Visual impairment in highly myopic eyes: The ZOC-BHVI High Myopia Cohort Study

Distribution and association of visual impairment with myopic maculopathy across age groups among highly myopic eyes - based on the new classification system (ATN)

Purpose

To investigate the percentages and risk factors for visual impairment (VI) across age groups in a highly myopic cohort with a wide range of age (18–93 years).

Methods

A total of 2099 eyes (1220 participants) were enrolled. All participants underwent detailed ocular examinations. Myopic maculopathy (MM) was assessed as myopic atrophy maculopathy (MAM), myopic traction maculopathy (MTM) or myopic neovascular maculopathy (MNM) based on the ATN system.

Results

Most participants younger than 50 years had normal vision, while the cumulative risk of VI and blindness gradually increased after 50–59 years. The percentage of each type of MM increased nonlinearly with ageing (all p < 0.001), with an accelerated period of increase after 45 years for MAM, and after 50 years for MTM and MNM. Axial length (AL) ≥30 mm was the only associated factor for mild VI or worse in participants aged 18–39 years (p < 0.001). Older age, AL ≥30 mm and the presence of MAM were predictors for mild VI or worse in the group aged 40–49 years (all p < 0.05). In participants aged ≥50 years, older age, female sex, longer AL and increased severity of MM were risk factors for VI and blindness (all p < 0.05).

Conclusion

The percentages of MM and related VI increased nonlinearly with older age, with a turning point at 45 years for MAM, preceding that of MTM, MNM and VI by 5 years, warranting future longitudinal studies to confirm. Different age groups presented different risk factors for VI. Timely screening should be in place for middle‐aged high myopes.

Hsa-miR-142-3p reduces collagen I in human scleral fibroblasts by targeting TGF-β1 in high myopia

High myopia has been continually increasing globally until now and often results in visual impairment. Scleral extracellular matrix (ECM) remodeling is considered a common factor contributing to progression of myopia. However, the role of microRNAs (miRNAs) in regulating scleral ECM organization is not well understood. We aimed to explore the effect and regulatory mechanism of hsa-miR-142-3p on collagen I in human scleral fibroblasts in high myopia. First, next-generation sequencing was conducted to identify 37 miRNAs differentially expressed in the aqueous humor of high myopia samples and control samples. Furthermore, hsa-miR-142-3p in the aqueous humor was found to positively relate to the ocular axial length. Besides, the results of immunofluorescence and Western blot assay indicated that hsa-miR-142-3p overexpression decreased collagen I expression in the human fetal scleral fibroblasts (HFSFs); while hsa-miR-142-3p downregulation increased collagen I. Moreover, hsa-miR-142-3p targets TGFβ-1 gene expression. Quantitative polymerase chain reaction (qPCR) and Western blot analysis showed that miRNA 142-3p reduced TGFβ-1 expression while an inhibitor had an opposite effect. Therefore, there is an inverse relationship between changes in miR-142-3p expression levels and those of collagen1a1 in human scleral fibroblasts. Such a dependence suggests that miR-142-3p may be a target to improve therapeutic management of this condition.

Study on the Optic Nerve Fiber Layer Thickness and Changes in Blood Flow in Myopic Children

Objective

The present study aims to observe the optic nerve fiber layer thickness and blood flow density in the papillary area and investigate the effects of axial length (AL) and the refractive state of the optic papilla blood flow density in children with different refractive conditions.

Methods

The present study was a clinical control study. The right eyes of 204 minors aged 6-17 years were studied. The eyes were divided into four groups according to myopic refractive states. OCTA analyzed the data to compare the radial peripapillary capillary (RPC) density and the difference in the retinal nerve fiber layer (RNFL) thickness adjacent to the optic papilla between the four refraction groups.

Results

The intra-optic disc blood flow density was significantly and negatively correlated with the AL and was negatively correlated with the AL in the inferior temporal quadrants. The RNFL in the superior, nasal, and inferior quadrants was negatively correlated with the AL. The RNFL in the temporal quadrant was positively correlated with the AL.

Conclusion

Our present study revealed that aAs myopia increased and the AL grew in children, the blood density of the entire image of the optic papilla, in the optic disc, and the retinal capillaries in the inferior parapapillary and temporal quadrant would change significantly. With increasing AL, a significant decrease in the intra-disc and para-disc RNFL was observed in the superior, nasal, and inferior quadrants, while a substantial increase in RNFL was observed in the temporal quadrant.