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High Myopia and the Complement System: Factor H in Myopic Maculopathy.

Enrique García-Gen1, Mariola Penadés1,2, Salvador Mérida1

  • 1Departamento Ciencias Biomédicas, Universidad CEU Cardenal Herrera, CEU Universities, 46115 Valencia, Spain.

Journal of Clinical Medicine
|July 2, 2021
PubMed
Summary

High myopia is linked to increased levels of complement Factor H (CFH), a key protein implicated in eye tissue degeneration. Elevated CFH is associated with maculopathy and reduced choroid thickness in high myopia patients.

Keywords:
aqueous humor sampleschoroid thicknesscomplement factor Hhigh myopiamaculopathy

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Area of Science:

  • Ophthalmology
  • Molecular Biology
  • Genetics

Background:

  • High myopia (HM) is a refractive error characterized by excessive axial length, leading to progressive eye tissue atrophy and visual acuity loss.
  • HM predisposes individuals to severe ocular conditions, including glaucoma, cataracts, retinal detachment, and macular atrophy.
  • Current understanding of the molecular mechanisms driving HM-related degeneration remains incomplete, despite extensive genetic and proteomic research.

Purpose of the Study:

  • To investigate the relationship between complement Factor H (CFH) and complement Factor D (CFD) and maculopathy in patients with degenerative myopia.
  • To assess the correlation of CFH and CFD levels with ocular parameters such as axial length, maculopathy classification, and choroid thickness.

Main Methods:

  • Aqueous humor samples were collected from 122 patients undergoing cataract surgery.
  • Eyes were categorized into high myopia (axial length > 26 mm), low myopia (23.5-25.9 mm), and control (< 23.4 mm) groups.
  • Maculopathy severity was assessed using fundus oculi findings, and subfoveal choroid thickness was measured via optical coherence tomography. CFH and CFD levels were quantified using ELISA.

Main Results:

  • CFH levels were significantly elevated in the high myopia group compared to low myopia and control groups (p < 0.05).
  • Significantly higher CFH concentrations were observed in eyes with choroidal atrophy and neovascularization (p < 0.05).
  • CFH concentration showed an inverse correlation with choroid thickness (R = -0.624), while CFD levels did not correlate with maculopathy.

Conclusions:

  • The study suggests a significant role for complement Factor H (CFH) in the pathological processes underlying high myopia and associated maculopathy.
  • Elevated CFH levels are linked to degenerative changes in the macula and reduced choroidal thickness in high myopia.
  • These findings highlight CFH as a potential molecular marker and therapeutic target for managing high myopia complications.