Research progress on mechanism of atropine in controlling myopia

The prevalence of myopia and high myopia has gradually increased, increased myopia is associated with an enhanced risk of pathological ocular complications and may lead to blinding disorders.The optometrists and parents initially pay more attention to juvenile myopia prevention and control.Atropine is the previous drug used to control myopia, and the evidence-based medicine has corroborated its clinical effect.However, its mechanism has been undetermined yet.It has been reported that the effective locations of atropine in inhibiting experimental myopia may be not related to the accommodation of ciliary muscle or the ciliary muscle is not the primary target, more and more attention is currently focused on the retina and sclera.Recently, the application of the highly selective muscarinic receptor antagonists and the combination of other drugs have been found that atropine exerts its myopia-controlling effect may be linked to multiple M receptors, and with the secretion and expression of dopamine, nitric oxide (NO), early grow response (EGR)-1, the protein change of the sclera and γ-aminobutyric acid (GABA)ergic signaling pathway.This paper reviewed the atropine on controlling experimental myopia in effective locations and its relationship with the cholinergic pathway, the dopamine pathway, the GABA pathway, the secretion of NO, the expression of EGR-1, and the process of scleral remodeling, hence offers the prospects for the study of atropine in myopia control.