzhou, Guangdong, China
  3. 3 School of Optometry & Vision Sciences, Cardiff University, Cardiff, UK
  1. Correspondence to Dr Klaus Trier, Trier Research Laboratories, Ojenlage Klaus Trier ApS, Hellerup, Hovedstaden, Denmark; ktrier{at}


Purpose Myopia is associated with an increased risk of permanent vision loss. The caffeine metabolite 7-methylxanthine (7-MX), licensed in Denmark since 2009 as a treatment to reduce the rate of childhood myopia progression, is the only orally administered therapy available. The purpose of the current study was to assess the rate of myopia progression in children taking 7-MX.

Methods Longitudinal cycloplegic refraction and axial length data for 711 myopic children from Denmark treated with varying doses of oral 7-MX (0–1200 mg per day) were analysed using linear mixed models.

Results The median age at baseline was 11.1 years (range 7.0 –15.0 years). Children were followed for an average of 3.6 years (range 0.9–9.1 years) and the average myopia progression was 1.34 dioptres (D) (range −6.50 to +0.75 D). Treatment with 7-MX was associated with a reduced rate of myopia progression (p<0.001) and axial elongation (p<0.002). Modelling suggested that, on average, an 11-year-old child taking 1000 mg 7-MX daily would develop −1.43 D of myopia over the next 6 years, compared with −2.27 D if untreated. Axial length in this child would increase by 0.84 mm over 6 years when taking a daily dose of 1000 mg of 7-MX, compared with 1.01 mm if untreated. No adverse effects of 7-MX therapy were reported.

Conclusions Oral intake of 7-MX was associated with reduced myopia progression and reduced axial elongation in this sample of myopic children from Denmark. Randomised controlled trials are needed to determine whether the association is causal.

  • Optics and Refraction

Data availability statement

Data included in supplementary material.

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Data availability statement

Data included in supplementary material.

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  • Contributors All authors participated in planning of the study, statistical analysis or writing of the manuscript. KT is responsible for the overall content.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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