Myopia Group Research Articles

Correlation between choroidal thickness and the degree of myopia

BACKGROUND: Myopia is a frequent visual problem, and the relationship between choroidal thickness (CT) and the degree of myopia has been a hot topic in myopia research. OBJECTIVE: This work aimed to explore the correlation between CT and the degree of myopia, providing a reference for diagnosing and treating myopia. METHODS: A cross-sectional study was conducted from September 2021 to December 2022, collecting data from 95 myopic patients aged between 18 and 50 years in the outpatient department. All subjects’ CT in the macular center (MC), spherical equivalent (SE), and other ocular parameters were measured. Furthermore, the Pearson correlation coefficient (PCC) analyzed relationships between CT and various factors. RESULTS: The choroid was thickest in the MC and gradually became thinner towards the periphery, with the thinnest region located nasally in the healthy group. In the mild, moderate, and severe myopia groups, the choroid was thickest at 1,000 μm temporal to the fovea, becoming thinner towards the periphery, with the thinnest region located nasally. The MC’s CT was correlated with a family history of myopia, SE, axial length (AL), and intraocular pressure (IOP). Meanwhile, there was a negative linear relationship between AL and CT in the MC (standard coefficient (SC) of -0.596, P-value of 0.000, tolerance of 0.217, and variance inflation factor (VIF) of 4.467), and a positive linear correlation between SE and CT in the MC (SC of 0.205, P-value of 0.013, tolerance of 0.257, and VIF of 3.792). CONCLUSION: This work provided clues for further understanding of the pathogenesis of myopic eyes and served as a scientific basis for early screening and treatment of myopia. Additionally, investigating the correlation between myopia and CT can also yield a reference for developing personalized myopia management strategies, which will help slow down myopia’s progression and prevent related complications.

Genetic background of high myopia in children.

High myopia is a significant risk factor for irreversible vision loss and can occur in isolation or as a component of various syndromes. However, the genetic basis of early-onset high myopia remains poorly understood. We aimed to identify the causative genetic variants for high myopia in a cohort of Slovenian children. The study included children referred to a tertiary paediatric ophthalmology centre at the University Eye Clinic in Ljubljana between 2010 and 2022. The participants met the following inclusion criteria: age ≤ 15 years and high myopia ≤-5.0 D before the age of 10 years. Genetic analysis included exome sequencing and/or molecular karyotyping. Participants were categorized based on clinical presentation: high myopia with systemic involvement, high myopia with ocular involvement, and isolated high myopia. Genetic analysis of 36 probands revealed a genetic cause of high myopia in 22 (61.1%) children. Among those with systemic involvement (50.0%), genetic causes were identified in 13 out of 18 children, with Stickler's and Pitt-Hopkins being the most common syndromes. Among cases of high myopia with ocular involvement (38.9%), a genetic cause was found in 8 out of 14 probands, including (likely) pathogenic variants in genes related to retinal dystrophies (CACNA1F, RPGR, RP2, NDP). The non-syndromic ARR3- associated high myopia was identified in the isolated high myopia group. A genetic cause of high myopia was identified in 61.1% of children tested, demonstrating the value of genetic testing in this population for diagnosis and proactive counseling.

In vivo assessment of cone loss and macular perfusion in children with myopia

This study evaluated cone density (CD) in the macular region and assess macular perfusion in children with varying degrees of myopia. This was a prospective, cross-sectional, observational study. Children underwent confocal scanning laser ophthalmoscopy (cSLO), optical coherence tomography (OCT), and OCT angiography (OCTA) imaging. A built-in software was used to measure mean CD (cells/mm2), retinal vessel density, choriocapillaris perfusion area, and choroidal thickness (CT). The study included 140 eyes from children categorized into four groups: emmetropia (31 eyes), low myopia (44 eyes), moderate myopia (31 eyes), and high myopia (34 eyes). The high myopia group exhibited significantly lower macular CD than the emmetropia group (P < 0.05). Additionally, the high myopia group showed thinner CT and higher choriocapillaris perfusion area in the macular region than the emmetropia group (all P < 0.01). Macular CD was significantly correlated with age, spherical equivalent, axial length, and CT (all P < 0.05). Generalized linear models revealed CT as the independent factor associated with macular CD (Wald χ2 = 9.265, P = 0.002). Children with high myopia demonstrate reduced CD in the macular region, accompanied by reduced CT. These findings may have important implications for future myopia prevention and management strategies.

Observations on relative peripheral refraction in Chinese adults with myopia based on a novel application of multispectral refraction topography

In this population-based observational cross-sectional study, we investigated retinal peripheral refraction in Chinese adults with myopia. We categorized 1511 Chinese adults with myopia (18 − 55 years) into low (LM), moderate (MM), and high myopia (HM) groups. Axial length, central corneal thickness, steep keratometry, flat keratometry, and intraocular pressure were measured. Refractive difference values (RDVs) for different eccentricities (RDV0–53) and the superior (RDV-S), inferior (RDV-I), temporal (RDV-T), and nasal (RDV-N) retinal regions were measured using multispectral refractive topography. The hyperopic defocus was higher for the MM group than for the LM group in RDV20–53, RDV-S, and RDV-T and HM group in RDV20–53, RDV-S, RDV-T and RDV-N. The hyperopic defocus was higher for the HM group than for the LM group in RDV20-53, RDV-S and RDV-T but lower for the LM group in RDV-N. RDV-N decreased with age (R2 = 0.0191, slope = − 0.01, p < 0.0001), whereas RDV-S (R2 = 0.0112, slope = 0.01,p < 0.0001) and RDV-T increased (R2 = 0.0038, slope = 0.01, p = 0.0160). RDV correlated with central spherical equivalent and axial length. Flat keratometry explained the most RDV variation (RDV20–30: β = 0.0714, p < 0.0001; RDV-N: β = 0.1801, p < 0.0001; RDV-S: β = 0.1426, p < 0.0001; RDV-T: β = 0.1239, p < 0.0001). Reference values for peripheral retinal defocus are provided for Chinese adults with different myopia ranges.

Automatic fovea detection and choroid segmentation for choroidal thickness assessment in optical coherence tomography.

To develop an automated model for subfoveal choroidal thickness (SFCT) detection in optical coherence tomography (OCT) images, addressing manual fovea location and choroidal contour challenges. Two procedures were proposed: defining the fovea and segmenting the choroid. Fovea localization from B-scan OCT image sequence with three-dimensional reconstruction (LocBscan-3D) predicted fovea location using central foveal depression features, and fovea localization from two-dimensional en-face OCT (LocEN-2D) used a mask region-based convolutional neural network (Mask R-CNN) model for optic disc detection, and determined the fovea location based on optic disc relative position. Choroid segmentation also employed Mask R-CNN. For 53 eyes in 28 healthy subjects, LocBscan-3D's mean difference between manual and predicted fovea locations was 170.0 µm, LocEN-2D yielded 675.9 µm. LocEN-2D performed better in non-high myopia group (P=0.02). SFCT measurements from Mask R-CNN aligned with manual values. Our models accurately predict SFCT in OCT images. LocBscan-3D excels in precise fovea localization even with high myopia. LocEN-2D shows high detection rates but lower accuracy especially in the high myopia group. Combining both models offers a robust SFCT assessment approach, promising efficiency and accuracy for large-scale studies and clinical use.

Characteristics of posterior precortical vitreous pockets visualized by swept-source OCT and en face OCT

To determine the characteristics of posterior precortical vitreous pockets (PPVPs) and to observe vitreous changes in myopic eyes by swept-source optical coherence tomography (SS-OCT) and en face imaging in a cohort of the Chinese Han population. This was a cross-sectional study. Volunteers (235 participants, 374 eyes) received an SS-OCT examination. The heights and widths of the PPVPs were measured by SS-OCT. The area of the PPVPs was measured on en face images. The relationships between PPVP size and sex, age, axial length (AL) and spherical equivalent (SE) were evaluated. The mean width and height were 6711.64 ± 1241.87 μm and 662.47 ± 326.39 μm, respectively. The area of the PPVPs was 30.296 ± 9.114 mm2. Boat-shaped, oval, and hook-shaped PPVPs were observed in 73.26%, 21.12%, and 5.62% of all eyes, respectively; 73.53% of all PPVPs had channels communicating with Cloquet’s tubes. There was a significant difference in the PPVP width among the participates over and under 50 years old (t = -2.508, P = 0.031). Age had a positive correlation with the PPVP width (r = 0.53, P = 0.001). The PPVP height showed significant differences among the different myopia groups (F = 3.618, P = 0.013). SE had a negative correlation with the PPVP height (r = -0.176, P = 0.001). However, there were no correlations between the AL and the width, height or area of the PPVPs (P = 0.117; P = 0.334; P = 0.057, respectively). Age and myopia affect the size of PPVPs. SS-OCT greatly facilitates visualization of the complex structure of the vitreous.

AI-based fully automatic analysis of retinal vascular morphology in pediatric high myopia

PurposeTo investigate the changes in retinal vascular structures associated with various stages of myopia by designing automated software based on an artificial intelligence model.MethodsThe study involved 1324 pediatric participants from the National Children’s Medical Center in China, and 2366 high-quality retinal images and corresponding refractive parameters were obtained and analyzed. Spherical equivalent refraction (SER) degree was calculated. We proposed a data analysis model based on a combination of the Convolutional Neural Networks (CNN) model and the attention module to classify images, segment vascular structures, and measure vascular parameters, such as main angle (MA), branching angle (BA), bifurcation edge angle (BEA) and bifurcation edge coefficient (BEC). One-way ANOVA compared parameter measurements between the normal fundus, low myopia, moderate myopia, and high myopia groups.ResultsThe mean age was 9.85 ± 2.60 years, with an average SER of -1.49 ± 3.16D in the right eye and − 1.48 ± 3.13D in the left eye. There were 279 (12.38%) images in the normal group and 384 (16.23%) images in the high myopia group. Compared with normal fundus, the MA of fundus vessels in different myopic refractive groups was significantly reduced (P = 0.006, P = 0.004, P = 0.019, respectively), and the performance of the venous system was particularly obvious (P < 0.001). At the same time, the BEC decreased disproportionately (P < 0.001). Further analysis of fundus vascular parameters at different degrees of myopia showed that there were also significant differences in BA and branching coefficient (BC). The arterial BA value of the fundus vessel in the high myopia group was lower than that of other groups (P = 0.032, 95% confidence interval [CI], 0.22–4.86), while the venous BA values increased (P = 0.026). The BEC values of high myopia were higher than those of low and moderate myopia groups. When the loss function of our data classification model converged to 0.09, the model accuracy reached 94.19%.ConclusionThe progression of myopia is associated with a series of quantitative retinal vascular parameters, particularly the vascular angles. As the degree of myopia increases, the diversity of vascular characteristics represented by these parameters also increases.

Prevalence and associations of dome-shaped maculas. The Beijing Eye Study.

To explore the prevalence and associated factors of a dome-shaped macula (DSM) in a general population. Out of the population-based Beijing Eye Study cohort (n = 3468 participants), the investigation included all eyes with an axial length of ≥25 mm, and a randomized sample of eyes with an axial length of <25 mm. Using optical coherence tomographic (OCT) images, we examined presence and height of DSMs, defined as an inward convexity of the foveal retinal pigment epithelium (RPE)/Bruch's membrane (BM) line, detectable in at least two OCT scans perpendicularly orientated to each other. The study cohort consisted of 366 eyes (314 individuals) with a mean age of 63.7 ± 9.7 years and a mean axial length of 24.8 ± 2.1 mm (median: 25.1 mm; range: 18.96-30.88 mm). Prevalence of DSMs (found in 6/366 eyes; 1.9%; 95%CI: 1.0, 3.0) increased from 0/125 (0%) in non-myopic eyes to 1/152 (0.7%; 95%CI: 0.0, 2.0) in moderately myopic eyes, and to 6/83 (7.2%; 95%CI: 1.7, 12.7) in the highly myopic group. In multivariable analysis, higher DSM prevalence corelated with longer axial length (OR: 2.05; 95%CI: 1.36, 3.08; p < 0.001) and higher stage of myopic macular degeneration (OR: 1.08; 95%CI: 1.01, 1.16; p = 0.03). The mean maximal DSM height was 139 ± 107 μm (median: 100 μm; range: 25-350 μm). It was associated with higher stage of myopic macular degeneration (beta: 0.24; p < 0.001) and higher prevalence of macular BM defects (beta: 0.17; p < 0.001). None of the DSMs showed a serous retinal detachment or relative choroidal thickening. Higher DSM prevalence correlated non-linearly with longer axial length, with DSM height increasing with the presence of a BM defect. DSMs may be associated with an axial elongation-related BM overproduction in the fundus midperiphery in all meridians.

Prevalence and associations of parapapillary scleral ridges: the Beijing Eye Study

PurposeTo explore the prevalence and associated factors of parapapillary scleral ridges (PSRs).MethodsOut of the cohort of the population-based Beijing Eye Study (n=3468 participants), the study included all eyes with an...

Retinal nerve fiber layer thickness and radial peripapillary capillaries density in myopic adults with optical coherence tomography angiography

PurposeTo evaluate retinal nerve fiber layer thickness (RNFLT) and radial peripapillary capillaries (RPC) density in adults with different degrees of myopia using optical coherence tomography angiography (OCTA) and explore their relationship with ocular factors, such as axial length (AL) and disc area.MethodsA total of 188 subjects were included in this cross-sectional study. The eyes were divided into four groups according to AL. OCTA was used for the assessment of RNFLT, RPC density, and other optic disc measurements, such as disc area. One-way analysis of variance was performed to compare differences between four groups, and P value < 0.01 was considered significant.ResultsThe RNFLT was significantly thinner in high myopia (HM) group at inferior nasal (IN) quadrant (P = 0.004) than low myopia (LM) group, but thicker at temporal inferior (TI) quadrant (P = 0.006). The RPC density of nasal superior (NS) quadrant, nasal inferior (NI) quadrant, and inferior nasal (IN) quadrant significantly decreased as AL increasing. By simple linear regression analysis, the inside disc RPC (iRPC) density tended to be correlated significantly with AL (0.3997%/mm, P < 0.0001). Peripapillary RPC (pRPC) density was in significant correlation with AL (-0.2791%/mm, P = 0.0045), and peripapillary RNFLT (pRNFLT) was in significant correlation with disc area (0.2774%/mm2, P = 0.0001).ConclusionRNFLT and RPC density were closely associated with AL and disc area. They might be new indexes in assessing and detecting myopia development via OCTA.

Peripheral Superficial Retina Vascular Density and Area of Radial Peripapillary Capillaries Changes in Myopic Individuals: A Wide-Field OCT Angiography Study.

Using swept-source optical coherence tomography (SS-OCT) to explore the effect of high myopia on superficial retina vascular density (SVD) of the peripheral region and the area of radial peripapillary capillaries (RPCs). In this cross-sectional study, a total of 91 volunteers (34 male subjects and 57 female subjects) were recruited and 34 individuals in the high myopic group (group A) and 57 individuals in the low myopic group (group B). Using the wide-field OCT-angiography (OCTA; 24 × 20 mm, 120 degrees angular field) compared the peripheral SVD and the area of RPC between the two groups and investigated its correlation with ocular axial length and diopter. Peripheral SVD of group B around the supratemporal (SVD1), supranasal (SVD2), infratemporal (SVD3), and infranasal (SVD4) directions were significantly higher than those of group A (all P < 0.05). The RPC area of group B around the supranasal (RPC2) and infranasal (RPC4) were significantly larger than that of group A (all P < 0.01). Ocular axial length and diopter were significantly correlated with SVD2 and SVD4 (all P < 0.05), and they also have a significant correlation with the supratemporal (RPC1), RPC2, and RPC4 (all P < 0.05). Peripheral SVD was decreased and the RPC area was mainly reduced on the nasal side in the high myopic group. Peripheral SVD and area of RPC are significantly correlated with ocular axial length and diopter. The wide-field OCTA can be used for new detection of myopia's impact on the retinal peripheral SVD and area of peripapillary RPC, offering new insights into the progression of myopia.

Study on the relationship between adolescent myopia and gut microbiota via 16S rRNA sequencing

Myopia has become a global public health problem, with a high incidence among adolescents. In recent years, the correlation between gut microbiota and various diseases has become a research hotspot. This paper analyzes the relationship between myopia and gut microbiota in adolescents based on 16S rRNA sequencing, opening up a new avenue for the prevention and control of myopia. 80 adolescents aged 6–15 years were included; fecal samples were collected to compare their diversity and species differences. There was no significant difference in α diversity when considering richness and evenness at the same time (P > 0.05). While the group difference in β diversity reached a significant level (R2 = 0.022, P < 0.05). The absolute quantification and relative abundance of phylum level Firmicutes and Actinobacteriota are different; among the top 30 genera, myopic group only one genus decreased in absolute quantification, while 13 genera decreased in relative quantification; so LEfSe analysis was performed, and the result showed that microbial community composition changed under Linear discriminant analysis (LDA) score, the top ten changes are shown in the figure; the Wilcoxon Rank sum test also found some significant changes in the absolute abundance of differential microbiota among different groups, at the phylum level, one bacterial phylum decreased and three bacterial phyla increased; at the genus level, 2 bacteria genera decreased and 29 bacteria genera increased. Functional pathways prediction found many myopic-related pathways were functionally enhanced in myopic patients (P < 0.05). Multivariate logistic regression analysis results showed that the area under the curve (AUC) of myopic patients predicted was close to or equal to 1. In conclusion, adolescent myopia is closely related to the gut microbiota, and the characteristic gut microbiota can distinguish myopia from healthy controls to a large extent. Therefore, it can be considered to regulate these characteristic gut microbiota to prevent and control myopia.

VEGFA may be a potential marker of myopic choroidal thickness and vascular density changes

To evaluate the changes of choroidal thickness (CT) and blood flow related to myopia, and its effects of vascular endothelial growth factor (VEGFA) on choroidal vessels in myopia. Subjects were included and divided into emmetropia (EM), non-high myopia (Non-HM) and high myopia (HM) groups. we measured choroidal thickness (CT), choriocapillaris vessel density (VD), and VEGFA content in tears in humans (137 subjects for CT, VD and 84 for tear) and detected the role of VEGFA in the choroid in form-deprivation myopia (FDM) in guinea pigs. Twenty-four guinea pigs were divided into control and FDM groups, and the expression changes of choroidal vessels and VEGFA were observed and compared using immunohistochemistry and Western blotting. Twenty-one guinea pigs were divided into control, FDM + Vehicle and FDM + Conbercept groups. The changes of diopter, axis length and choroidal vessels after intravitreal injection of Conbercept were observed. There were significant differences in CT and VD among the three groups (p < 0.05). VEGFA levels in tears were significantly lower in the myopic groups, with a decreasing trend from EM to Non-HM to HM. The choroidal vascular area fraction of FDM decreased compared to the control group. FDM guinea pigs exhibited reduced choroidal vasculature and significant downregulation of VEGFA expression. Following intravitreal injection of conbercept, the FDM + Conbercept group showed greater myopia, longer axial length, and lower choroidal vascular area fraction compared to the control group. VEGFA may participate in the regulation of choroidal blood vessels and blood flow in the progression of myopia. The reduction in VEGFA may accelerates the progression of myopia.

The Distribution and Influence Factors of Non-Invasive Tear Film Break-Up Time in Children.

To explore the distribution and influence factors of non-invasive tear film break-up time (NIBUT) in children. This is a hospital-based cross-sectional study. Spherical equivalent error (SER) was measured with cycloplegia. NIBUT was measured by an ocular surface integrated analyzer. A total of 1269 children (1269 eyes) were included in this study. Participants' median age was 11 (range 6-18) years. 47.1% (598/1269) of participants were boys. The median NIBUT of myopic children and non-myopic children were 9.9seconds (s) (Inter-quartile range, IQR: 6.4 to 16.1) and 10.9 s (IQR: 8.8 to 17.9), respectively, which was statistically significant (p = 0.004). In myopic children, 49.9% (573/1148) were able to achieve NIBUT of 10 s or more, compared to 67.8% (82/121) in non-myopic children, which was statistically significant (p < 0.001). There were 41 (3.57%) children in the myopic group and none (0%) in the non-myopic group with dry eye disease (p = 0.028). There was a positive correlation between NIBUT and age: NIBUT = 9.256 + 0.352*Age. 71.8% (824/1148) of myopic children used electronic products almost every day, compared to 37.2% (45/121) of non-myopic children, which was statistically significant (p < 0.001). The NIBUT of myopic children was significantly shorter than that of non-myopic children. Children with myopia are more likely to have dry eyes. NIBUT increases with age. High frequency of electronic product use may be an important cause to NIBUT shortening in children.

Clinical Efficacy of MiSight 1 day Soft Contact Lenses in Korean Myopic Children.

This study aimed to investigate the clinical efficacy of MiSight 1 day soft contact lenses (MiSight CL) in Korean children with mild-to-moderate myopia. In addition, the study compared the effects of MiSight CL in children who had or had not previously used orthokeratology contact lenses (Ortho-K). A total of 66 children aged 5 to 16 years, who were prescribed MiSight CL, were included in the study. Based on a myopia degree of -4 diopters (D), children were divided into mild and severe myopia groups to compare the effectiveness of myopia suppression. In addition, 55 eyes previously using Ortho-K were compared with 76 eyes using MiSight CL for the first time. The average follow-up period was 6.58±3.74 months. The average refractive value before using MiSight CL was 3.64±1.56 D, and there was no significant change in the final visit. Comparing myopia suppression between different degrees of myopia and previous use of Ortho-K lenses, there was no significant change in refractive error before and after using MiSight CL (unpaired t test, P >0.05). The main reason for Ortho-K failure was low visual acuity after correction. Regardless of Ortho-K history, children showed good visual acuity after wearing MiSight CL, and no other side effects were observed. MiSight CL effectively inhibited the progression of myopia in Korean children with mild-to-moderate myopia. MiSight CL offer the advantage of easy application, making them a viable alternative when Ortho-K are not suitable.

Vessel density, macula thickness and foveal avascular zone measurements in young African adults with moderate myopia: A pilot study.

The aim of this study was to investigate the association between macula thickness and vessel density in African myopic and emmetropic eyes through the use of Spectral Domain Optical Coherence Tomography (OCT). The study population comprised African adults aged 18-35 years old. The study was conducted at a University eye clinic located in Durban, South Africa. Purposive sampling was utilised to obtain 59 participants of whom 24 were myopes and 35 were emmetropes. Vessel density (VD), foveal avascular zone (FAZ) and retinal thickness (RT) were obtained using the Heidelberg Spectralis OCT with angiography. Thereafter, a multivariate linear regression was used to investigate associations between the spherical equivalent myopic refractive error and VD, FAZ and RT for the myopic group only. Myopic participants had a mean spherical equivalent (MSE) and standard deviation (SD) of -4.79 D (1.27) while the emmetropic group had an MSE (SD) of -0.32 D (0.46). Both superficial and deep VD were significantly decreased at the central fovea (radius (r) = 0.4 mm), peri-foveal (r = 1.10-1.45 mm) and para-foveal (r = 0.75-1.10 mm) sectors in myopes when compared with emmetropes. Myopes showed a significant reduction in RT in the inner retinal layer across the inferior and temporal zones of the peri-foveal region as well as the inferior and temporal zones of the para-foveal region when compared with emmetropes. A significantly smaller FAZ was found at both the superficial and deep vascular plexuses (p < 0.001). In African myopes, significant associations were not found between MSE and VD or FAZ and macula retinal thickness. Retinal vascular and thickness reduction may occur in young African adults with moderate myopia. A broad-based study targeting VD and IRT in African myopes is proposed to confirm preclinical myopic macula disruptions in adults of African ethnicity. OCT angiography should be considered when monitoring progressive myopia.

Relationship between the length of macular Bruch's membrane on fundus photograph and myopia occurrence in pre-myopia children aged 3–6 years: A 3-year longitudinal study

PurposeTo evaluate the occurrence and influencing factors of myopia occurrence in pre-myopia children aged 3–6 years. MethodsThis study included 204 pre-myopia (-0.50D<spherical equivalent (SE) ≤+0.75D) children with three years follow-up in Beijing Hyperopia Reserve Research. All participants underwent a comprehensive eye examination. The length of macular Bruch's membrane (BM) and the temporal vascular arcade angle were measured upon fundus photographs. ResultsMean age at initial visit was 4.28 ± 0.98 years and mean SE was 0.45 ± 0.29D. Both at baseline and after 3 years of follow-up, axial length was longer in boys than that in girls. (all P < 0.001) Children were divided into two groups according to the refractive status of children at the final follow-up: Myopia group (SE≤-0.50D) and Non-myopia group (SE>-0.50D). The length of macular BM was shorter in Myopia group than that in Non-myopia group (P < 0.001). Baseline SE and the length of macular BM were independent influencing factors which associated with myopia occurrence (OR, 0.031; 95 % CI, 0.008–0.117, P < 0.001 and OR, 0.204; 95 % CI, 0.055–0.763, P = 0.018, respectively) by multivariate binary logistic regression analysis. SE changing process represented the changes of SE, Myopia group had bigger SE changes (P < 0.001). And in the multivariate liner regression analysis, age was the common influencing factor of SE changing process in total participants, Non-myopia group and Myopia group (B = 0.234, P < 0.001; B = 0.078, P = 0.010; B = 0.161, P = 0.046, respectively) ConclusionsInitial SE and the length of macular BM in pre-myopia children aged 3–6 years were the independent factors of the occurrence of myopia. And initial age was the common factor that associated with SE changing process.

Relative peripheral refraction in school children with different refractive errors using a novel multispectral refraction topographer.

To compare relative peripheral refraction (RPR) in Chinese school children with different refractive errors using multispectral refraction topography (MRT). A total of 713 eyes of primary school children [172 emmetropia (E), 429 low myopia (LM), 80 moderate myopia (MM), and 32 low hypermetropia (LH)] aged 10 to 13y were analyzed. RPRs were measured using MRT without mydriasis. MRT results showed RPR at 0-15° (RPR 0-15), 15°-30° (RPR 15-30), and 30°-45° (RPR 30-45) annular in the inferior (RPR-I), superior (RPR-S), nasal (RPR-N), and temporal (RPR-T) quadrants. Spherical equivalent (SE) was detected and calculated using an autorefractor. There were significant differences of RPR 15-30 between groups MM [0.02 (-0.12; 0.18)] and LH [-0.13 (-0.36; 0.12)] (P<0.05), MM and E [-0.06 (-0.20; 0.10)] (P<0.05), and LM [-0.02 (-0.15; 0.15)] and E (P<0.05). There were also significant differences of RPR 30-45 between groups MM [0.45 (0.18; 0.74)] and E [0.29 (-0.09; 0.67)] (P<0.05), and LM [0.44 (0.14; 0.76)] and E (P<0.001). RPR values increased from the hyperopic to medium myopic group in each annular. There were significant differences of RPR-S between groups MM [-0.02 (-0.60; 0.30)] and E [-0.44 (-0.89; -0.04)] (P<0.001), and LM [-0.28 (-0.71; 0.12)] and E (P<0.05). There were also significant differences of RPR-T between groups MM [0.37 (0.21; 0.78)] and LH [0.14 (-0.52; 0.50)] (P<0.05), LM [0.41 (0.06; 0.84)] and LH (P<0.05), and LM and E [0.29 (-0.10; 0.68), P<0.05]. A Spearman's correlation analysis showed a negative correlation between RPR and SE in the 15°-30° (P=0.005), 30°-45° (P<0.05) annular (P=0.002), superior (P<0.001), and temporal (P=0.001) quadrants. Without pupil dilation, values for RPR 15-30, 30-45, RPR-S, and T shows significant differences between myopic eyes and emmetropia, and the differences are negatively correlated with SE.

The miR-15b-5p/miR-379-3p-FOXO axis regulates cell cycle and apoptosis in scleral remodeling during experimental myopia

BackgroundMyopia is one of the most common eye diseases in children and adolescents worldwide, and scleral remodeling plays a role in myopia progression. However, the identity of the initiating factors and signaling pathways that induce myopia-associated scleral remodeling is still unclear. This study aimed to identify biomarkers of scleral remodeling to elucidate the pathogenesis of myopia.MethodsThe gene expression omnibus (GEO) and comparative toxicogenomics database (CTD) mining were used to identify the miRNA-mRNA regulatory network related to scleral remodeling in myopia. Real-time quantitative PCR (RT-qPCR), Western blot, immunofluorescence, H&E staining, Masson staining, and flow cytometry were used to detect the changes in the FOXO signaling pathway, fibrosis, apoptosis, cell cycle, and other related factors in scleral remodeling.ResultsmiR-15b-5p/miR-379-3p can regulate the FOXO signaling pathway. Confirmatory studies confirmed that the axial length of the eye was significantly increased, the scleral thickness was thinner, the levels of miR-15b-5p, miR-379-3p, PTEN, p-PTEN, FOXO3a, cyclin-dependent kinase (CDK) inhibitor 1B (CDKN1B) were increased, and the levels of IGF1R were decreased in Len-induced myopia (LIM) group. CDK2, cyclin D1 (CCND1), and cell cycle block assessed by flow cytometry indicated G1/S cell cycle arrest in myopic sclera. The increase in BAX level and the decrease in BCL-2 level indicated enhanced apoptosis of the myopic sclera. In addition, we found that the levels of transforming growth factor-β1 (TGF-β1), collagen type 1 (COL-1), and α-smooth muscle actin (α-SMA) were decreased, suggesting scleral remodeling occurred in myopia.ConclusionsmiR-15b-5p/miR-379-3p can regulate the scleral cell cycle and apoptosis through the IGF1R/PTEN/FOXO signaling pathway, thereby promoting scleral remodeling in myopia progression.Graphical

Effects of 2 Hz flickering light on refractive state, fundus imaging and visual function of C57BL/6 mice

In this study, we investigated the effects of flickering light on refractive development of mice and the changes of fundus structure and function during this process. C57BL/6 mice were randomly divided into control group and flickering light-induced myopia (FLM) group. Mice in the control group were fed under normal lighting. FLM group mice were fed under lighting with a duty cycle of 50% and flash frequency of 2 Hz. Refractive status, axial length (AL), corneal radius of curvature (CRC), and electroretinogram signals were measured in all animals before treatment and at 2 and 4 weeks after treatment. Retinal thickness (RT), choroidal thickness (ChT) and choroidal blood perfusion (ChBP) were measured by optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). After 4 weeks of flickering light stimulation, the mice became myopia, the AL increased, but the CRC remained constant. The induction of myopia reduced the implicit time and amplitude of a-wave and b-wave in electroretinogram, which affects the function of retina. Full-layer retinal thickness, ChT and ChBP decreased at both 2 and 4 weeks after flickering light induction. The superficial and middle layers of the retina were significantly thinner, while the deep layer was only slightly thinner without statistical significance. Calculated by the concentric circle algorithm, the decrease of choroidal blood perfusion in FLM was mainly concentrated in the concentric circle area with the optic disc as the center radius of 150–450 μm. In conclusion, the present study shows that flickering light can successfully induce myopia in C57BL/6 mice, affect the electrophysiological activity of retina, and cause changes in fundus tissue structure and blood flow.