角膜生物力学是近视和散光的诱因：来自孟德尔随机化的证据

IF 3.2 Q1 OPHTHALMOLOGY

Ophthalmology science Pub Date : 2025-02-12 DOI:10.1016/j.xops.2025.100738

Pinghui Wei PhD , Guoge Han PhD , Qi Su MBBS , Lanbo Jia MBBS , Chao Xue PhD , Yan Wang PhD

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引用次数: 0

摘要

目的屈光不正与角膜生物力学性能之间的因果关系尚不明确。本研究旨在利用孟德尔随机化（MR）来阐明这种关系，为屈光不正的预防和治疗提供新的见解。设计双向、双样本MR分析。参与者的角膜生物力学数据来自英国生物银行的97653名欧洲参与者，而屈光不正数据来自英国生物银行和FinnGen联盟。方法本研究的暴露点为角膜生物力学参数，特别是角膜迟滞（CH）和角膜阻力因子（CRF）。结果定义为屈光不正，包括近视、远视和散光，以及屈光功率，包括球面和圆柱形功率。对来自UK Biobank和FinnGen财团的MR估计值进行了荟萃分析，并使用Q检验和I2统计来评估异质性。此外，进行了反向MR分析，以检查屈光状态对角膜生物力学的潜在因果影响。主要观察指标：角膜迟滞和CRF是近视和散光的病因。结果来自UK Biobank的数据显示，CH和CRF对近视的发展具有保护作用(CH：优势比(OR) = 0.9936, P = 7.79 × 10−4；CRF: = 0.9946, P = 2.41×10−3)和散光(CH:或者= 0.9975,P = 0.02;Crf = 0.9977, p = 0.017)。相反，角膜代偿性眼压升高是近视发展的危险因素（OR = 1.0091, P = 2.07 × 10−2）。meta分析结合了两个来源的数据，支持CH和CRF与近视发展之间的因果关系，尽管远视没有发现显著的因果关系。反向MR分析表明，球功率对CH有因果关系（OR = 1.0664, P = 4.32 × 10−5）。结论角膜生物力学参数，特别是CH和CRF可作为预测近视的早期生物指标。这种保护作用支持它们在临床筛查中使用，以加强早期干预策略。角膜代偿性眼压是近视的危险因素，是一种新的治疗靶点。未来的研究应阐明潜在的机制和评估生物力学干预，潜在地改变屈光不正的管理和减少视力损害。财务披露作者在本文中讨论的任何材料中没有专有或商业利益。

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Corneal Biomechanics as a Causal Factor in Myopia and Astigmatism: Evidence from Mendelian Randomization

Purpose

The causal relationship between refractive errors and corneal biomechanical properties remains uncertain. This study aimed to clarify this relationship using Mendelian randomization (MR), offering new insights into the prevention and treatment of refractive errors.

Design

A bidirectional, 2-sample MR analysis.

Participants

Corneal biomechanical data were obtained from 97 653 European participants in the UK Biobank, whereas refractive error data were sourced from the UK Biobank and FinnGen consortia.

Methods

The exposures in this study were identified as corneal biomechanical parameters, specifically corneal hysteresis (CH) and the corneal resistance factor (CRF). The outcomes were defined as refractive errors, including myopia, hyperopia, and astigmatism, along with refractive power, encompassing both spherical and cylindrical power. A meta-analysis was performed to combine the MR estimates from both UK Biobank and FinnGen consortia, with heterogeneity assessed using the Q test and I² statistics. Additionally, a reverse MR analysis was conducted to examine the potential causal effect of the refractive status on corneal biomechanics.

Main Outcome Measures

Corneal hysteresis and CRF as causal factors in myopia and astigmatism.

Results

Data from UK Biobank revealed that CH and CRF were protective against the development of myopia (CH: odds ratio (OR) = 0.9936, P = 7.79 × 10⁻⁴; CRF: OR = 0.9946, P = 2.41 × 10⁻³) and astigmatism (CH: OR = 0.9975, P = 0.02; CRF: OR = 0.9977, P = 0.017). Conversely, increased corneal-compensated intraocular pressure was a risk factor for myopia development (OR = 1.0091, P = 2.07 × 10⁻²). The meta-analysis, which combined data from both sources, supported a causal relationship between CH and CRF and the development of myopia, although no significant causal link was found for hyperopia. Reverse MR analysis demonstrated a causal effect of spherical power on CH (OR = 1.0664, P = 4.32 × 10⁻⁵).

Conclusions

Corneal biomechanical parameters, particularly CH and CRF, may serve as early biomarkers for predicting myopia. This protective role supports their use in clinical screening to enhance early intervention strategies. Corneal-compensated intraocular pressure is a risk factor for myopia and represents a novel therapeutic target. Future research should clarify the underlying mechanisms and assess biomechanical interventions, potentially transforming refractive error management and reducing visual impairment.