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Advances in High Myopia and Glaucoma
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Advances in High Myopia and Glaucoma

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: closed (20 June 2023) | Viewed by 10592

Special Issue Editors

Prof. Dr. Xiulan Zhang

E-Mail Website
Guest Editor
Zhongshan Ophthalmic Center (ZOC), Sun Yet-sen University, Guangzhou 510600, China
Interests: glaucoma; imaging in ophthalmology; high myopia
Dr. Shida Chen

E-Mail Website
Guest Editor
Zhongshan Ophthalmic Center (ZOC), Sun Yet-sen University, Guangzhou 510600, China
Interests: retina; high myopia; glaucoma

Special Issue Information

Dear Colleagues,

In recent decades, high myopia has markedly increased worldwide, especially in East Asia. High myopia is highly correlated with glaucoma, which also causes visual field defects, thinning of the retinal nerve fiber layer and macular ganglion cell–inner plexiform, and impacts the morphology of optic nerve, leading to irreversible blindness. Therefore, accurate diagnosis of glaucoma in HM is challenging. Furthermore, the role of intraocular pressure in the pathogenesis and development of high myopia remains unknown.

The purpose of this Special Issue is to highlight novel findings on high myopia and glaucoma, including pathophysiological mechanisms of high myopia, novel imaging markers of high myopia with glaucoma, the natural history of visual field defects and retinal and optic nerve structure changes based on optical coherence tomography (OCT), fundus change, other novel techniques in high myopia with or without glaucoma, the role of intraocular pressure, and novel treatments. This Issue will highlight manuscripts based on a combination of original research and review papers.

Prof. Dr. Xiulan Zhang
Dr. Shida Chen
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • high myopia
  • glaucoma
  • neurodegeneration
  • neuropathy
  • OCT
  • visual field
  • intraocular pressure
  • biomechanics

Published Papers (6 papers)

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Research

Jump to: Review

13 pages, 1014 KiB  
Article
Low-Dose Atropine Induces Changes in Ocular Biometrics in Myopic Children: Exploring Temporal Changes by Linear Mixed Models and Contribution to Treatment Effect by Mediation Analyses
by Anders Hvid-Hansen, Nina Jacobsen, Jesper Hjortdal, Flemming Møller, Brice Ozenne and Line Kessel
J. Clin. Med. 2023, 12(4), 1605; https://doi.org/10.3390/jcm12041605 - 17 Feb 2023
Cited by 2 | Viewed by 1280
Abstract
This study aimed to investigate changes in non-cycloplegic ocular biometrics during the initial six months of treatment with a 0.1% atropine loading dose and 0.01% atropine compared with a placebo and analyze their contribution to the treatment effect on cycloplegic spherical equivalent (SE) [...] Read more.
This study aimed to investigate changes in non-cycloplegic ocular biometrics during the initial six months of treatment with a 0.1% atropine loading dose and 0.01% atropine compared with a placebo and analyze their contribution to the treatment effect on cycloplegic spherical equivalent (SE) progression. The study was based on a randomized, double-masked, placebo-controlled, multicenter trial evaluating a 0.1% atropine six-month loading dose and 0.01% atropine in reducing myopic progression in Danish children. The treatment phase was 24 months, and the washout phase was 12 months. Parameters measured included changes in axial length (AL), anterior chamber depth (ACD), lens thickness (LT), vitreous chamber depth (VCD), and choroidal thickness (ChT), while cycloplegic SE and lens power were calculated. Longitudinal changes and contributions to treatment effects were analyzed using constrained linear mixed models and mediation analyses, respectively. After six months, AL was 0.13 mm shorter (95% confidence interval [CI], −0.18 to −0.07 [adjusted p < 0.001]) and 0.06 mm shorter (95% CI, −0.11 to −0.01 [adjusted p = 0.060]) with a 0.1% atropine loading dose and 0.01% atropine, respectively, compared to the placebo group. Similar concentration-dependent changes were found with ACD, LT, VCD, ChT, and cycloplegic SE. Although the treatment effects trended toward concentration-dependent responses, only the treatment effect mediated by AL at three months differed significantly between 0.01% atropine and a 0.1% atropine loading dose (adjusted p = 0.023). Several ocular biometrics, including AL, ACD, and LT, changed dose-dependently during low-dose atropine treatment. Moreover, the treatment effect of atropine on SE progression was mediated by a subset of ocular biometrics, mainly AL, with trends toward concentration dependency and distributional shifts over time. Full article
(This article belongs to the Special Issue Advances in High Myopia and Glaucoma)
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13 pages, 2715 KiB  
Article
The Differential Expression of Circular RNAs and the Role of circAFF1 in Lens Epithelial Cells of High-Myopic Cataract
by Shiyu Ma, Xiangjia Zhu, Dan Li, Fan Yang, Jiaqi Meng, Yongxiang Jiang, Jing Ma and Yi Lu
J. Clin. Med. 2023, 12(3), 813; https://doi.org/10.3390/jcm12030813 - 19 Jan 2023
Cited by 2 | Viewed by 1466
Abstract
High-myopic cataract (HMC) is a complex cataract with earlier onset and more rapid progress than age-related cataract (ARC). Circular RNAs (circRNAs) have been implicated in many diseases. However, their involvement in HMC remain largely unexplored. To investigate the role of dysregulated circRNAs in [...] Read more.
High-myopic cataract (HMC) is a complex cataract with earlier onset and more rapid progress than age-related cataract (ARC). Circular RNAs (circRNAs) have been implicated in many diseases. However, their involvement in HMC remain largely unexplored. To investigate the role of dysregulated circRNAs in HMC, lens epithelium samples from 24 HMC and 24 ARC patients were used for whole transcriptome sequencing. Compared with ARC, HMC had 3687 uniquely expressed circRNAs and 1163 significantly differentially expressed circRNAs (DEcRs) (|log2FC| > 1, p < 0.05). A putative circRNA-miRNA-mRNA network was constructed based on correlation analysis. We validated the differential expression of 3 DEcRs by quantitative polymerase chain reaction (qPCR) using different sets of samples. We further investigated the role of circAFF1 in cultured lens epithelial cells (LECs) and found that the overexpression of circAFF1 promoted cell proliferation, migration and inhibited apoptosis. We also showed that circAFF1 upregulated Tropomyosin 1 (TPM1) expression by sponging miR-760, which was consistent with the network prediction. Collectively, our study suggested the involvement of circRNAs in the pathogenesis of HMC and provide a resource for further study on this topic. Full article
(This article belongs to the Special Issue Advances in High Myopia and Glaucoma)
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10 pages, 1379 KiB  
Article
Changes in the Choroidal Thickness of Children Wearing MiSight to Control Myopia
by Francisco Luis Prieto-Garrido, Cesar Villa-Collar, Jose Luis Hernandez-Verdejo, Cristina Alvarez-Peregrina and Alicia Ruiz-Pomeda
J. Clin. Med. 2022, 11(13), 3833; https://doi.org/10.3390/jcm11133833 - 01 Jul 2022
Cited by 6 | Viewed by 2206
Abstract
Background: Due to the importance of choroidal thickness in the development of myopia, this study examined the effect of MiSight contact lenses (CLs) on the choroidal thickness of myopic children and the differences between responders and non-responders to the treatment with these CLs. [...] Read more.
Background: Due to the importance of choroidal thickness in the development of myopia, this study examined the effect of MiSight contact lenses (CLs) on the choroidal thickness of myopic children and the differences between responders and non-responders to the treatment with these CLs. Methods: A total of 41 myopic children were fitted with MiSight CLs and 33 with single-vision spectacles. They were followed up for two years. Subfoveal choroidal thickness and choroidal thickness 1 and 3 mm temporal and nasal to the fovea were measured by OCT at baseline and one and two years after the treatment. Differences in all the choroidal thickness parameters were assessed in each group over time. Patients from the MiSight group were classified based on a specific range of changes in axial length at the end of the second year of treatment as “responders” (AL change < 0.22 mm/per year) and “non-responders”, and the choroidal thickness of both groups was analyzed. Results: The subfoveal choroidal thickness of the MiSight and single-vision spectacle groups did not show any changes over time. Wearing MiSight CLs induced relative choroidal thickening in the responder group in the first year of treatment. Conclusion: Choroidal thickness might work as a predictor of the effectiveness of MiSight in myopia treatment. Full article
(This article belongs to the Special Issue Advances in High Myopia and Glaucoma)
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10 pages, 999 KiB  
Article
Axial Growth Driven by Physical Development and Myopia among Children: A Two Year Cohort Study
by Shida Chen, Yangfeng Guo, Xiaotong Han, Xinping Yu, Qianyun Chen, Decai Wang, Xiang Chen, Ling Jin, Jason Ha, Yuting Li, Yabin Qu, Rong Lin, Mingguang He, Yangfa Zeng and Yizhi Liu
J. Clin. Med. 2022, 11(13), 3642; https://doi.org/10.3390/jcm11133642 - 23 Jun 2022
Cited by 7 | Viewed by 1593
Abstract
Background: The physical process of axial length growth among children and its role in the occurrence of myopia remain insufficiently explored. In this study, we investigate the patterns of ocular axial growth among persistent myopia (PM) and persistent non-myopia (PNM) children aged 3 [...] Read more.
Background: The physical process of axial length growth among children and its role in the occurrence of myopia remain insufficiently explored. In this study, we investigate the patterns of ocular axial growth among persistent myopia (PM) and persistent non-myopia (PNM) children aged 3 to 15 years. Methods: A group of 6353 children aged 3 to 15 years, selected from rural schools in China, were followed up annually for 2 years. Biometric measurements including axial length (AL) and spherical equivalent refraction (SER) were obtained. Body height was recorded. Children were divided into two groups: PM group defined as SER of −0.50 D or less; PNM group defined as −0.50 D < SER < +3.0 D during follow-up. Results: Annual AL growth was fairly consistent for PNM eyes of children aged 3 to 11 years and then reduced significantly (independent t test, p < 0.001) for children aged 12 years and older. This pattern of AL changes was similar for PM children, although the AL growth was greater among them. Among children aged 6 and older, body height change was concomitant to AL growth (p < 0.01) and SER myopic shift (p < 0.001) until reaching 12 years old (p = 0.308 and p = 0.679, respectively). Conclusions: Stature growth and AL growth are both remarkable and consistent and concomitant but start to attenuate when the children reach 10 to 12 years old among emmetropic children. This observation suggests that AL growth is driven by physical development until 12 years old, whereas its excessive growth is dominated by myopia development. Full article
(This article belongs to the Special Issue Advances in High Myopia and Glaucoma)
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Review

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27 pages, 21578 KiB  
Review
Peripapillary Intrachoroidal Cavitation
by Adèle Ehongo and Noélie Bacq
J. Clin. Med. 2023, 12(14), 4712; https://doi.org/10.3390/jcm12144712 - 16 Jul 2023
Cited by 1 | Viewed by 1358
Abstract
Peripapillary intrachoroidal cavitation (PICC) is a yellow-orange lesion, located at the outer border of the myopic conus. First described as a localized detachment of the retinal pigment epithelium, its intrachoroidal location was later revealed, justifying its current name. PICC is related to other [...] Read more.
Peripapillary intrachoroidal cavitation (PICC) is a yellow-orange lesion, located at the outer border of the myopic conus. First described as a localized detachment of the retinal pigment epithelium, its intrachoroidal location was later revealed, justifying its current name. PICC is related to other myopic complications such as posterior staphyloma, but its pathogenesis is not clear to date. Although it has been considered a benign condition, most eyes with PICC show visual field defects, which leads to diagnostic uncertainty as these deficits resemble those seen in glaucoma. Furthermore, eyes with PICC may develop macular detachment with retinoschisis. Finally, misdiagnosis of PICC as a metastatic choroidal tumor may lead to unnecessary and anxiety-inducing investigations. Advances in optical coherence tomography (OCT) imaging have improved the visualization of ocular structures, contributing to the understanding of PICC. Recently, high optic nerve sheath traction forces during eye movements in highly myopic eyes have been suggested as promoters of PICC, renewing interest around this condition. However, a review of PICC is still lacking. Therefore, we aimed to provide a concise yet comprehensive overview of the current state of the art, focusing on OCT illustrations, pathophysiology and potential future perspectives based on the biomechanics of the optic nerve. Full article
(This article belongs to the Special Issue Advances in High Myopia and Glaucoma)
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17 pages, 1411 KiB  
Review
Anatomic Peculiarities Associated with Axial Elongation of the Myopic Eye
by Jost B. Jonas, Mukharram M. Bikbov, Ya-Xing Wang, Rahul A. Jonas and Songhomitra Panda-Jonas
J. Clin. Med. 2023, 12(4), 1317; https://doi.org/10.3390/jcm12041317 - 07 Feb 2023
Cited by 2 | Viewed by 1894
Abstract
Purpose: To describe anatomical peculiarities associated with axial elongation in the human myopic eye. Methods: Reviewing the results of previous histomorphometrical investigations of enucleated human globes, as well as reviewing findings obtained in population-based studies and hospital-based clinical investigations of myopic patients and [...] Read more.
Purpose: To describe anatomical peculiarities associated with axial elongation in the human myopic eye. Methods: Reviewing the results of previous histomorphometrical investigations of enucleated human globes, as well as reviewing findings obtained in population-based studies and hospital-based clinical investigations of myopic patients and non-myopic individuals. Results: Myopic axial elongation is associated with a change from a mostly spherical eye shape to a prolate ellipsoid form. It is combined with choroidal and scleral thinning, most pronounced at the posterior pole and less pronounced in the fundus midperiphery. In the fundus midperiphery, the retina and density of the retinal pigment epithelium (RPE) and photoreceptors decrease with a longer axial length, while in the macular region, retinal thickness, RPE cell density, and choriocapillaris thickness are not related to axial length. With axial elongation, a parapapillary gamma zone develops, leading to an enlargement of the optic disc-fovea distance and a decrease in angle kappa. Axial elongation is also correlated with an increase in the surface and volume of Bruch’s membrane (BM), while BM thickness remains unchanged. Axial elongation causes moderately myopic eyes to show a shift of BM opening to the foveal direction so that the horizontal disc diameter becomes shorter (with a consequent vertical ovalization of the optic disc shape), a temporal gamma zone develops, and the optic nerve exit takes an oblique course. Features of high myopia are an enlargement of the RPE opening (myopic parapapillary beta zone) and BM opening (secondary macrodisc), elongation and thinning of the lamina cribrosa, peripapillary scleral flange (parapapillary delta zone) and peripapillary choroidal border tissue, secondary BM defects in the macular region, myopic maculoschisis, macular neovascularization, and cobblestones in the fundus periphery. Conclusions: These features combined may be explained by a growth in BM in the fundus midperiphery leading to axial elongation. Full article
(This article belongs to the Special Issue Advances in High Myopia and Glaucoma)
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