Abstract
Currently, myopic retinopathy is the most common irreversible blinding disease but its pathophysiology is not completely clear. A cross-sectional, observational study was conducted in a single center to analyze aqueous samples from highly myopic eyes (axial length >25 mm, n = 92) and ametropic or mild myopic eyes (n = 88) for inflammatory cytokines. Vascular endothelial growth factor (VEGF), Interleukin 6 (IL-6), and matrix metalloproteinase-2 (MMP-2) were measured using an enzyme-linked immunosorbent assay. IL-6 and MMP-2 were significantly higher in the highly myopic eyes than in the non-high myopic eyes (IL-6: 11.90 vs. 4.38 pg/mL, p < 0.0001; MMP-2: 13.10 vs. 8.82 ng/mL, p = 0.0003) while adjusting for age, gender, and intraocular pressure. There was a significant positive association between levels of IL-6 and MMP-2 in aqueous humor and the axial lengths of the eye globes (IL-6, β = 0.065, p < 0.0001, n = 134; MMP-2, β = 0.097, p < 0.0001, n = 131). Conversely, VEGF in aqueous humor was significantly lower in the highly myopic eyes than in the non-high myopic eyes (45.56 vs. 96.90 pg/mL, p < 0.0001, n = 153) while age, gender, and intraocular pressure were adjusted. The results suggest that low-grade intraocular inflammation may play an important role in the development and progression of high myopia and myopic retinopathy.
Highlights
Myopic retinopathy is the most common irreversible blinding disease but its pathophysiology is not completely clear
Out of 180 samples, 92 samples were from highly myopic eyes and the other 88 samples were from regular senile cataract patients without high myopia or myopia with a globe axial length no longer than 25 mm
Few studies have examined the possible association between chronic inflammation and myopia development or progression[21,22]
Summary
Myopic retinopathy is the most common irreversible blinding disease but its pathophysiology is not completely clear. There are many patients whose refractive error and eye structure experience a progressive change over their whole lifetime These changes include elongation of the eye globe axis, stretching of the eye wall, degenerative changes such as geographic atrophy of the retina and choroid, and choroidal neovascularization at the macular region. The association between myopia and subclinical chorioretinal inflammation has rarely been explored and relevant data is in paucity[21,22] One reason for this is that there is no clinically perceivable inflammation in the retina or choroid of myopic eyes and it is not justified to sample ocular fluid from these patients. The aim of this study is to investigate if there is a connection between low-grade intraocular inflammation and highly myopic eyes using undiluted aqueous humor samples from a senile cataract population who received cataract extraction at a single eye hospital from January 2016 to October of 2017
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