Abstract
Twice as many teenagers in the UK are becoming short-sighted now, compared with the 1960s; many develop a dangerously high degree of short-sightedness (“progressive myopia”) with a risk of sight-threatening conditions in adulthood, such as retinal detachment and glaucoma. The rise in short-sightedness is even more dramatic in the Far East, where over 95% of young men are now shortsighted. One crucial feature in short-sightedness is that the eyeball becomes longer, as the white coat of the eye (sclera) is becoming softer and stretchable. We do not know how exactly this happens, but it must involve the cells that make the collagen in the sclera. At the moment lengthening of the eyeball cannot be reversed and the few existing treatments can only slow myopia progression, not stop it. New and better treatments are needed but a clear understanding of the molecular mechanisms of post-natal eye growth in humans is lacking. Critically, because myopia develops in childhood at a physiological location prohibiting biopsies, we are lacking an understanding of the cellular components involved in human eye growth and myopia, and especially how the tissues that build the eye structurally, the sclera and the choroid, are modulated during normal eye growth. We have recently begun to establish a biobank of primary fibroblasts from the sclera and choroid of pediatric, adolescent and adult tissue, to better understand how the cell populations change in those tissue as the eye grows and settles at its final adult size and shape. We have already been able to demonstrate significant differences in the cells from young and old eyes, as well as regional differences between the posterior and the anterior sections of the eye. We plan to analyse in detail the cellular profiles of the sclera during postnatal eye growth to identify markers of the different stages of eye growth (from infant to elderly). This will allow us to better understand normal eye growth and identify potential markers and new drug targets to prevent and treat myopia. Because pediatric donor tissue is so rare, our unique cell bank will be critical to the development of future studies.
