[Recent advances in the mechanistic research of presbyopia]

Presbyopia is a common age-related disorder characterized by a progressive decline in ocular accommodative function, primarily manifesting as reduced near visual acuity. Traditionally, it has been attributed to lens sclerosis. Recent molecular biological studies have elucidated the core mechanisms underlying lens sclerosis from the perspectives of oxidative stress, cytoskeletal remodeling, and activation of mechanically sensitive ion channels. In addition, emerging biomechanical imaging technologies such as optical coherence elastography and Brillouin microscopy have provided novel tools for the quantitative assessment of biomechanical properties of the lens and intraocular tissues. Concurrently, declining ciliary body function, scleral stiffening, aqueous humor-vitreous system homeostatic imbalance, and age-related degeneration of the visual nervous system collectively highlight the multifactorial nature of presbyopia. This review summarizes recent advances in understanding the mechanisms of presbyopia development, aiming to provide insights for both clinical practice and basic research.