Af Kristine Bindslev
Den danske øjenlæge Klaus Triers har gjort en banebrydende opdagelse. Gennem studier i 20 år har han fundet frem til, at et stof, 7-methylxanthin, udvundet af kakao, kan nedsætte børns nærsynethed. En god nyhed for de ti procent af danske børn, som har den lidelse.
Halvdelen af børnene fik i et forsøg, ledet af den danske øjenlæge Klaus Trier, stabiliseret deres nærsynethed med kakaopiller. Efter et års behandling er det lykkedes helt at standse øgningen hos halvdelen af de børn, som har været med i forsøget. For den anden halvdel reduceredes væksten af nærsynethed med 50 procent i forhold til, hvordan den ellers ville have været.
Hvordan virker 7-methylxanthin
Stoffet fra kakaoen, 7-methylxanthin, går ind og påvirker øjets collagenniveau, som sørger for, at det hvide i øjet ikke bliver så blødt, at øjet bliver aflangt og dermed nærsynet.
Studiet
En 36 måneders undersøgelse fuldført af 61 nærsynede børn (gennemsnitlig alder 11 år) har nu vist, at behandling med 7-methylxanthin i tabletform faktisk reducerer øjets længdevækst med gennemsnitligt ca. 50 % over 24 måneder. Så længe behandlingen fortsættes, falder øjets væksthastighed, og væksten af nærsynetheden aftager, men når behandlingen afbrydes, bortfalder effekten.
Efter et års behandling af 10-13-årige nærsynede børn var øgningen af nærsynetheden standset hos 47 % af de børn, som fik tabletter med 7-methylxanthin, mens det kun var tilfældet hos 17 % af dem, som fik kalktabletter. Tilsvarende var øjets længdevækst blevet normalt hos 44 % af de børn, som fik tabletter med 7-methylxanthin, mens det kun var tilfældet hos 14 % af de børn, som fik kalktabletter. Disse resultater blev opnået med en dosis på én tablet á 400 mg dagligt. Foreløbige resultater tyder på, at dosering med én tablet to gange dagligt virker betydeligt bedre.
Der har ikke vist sig nogen bivirkninger af behandlingen.
Sæt ind i barndommen
Hvorfor netop forsøge at forebygge? Jo, er skaden sket, er løbet så at sige kørt: Et øje, som er blevet aflangt og nærsynet, kan ikke reddes, så det gælder om at komme i gang med kakao-behandlingen så tidligt som muligt. Det skyldes, at bindevævet i nærsynede børns øjne skal have hjælp, indtil børnene er fuldt udvoksede, derefter sker der en krydsbinding med kroppens andre bindevæv og sener, og så kan øjet klare sig selv, idet nærsynethed stopper ved 20-årsalderen.
Flere forsøg
Et forsøg foretaget i samarbejde med kinesiske forskere har desuden vist, at det var muligt helt at forebygge nærsynethed hos marsvin ved at give dem kakaostoffet, inden de ellers ville have udviklet nærsynethed.
Belladonna giver flere bivirkninger end forbedringer
Blandt de metoder, som også ser ud til at have effekt, er daglig drypning med atropin (belladonna), som har fundet betydelig udbredelse i for eksempel Taiwan, hvor omkring 25 % af alle nærsynede børn anvender behandlingen. I den vestlige verden bruges metoden stort set ikke, da bivirkningerne er betydelige. Dråberne udvider pupillerne og forårsager derfor lysskyhed. Desuden lammes fokuseringsmusklen i øjet, hvilket gør det nødvendigt at bruge læsebrille. Det er også muligt, at langvarig drypning med atropin medfører mere permanente bivirkninger – også efter at behandlingen ar afsluttet.
Kakao udgør ingen fare
7-methylxanthin indtages i tabletform, hvilket for det første er nemmere end at skulle dryppe øjnene. Dertil kommer, at effekten på udviklingen af nærsynetheden ser ud til at være på højde med eller bedre end den, der opnås med atropin øjendråber. Vigtigst er dog nok, at der har ikke vist sig bivirkninger af behandlingen. ”Det er betryggende, at 7-methylxanthin findes i almindelige fødemidler som kaffe og kakao. Omfattende undersøgelser har vist, at regelmæssig indtagelse af disse fødevarer ikke udgør nogen fare for helbredet, hvilket gør det usandsynligt, at selv langvarig behandling med 7-methylxanthin skulle udgøre nogen risiko”, siger Klaus Trier.
Han fortæller ligeledes, hvordan han for et år siden præsenterede sine foreløbige data vedrørende behandling af nærsynede børn med kakaostoffet 7-methylxanthin ved en konference om nærsynethed på universitetet i Berkeley. Siden har der været stigende interesse og en del henvendelser fra anerkendte forskere i forskellige lande. Ved den amerikanske øjenforskningsforening ARVO’s årlige møde i foråret 2014 fremlagde en forskergruppe fra Berkeley resultater, som tyder på, at 7-methylxanthin bremser eksperimentelt udløst nærsynethed hos kyllinger. ”Der vil naturligvis altid være en vis naturlig skepsis overfor sådanne positive behandlingsdata, og man kan ikke forvente fuld opbakning, før resultaterne er bekræftet gennem yderligere afprøvninger af behandlingen andre steder”, siger Klaus Trier.
Hellere forebygge end behandle
Klaus Trier forklarer, hvorfor det er vigtigt at forebygge frem for at behandle. ”Nærsynethed er globalt set et stigende problem og blandt de førende årsager til blindhed i mange lande, især i Østasien. Korrektion af nærsynethed med briller, kontaktlinser, eller laserkirurgi reducerer ikke den øgede risiko for blindhed, som skyldes, at nethinden bliver mekanisk belastet i det alt for lange nærsynede øje. Det vil derfor være bedre at forebygge, at øjet vokser sig for langt”, siger Klaus Trier.
Som man vil kunne læse på Klaus Triers hjemmeside, er nærsynethed, udover at være et besværligt handikap, som kræver optisk korrektion, også forbundet med forhøjet risiko for synstruende øjenlidelser som nethindeløsning, AMD (nethindeforkalkning) og grøn stær. På grund af disse komplikationer er nærsynethed blandt de væsentligste årsager til blindhed. Ud af de ca. 600 tilfælde af nethindeløsning, som hvert år forekommer i Danmark, ville skønsmæssigt 300 kunne forhindres, hvis nærsynethed over -3 dioptrier kunne forebygges. Også et stort antal tilfælde af AMD og grøn stær ville kunne forebygges.
Få tilskud til at bremse dit barns nærsynethed
7-methylxanthin findes i kakaobønner og kaffe. Som lægemiddel er kakaotabletterne recept-pligtige. Tabletterne med 7-methylxanthin produceres af Glostrup Apotek og fås på recept. Øjenlægen kan søge 60-85 % sygesikringstilskud hos Lægemiddelstyrelsen. For at bedømme effekten af behandlingen er det hensigtsmæssigt, at der foretages udmåling af øjets længde og graden af nærsynethed ved behandlingens start, efter et halvt år, og derefter én gang om året. Dosis er én tablet morgen og aften. Behandlingen bør fortsætte frem til 18 års alderen. I tilfælde af graviditet bør behandlingen afbrydes, ligesom man indtil videre bør afstå fra behandlingen i tilfælde af sukkersyge, epilepsi eller andre alvorlige kroniske tilstande.
Link: www.klaustrier.dk
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