Gene-environment interaction in myopia

The whole life cycle myopia management

Myopia stands as a prevalent ocular condition with global implications, impacting individuals at various life stages. In school-age children and adolescents, uncorrected myopia impedes reading and academic performance. Among middle-aged and elderly populations, myopia poses severe risks such as macular degeneration, macular holes and retinal detachment, leading to irreversible visual impairment. The term "myopia management" is widely embraced by ophthalmic practitioners and optometry associations worldwide, encompassing strategies to correct refractive errors and ongoing assessment of disease progression, aiming to reduce the progression of myopia and axial elongation. To date, current management strategies for myopia include public health policies, optical solutions, medical interventions and surgical options, but these interventions are general and lack age specificity. Despite existing interventions, we propose the concept of "Whole Life Cycle Myopia Management" in this review. This approach outlined major risk factors of myopia through the whole life cycle, discussed current interventions for myopia and provided age-specific management strategies for myopia of eight different life stages-infancies, toddlers, preschoolers, school-age children, adolescents, young adults, middle-age and old-age, including the prevention of myopia onset, slowing of myopia progression and monitoring of myopia complications. Achieving the "Whole Life Cycle Myopia Management" requires collaborations efforts from government, schools, hospitals and families, to restore vision and enhance the quality of life for those individuals affected by myopia.

Association of a COL1A1 gene haplotype with pathologic myopia in a Northern Chinese Han population

To investigate the relationship between COL1A1 variations and the susceptibility to pathologic myopia (PM) among the general population in Northern China, we included 525 PM patients and 1105 non-myopic controls. All PM patients underwent comprehensive ophthalmologic examinations. DNA was extracted from peripheral venous blood samples and genotyped using the MassArray System. Statistical analyses, including Hardy-Weinberg equilibrium, χ2 test, and linkage disequilibrium analysis, were conducted to compare the genotypic and allelic distributions of SNPs between PM patients and controls. The results showed no significant differences in the genotypic and allelic distributions of rs2075555, rs2269336, and rs1107946 between the PM and control groups. However, haplotype analysis revealed that the G-G-C and T-C-A haplotypes are risk factors for PM (G-G-C: OR = 1.399, 95% CI = 1.206-1.623, P < 0.001, Pc < 0.001; T-C-A: OR = 1.248, 95% CI = 1.064-1.456, P = 0.007, Pc = 0.021). Although individual SNPs in COL1A1 were not significantly associated with PM, specific haplotypes (G-G-C and T-C-A) were identified as risk factors. This suggests a potential role of COL1A1 in the development of PM.

Electroacupuncture Slows Experimental Myopia Progression by Improving Retinal Mitochondrial Function: A Study Based on Single-Cell RNA Sequencing

This study aimed to establish a complete atlas of retinal cells in lens-induced myopia (LIM) and electroacupuncture (EA) intervention by single-cell RNA sequencing (scRNA-seq) and to explore the potential mechanism of EA in improving experimental myopia progression in guinea pigs. scRNA-seq is used to assess changes in individual cellular gene levels in the retina of LIM- and EA-treated guinea pigs. In addition, the role of EA in slowing myopia progression by improving retinal mitochondrial function is further investigated. scRNA-seq identified ten cell clusters in the retina of LIM and EA guinea pigs and mitochondrial respiratory chain-related genes in Cones and Muller-glia cells-Cytochrome oxidase subunit III (COX3), NADH dehydrogenase subunit 4 (ND4), and NADH dehydrogenase subunit 2 (ND2) are closely related to lens-induced myopia. A comprehensive atlas in the retina of LIM and EA guinea pigs at a single-cell level is established, and the positive role of EA in improving retinal mitochondrial function to slow the experimental myopia progression in guinea pigs is revealed.

PAX6 gene promoter methylation is correlated with myopia in Chinese adolescents: a pilot sutdy

PURPOSE

A large number of epidemiological studies have shown that myopia is a complex disease involving genetic, environmental, and behavioral factors. The purpose of this study was to explore the role of PAX6 gene methylation in myopia in Chinese adolescents.

METHODS

Eighty junior high school students were divided into four groups based on their vision test results: mild myopia, moderate myopia, severe myopia, and non-myopia control. The methylation level of PAX6 gene promoter was detected by bisulfate pyrosequencing.

RESULTS

The methylation level of PAX6 gene in myopia group (8.06% ± 1.43%) was slightly but significantly higher than that in non-myopia controls (7.26% ± 1.17%). In addition, PAX6 gene methylation levels presented a decreasing pattern along with the aggravation of myopia. Post-hoc analysis indicated significant inter-group differences for the mild myopia group and other groups (All p < .05). In the subgroup analysis by gender, the methylation level of PAX6 gene promoter in girls was higher than that in boys (p = .023). The ROC curves showed a high accuracy of PAX6 gene methylation to predict mild myopia (AUC (95% CI) = 0.828 (0.709-0.947), p < .001).

CONCLUSIONS

The methylation of PAX6 gene might play a role in the onset and progression of myopia in Chinese adolescents. And this could potentially explore the potential molecular mechanisms of juvenile myopia in the future.

Associations of Near Work, Time Outdoors, and Sleep Duration With Myopic Regression 5 Years After SMILE and FS-LASIK: A Cross-sectional Study

PURPOSE

To investigate the association of near work, time outdoors, and sleep duration with myopic regression 5 years after small incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK) .

METHODS

This cross-sectional study included patients who received SMILE or FS-LASIK at Beijing Tongren Hospital 5 years ago. The patients underwent ophthalmic examinations including visual acuity, intraocular pressure, subjective refraction, slit-lamp examination, keratometry, corneal topography, optical coherence tomography, and fundus examination from January 2020 to March 2023. Fluorescein break-up time was measured and the Ocular Surface Disease Index questionnaire was completed to exclude dry eye. A self-administered questionnaire was used to collect data on near work exposure, physical activities, and sleep duration.

RESULTS

A total of 323 eyes were included in the analysis, with a 5-year incidence rate of myopic regression after SMILE or FSLASIK of 16.1%. After adjusted for all confounders, total near work more than 8 hours/day revealed a significant association with myopic regression (odds ratio: 2.461; 95% CI: 1.143 to 5.298, P = .021), particularly in younger adults, women, and patients with high myopia and FS-LASIK treatment. The significant association between sleep duration 8 hours/day or more and myopic regression was restricted to women and patients with FS-LASIK (near significant). However, no significant associations were observed between continuous near work or time outdoors and myopic regression.

CONCLUSIONS

Excessive near work exposure was associated with greater myopic regression 5 years after SMILE or FS-LASIK. It is crucial to maintain good visual behavior and care for preventing regression after SMILE or FS-LASIK, especially for younger patients and eyes with high myopia. [J Refract Surg. 2024;40(1):e10-e19.].