Myopia prevalence is still rising worldwide, addressing the worldwide myopia “epidemic” is of utmost importance, since the World Health Organization estimates that half of the world's population will suffer from myopia by the middle of the century. In addition to causing vision loss, myopia is closely associated with irreversible blinding disorders such as glaucoma and retinopathy. The pathophysiology of myopia is strongly linked to the biomechanical effects of intraocular pressure(IOP)on the scleral structure. Scleral tissue undergoes considerable structural remodelling during myopia development, increasing its sensitivity to the mechanical stresses of IOP. Important mechanisms include increased collagen degradation brought on by matrix metalloproteinase(MMP-2)activity, extracellular matrix dynamics destabilization from an imbalance in the regulation of tissue inhibitor of metalloproteinase(TIMPs), aberrant choroidal blood supply brought on by activation of the hypoxia-inducible factor-1α(HIF-1α)pathway, and cascading regulation of the PI3K/AKT signaling pathway in scleral remodeling. This study provides a significant scientific foundation and fresh concepts for the future research into myopia prevention and control strategies by methodically examining the connection between changes in IOP and the development of myopia as well as its molecular underpinnings.

山东省医药卫生科技发展计划项目(No.202207020770); 山东中医药科技项目(No.M-2022165); 山东省医药卫生科技项目(No.202307021577)