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      The Effects of Scleral Collagen Cross-Linking Using Glyceraldehyde on the Progression of Form-Deprived Myopia in Guinea Pigs

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          Abstract

          To investigate the effects of collagen cross-linking using glyceraldehyde on the biomechanical properties of the sclera and the axial elongation of form-deprived myopia in the guinea pig. Thirty-six guinea pigs were randomly assigned to four groups: FDM (form-deprived myopia); FDMG (form-deprived myopia treated with glyceraldehyde); FDMS (form-deprived myopia treated with 0.9% isotonic sodium chloride); and normal control (free of form-deprivation). FDM was achieved in the right eye using a latex facemask. The right eye in FDMG was treated with a posterior subtenon injection of 0.5 M glyceraldehyde; 0.9% isotonic sodium chloride was administered to the right eye in FDMS group using the same method. Axial length, refraction, and stress-strain of the sclera were measured at scheduled time points. The treated eyes were also examined histologically by light microscopy. It was found that glyceraldehyde treatment significantly increased the stiffness of the sclera in the FDM eyes and abnormalities have not been observed in the retina and optic nerve of the treated eyes. But the development of myopia was not affected.

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          Most cited references31

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          Riboflavin/ultraviolet-a–induced collagen crosslinking for the treatment of keratoconus

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            Role of the sclera in the development and pathological complications of myopia.

            N McBrien (2003)
            Myopia is one of the most prevalent ocular conditions and is the result of a mismatch between the power of the eye and axial length of the eye. As a result images of distant objects are brought to a focus in front of the retina resulting in blurred vision. In the vast majority of cases the structural cause of myopia is an excessive axial length of the eye, or more specifically the vitreous chamber depth. In about 2% of the general population, the degree of myopia is above 6 dioptres (D) and is termed high myopia. The prevalence of sight-threatening ocular pathology is markedly increased in eyes with high degrees of myopia ( > -6 D). This results from the excessive axial elongation of the eye which, by necessity, must involve the outer coat of the eye, the sclera. Consequently, high myopia is reported as a leading cause of registered blindness and partial sight. Current theories of refractive development acknowledge the pivotal role of the sclera in the control of eye size and the development of myopia. This review considers the major biochemical mechanisms that underlie the normal development of the mammalian sclera and how the scleral structure influences the rate of eye growth during development. The review will characterise the aberrant mechanisms of scleral remodelling which underlie the development of myopia. In describing these mechanisms we highlight how certain critical events in both the early and later stages of myopia development lead to scleral thinning, the loss of scleral tissue, the weakening of the scleral mechanical properties and, ultimately, to the development of posterior staphyloma. This review aims to build on existing models to illustrate that the prevention of aberrant scleral remodelling must be the goal of any long-term therapy for the amelioration of the permanent vision loss associated with high myopia.
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              The sclera and myopia.

              Myopia is a very common ocular problem, affecting perhaps one billion people worldwide. Most myopia is produced by lengthening of the vitreous chamber of the ocular globe. High myopia is characterized by scleral thinning and localized ectasia of the posterior sclera. The sclera is a dense, fibrous, viscoelastic connective tissue that forms the outer coat of the eye and consists of irregularly arranged lamellae of collagen fibrils interspersed with proteoglycans and non-collagenous glycoproteins. Scleral fibroblasts are located between scleral lamellae, and are responsible for synthesizing the extracellular matrix in which they reside. Research highlighted in this review clearly demonstrates that the sclera is not a static container of the eye, but rather is a dynamic tissue, capable of altering extracellular matrix composition and its biomechanical properties in response to changes in the visual environment to regulate ocular size and refraction. Based on these studies, a strategy directed at reversing myopia-associated scleral extracellular matrix remodeling events would be warranted, particularly in cases of high myopia in humans.
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                Author and article information

                Journal
                J Ophthalmol
                J Ophthalmol
                JOPH
                Journal of Ophthalmology
                Hindawi Publishing Corporation
                2090-004X
                2090-0058
                2016
                18 July 2016
                : 2016
                : 3526153
                Affiliations
                1Tianjin Eye Hospital, Clinical College of Ophthalmology Tianjin Medical University, No. 4 Gansu Road, Heping District, Tianjin 300020, China
                2Tianjin Medical University Eye Hospital, Tianjin Medical University Eye Institute, No. 251 Fukang Road, Nankai District, Tianjin 300384, China
                Author notes

                Academic Editor: Suphi Taneri

                Author information
                http://orcid.org/0000-0002-8567-5968
                Article
                10.1155/2016/3526153
                4967684
                27504195
                21834b40-aaa3-46fd-89a1-b5e3fb7ca8c3
                Copyright © 2016 Yanhua Chu et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 24 March 2016
                : 19 June 2016
                Funding
                Funded by: Scientific Foundation of Tianjin Bureau of Health
                Award ID: 2011KY32
                Funded by: Key Scientific and Technological Project of Tianjin Bureau of Health
                Award ID: 12KG124
                Funded by: Foundation of Tianjin Municipal Scientific and Technological Department
                Award ID: 15JCYBJC26500
                Categories
                Research Article

                Ophthalmology & Optometry
                Ophthalmology & Optometry

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