Sclera as the target tissue in progressive myopia
Related Experiment Video
Updated: Mar 21, 2026
Scleral Cross-linking Using Riboflavin and Ultraviolet-A Radiation for Prevention of Axial Myopia in a Rabbit Model
Published on: April 3, 2016
Insights
Children with progressive myopia exhibit weakened corneoscleral tissue and connective tissue dysplasia, alongside hormonal and autonomic nervous system imbalances. These factors are more severe in acquired complicated myopia, impacting scleral function.
Area of Science:
- Ophthalmology
- Biomedical Engineering
- Genetics
Background:
- Progressive myopia in children is associated with structural and functional changes in the eye's connective tissues.
- Understanding the biomechanical properties of the corneosclera is crucial for myopia management.
- Connective tissue (CT) abnormalities may play a significant role in the pathogenesis of myopia.
Purpose of the Study:
- To investigate the corneoscleral shell and connective tissue (CT) system in children with acquired and congenital progressive myopia.
- To identify diagnostic criteria for assessing weakened scleral supporting function in myopic children.
- To explore the relationship between myopia severity, CT health, hormonal balance, and autonomic nervous system function.
Main Methods:
- Examined 155 children (aged 9-17) with varying degrees of myopia, including those with complicated myopia (CM) and peripheral retinal degeneration (PRD).
- Measured corneal hysteresis (CH), scleral acoustic density (SAD), X-ray vertebral topography, plantography, joint hypermobility, serum cortisol (SC), and autonomic balance.
- Correlated these measurements with myopia severity and type (acquired vs. congenital).
Main Results:
- Corneal hysteresis (CH) and scleral acoustic density (SAD) decreased with increasing myopia severity, with the lowest values observed in acquired CM.
- Serum cortisol (SC) levels were lower in children with higher myopia and were lowest in acquired CM.
- Connective tissue dysplasia was prevalent and increased with myopia severity, occurring in over 90% of children with high acquired and congenital myopia. Autonomic nervous system imbalance was also noted.
Conclusions:
- School-aged children with progressive myopia demonstrate biomechanical abnormalities of the corneosclera, CT dysplasia, reduced SC, and VNS imbalance.
- These abnormalities are more pronounced in acquired complicated myopia.
- Findings aid in understanding myopia pathogenesis and in the diagnostic/prognostic evaluation of myopic children, particularly for considering sclera-strengthening interventions.
Unlabelled:
Introduction: The aim of the study was to study the eye corneoscleral shell and connective tissue (CT) system in children with acquired and congenital progressive myopia, and to identify the informative diagnostic criteria of weakened supporting function of the sclera.
Material And Methods:
155 children aged 9-17 were examined: 18 had emmetropia or hyperopia, 20--low, 32--moderate and 85--high myopia. 32 children had complicated myopia (CM) due to peripheral retinal degeneration (PRD). Corneal hysteresis (CH), scleral acoustic density (SAD), X-ray vertebral topography, plantography, joint hypermobility, serum cortisol (SC), and autonomic balance were measured.
Results:
Corneal hysteresis, mmHg and SAD, rel. units (mean ± SE) were lower if myopia was higher: in low myopia, CH was 13.0 ± 0.3, in moderate myopia, 11.9 ± 0.3#, in high myopia, 10.7 ± 0.3#; SAD was resp. 215.9 ± 5.2, 204.9 ± 3.7# and 192.8 ± 5.8# (#: p < 0.05 with regard to low myopia). The lowest CH (10.3 ± 0.4) and SAD (186.5 ± 7.3) were found in acquired CM. Congenital myopia with PRD showed CH and SAD greater than in acquired CM (p < 0.05). Serum cortisol (nmol/L) in hyperopia was 335.8 ± 40.9 and dropped with higher myopia: in low myopia--290.7 ± 58.6, in moderate--250.9 ± 26.4, in high--243.9 ± 20.5. The lowest SC was found in acquired CM, consistent with CH and SAD. Connective tissue dysplasia progressed with higher myopia: it was found in 76.9% of children with low, 82.4% with moderate, 89.2% with high acquired myopia, and 91.7% with congenital myopia. Biomechanical defects of CT and hormonal imbalance were combined with vegetative nervous system (VNS) imbalance: in high myopia only 20.5% of children were eutonic, 61.5%--sympathicotonic and 17.5% parasympathicotonic.
Conclusions:
School age children with progressive myopia showed biomechanical abnormalities of the corneosclera, along with CT dysplasia, decreased SC and imbalanced VNS, more pronounced in acquired complicated myopia. Our findings contribute to the understanding of myopia pathogenesis and to the diagnostic/prognostic evaluation of myopic children, in particular when deciding whether sclera-strengthening intervention is needed.
Related Concept Videos
01:16Focusing of Light in the Eye
01:25Glaucoma: Overview
01:27Open Angle Glaucoma: Treatment
Drugs such as carbonic anhydrase inhibitors, α2- and...
01:28Angle Closure Glaucoma: Treatment