Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Nov 1;62(14):17.
doi: 10.1167/iovs.62.14.17.

Lowering Intraocular Pressure: A Potential Approach for Controlling High Myopia Progression

Peiyuan Wang  1 , Shida Chen  1 , Yaoming Liu  1 , Fengbin Lin  1 , Yunhe Song  1 , Tuozhang Li  2 , Tin Aung  3 , Xiulan Zhang  1 ; GSHM study group
Affiliations

Lowering Intraocular Pressure: A Potential Approach for Controlling High Myopia Progression

Peiyuan Wang et al. Invest Ophthalmol Vis Sci. .

Abstract

High myopia is among the most common causes of vision impairment, and it is mainly characterized by abnormal elongation of the axial length, leading to pathologic changes in the ocular structures. Owing to the close relationship between high myopia and glaucoma, the association between intraocular pressure (IOP) and high myopia progression has garnered attention. However, whether lowering IOP can retard the progression of high myopia is unclear. On reviewing previous studies, we suggest that lowering IOP plays a role in progressive axial length elongation in high myopia, particularly in pathologic myopia, wherein the sclera is more remodeled. Based on the responses of the ocular layers, we further proposed the potential mechanisms. For the sclera, lowering the IOP could inhibit the activation of scleral fibroblasts and then reduce scleral remodeling, and a decrease in the scleral distending force would retard the ocular expansion like a balloon. For the choroid, lowering IOP results in an increase in choroidal blood perfusion, thereby reducing scleral hypoxia and slowing down scleral remodeling. The final effect of these pathways is slowing axial elongation and the development of scleral staphyloma. Further animal and clinical studies regarding high myopia with varied degree of IOP and the changes of choroid and sclera during IOP fluctuation in high myopia are needed to verify the role of IOP in the pathogenesis and progression of high myopia. It is hoped that this may lead to the development of a prospective treatment option to prevent and control high myopia progression.

PubMed Disclaimer

Conflict of interest statement

Disclosure: P. Wang, None; S. Chen, None; Y. Liu, None; F. Lin, None; Y. Song, None; T. Li, None; T. Aung, None; X. Zhang, None

Figures

Figure.
Figure.
The potential mechanisms for the control of high myopia progression through the lowering of IOP.
See this image and copyright information in PMC

References

    1. Flitcroft DI, He M, Jonas JB, et al.. IMI—defining and classifying myopia: a proposed set of standards for clinical and epidemiologic studies. Invest Ophthalmol Vis Sci. 2019; 60(3): M20–M30. - PMC - PubMed
    1. Ikuno Y. Overview of the complications of high myopia. Retina. 2017; 37(12): 2347–2351. - PubMed
    1. Ohno-Matsui K, Lai TYY, Lai CC, Cheung CMG.. Updates of pathologic myopia. Prog Retin Eye Res. 2016; 52: 156–187. - PubMed
    1. Morgan IG, Ohno-Matsui K, Myopia Saw SM.. Lancet. 2012; 379(9827): 1739–1748. - PubMed
    1. Wong YL, Saw SM.. Epidemiology of pathologic myopia in Asia and worldwide. Asia Pac J Ophthalmol (Phila). 2016; 5(6): 394–402. - PubMed

Publication types