Scleral collagen cross linkage in progressive myopia

Area of Science:

• Ophthalmology
• Biomaterials Science
• Biomechanical Engineering

Background:

• High myopia is linked to scleral thinning and ectasia, impacting ocular biomechanics.
• Scleral structural abnormalities, including reduced collagen diameter and defective cross-linking, contribute to myopia progression.
• Strengthening the sclera via collagen cross-linking offers a potential therapeutic strategy for myopia control.

Approach:

• This systematic review synthesizes current evidence on scleral collagen cross-linking (SXL) interventions.
• Various SXL techniques, mechanisms, cytotoxicity, and developmental stages are compared.
• In-vivo methods for evaluating post-SXL scleral biomechanics in human eyes are discussed.

Key Points:

• SXL aims to reverse scleral thinning and improve biomechanical properties, potentially halting myopia progression.
• Exogenous collagen cross-linkage can be induced using light or dark methods with different mediators.
• The review critically assesses the transition of SXL from preclinical research to clinical application.

Conclusions:

• SXL represents a promising avenue for managing progressive myopia by enhancing scleral rigidity.
• Further research and clinical evaluation are needed to optimize SXL techniques and confirm efficacy and safety in humans.
• Understanding scleral biomechanics is crucial for developing effective treatments for myopia progression.