Metabolomic characteristics of aqueous humor in young myopia patients without fundus complications

To explore the potential mechanisms of myopia by detecting metabolites in the aqueous humour (AH) of young patients with myopia without fundus complications.

Randomised controlled trials (RCTs). A total of 65 AH samples (65 eyes) were collected in Weifang Eye Hospital. Untargeted metabolomics was conducted via liquid chromatography‒tandem mass spectrometry (LC‒MS/MS). Receiver operating characteristic (ROC) curves were generated.

Patients were divided into three groups according to axial length (AL). There were 21 patients (21 eyes) in the moderate-myopia (MM) group (24.00 mm < AL ≤ 26.00 mm), 24 patients (24 eyes) in the high-myopia (HM) group (26.00 mm < AL ≤ 28.00 mm), and 20 patients (20 eyes) in the ultrahigh-myopia (UHM) group (AL > 28.00 mm). A total of 2203 metabolites were detected in the AH samples, and there were 62 shared differentially abundant metabolites among the three groups. KEGG pathways among the three groups included sphingolipid metabolism, lipid and atherosclerosis, and the pentose phosphate pathway (PPP). The key metabolites DL-glutamine, phytosphingosine, D-erythrose 4-phosphate, and pyridoxine phosphate exhibited the strongest correlations with AL (all P values were <0.0001). In the ROC analysis, DL-glutamine, phytosphingosine, and D-erythrose 4-phosphate were good biomarkers for MM. Pyridoxine phosphate was a potential biomarker for UHM.

Abnormal sphingolipid metabolism was closely related to myopia. Changes in phytosphingosine levels in the AH among various AL groups may serve as early warning signs of retinal changes. These metabolic pathways and metabolites could serve as intervention targets for myopia management in the future.