Topical Application of Bunazosin Hydrochloride Suppresses Myopia Progression With an Increase in Choroidal Blood Perfusion

PURPOSE. The incidence of myopia has rapidly increased in recent decades, making it a growing public health concern worldwide. Interventions to suppress the progression of myopia are needed; one suggested strategy is the prevention of choroidal thinning, which can improve choroidal blood perfusion (ChBP). Bunazosin hydrochloride (BH) is an alpha1-adrenergic blocker and commercialized glaucoma eye drop that increases in blood circulation in the eye. In this study, we evaluated the efficacy of BH in suppressing the progression of myopia in a lens-induced murine model. METHODS. Lens-induced myopia was induced in 3-week-old C57BL/6 J mice with -30 diopter (D) lenses for three weeks. Refractive error, axial length, and choroidal thickness were evaluated at three and six weeks of age using an infrared photorefractor and a spectral domain optical coherence tomography (OCT) system. Moreover, ChBP and scleral thickness were evaluated using swept-source OCT and histological analysis. RESULTS. Compared with the controls, the administration of BH eye drops suppressed the myopic shift of refractive error (mean difference +/- standard error in the eye with -30 D lens, -13.65 +/- 5.69 D vs. 2.55 +/- 4.30 D; P < 0.001), axial elongation (0.226 +/- 0.013 mm vs. 0.183 +/- 0.023 mm; P < 0.05), choroidal thinning (-2.01 +/- 1.80 mu m vs. 1.88 +/- 1.27 mu m; P < 0.001), and scleral thinning (11.41 +/- 3.91 mu m vs. 19.72 +/- 4.01 mu m; P < 0.01) with myopia progression and increased ChBP (52.0% +/- 4.1% vs. 59.5% +/- 6.3%; P < 0.05). The suppressive effect of BH eye drops was dose-dependent and higher than that of other glaucoma eye drops and alpha1 blockers. CONCLUSIONS. These results demonstrate the potential of BH eye drops in the treatment of myopia and support further investigation of their efficacy in humans. Further studies are needed to determine the mechanism of action and long-term safety of this treatment.