Vision disorders are a global issue, affecting one in three individuals worldwide. The complexity of the human eye often leaves many eye conditions unexplained, restricting the diagnostic and therapeutic options for those affected. However, groundbreaking research from the Tokyo Medical and Dental University (TMDU) in Japan offers new hope.
Published in the April 1, 2024 edition of JAMA Ophthalmology, the TMDU team has advanced the use of a cutting-edge form of optical coherence tomography (OCT). This innovative technique facilitates a detailed study of the sclera – the white outer layer of the eyeball, usually a challenging area for ophthalmologists to examine in detail in live patients and specimens.
Lead author Dr. Kyoko Ohno-Matsui explains the significance of this study. The sclera, composed of collagen fibers, safeguards the retina, optic nerve, and other nerve tissues in the eye. Any irregularities in the sclera’s shape can trigger complications, including blindness. Until now, assessing the sclera’s thickness was the only possible measurement, but this new technique allows for a broader and more detailed examination.
The researchers have devised a method to use polarization-sensitive OCT (PS-OCT), a procedure where light’s polarization serves as a contrast mechanism. This approach has allowed the team to explore the properties of the collagen fibers in the sclera of patients with high myopia. They specifically studied the relation between myopathy and dome-shaped macula (DSM), a condition where a specialized area in the retina protrudes outwards.
After analyzing 89 highly myopic eyes from 72 patients, primarily over 50 years old, the researchers made some intriguing discoveries. They found the sclera divided into inner and outer layers, each with a different structural arrangement. Furthermore, in patients with DSM, the fibers of the inner layer were clustered and thickened, while those of the outer layer were squeezed and thinned.
Senior author Dr. Masahiro Yamanari believes that the successful use of PS-OCT to visualize the organization of fibrous tissue in eye structures could significantly impact clinical research, diagnostics, and therapeutics. Recognizing fiber patterns in common scleral pathologies like DSM and staphylomas could lead to targeted therapies to treat scleral abnormalities early and limit potential damage to the overlying neural tissue.
The hope is that PS-OCT will lead to significant medical discoveries that will better enable people to safeguard their precious sense of sight. This is a noteworthy leap forward in ophthalmology, bringing us closer to understanding the intricacies of the human eye and developing more effective treatments for vision impairments.
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