Myopia is one of the most prevalent ocular conditions and is the result of a mismatch between the power of the eye and axial length of the eye. As a result images of distant objects are brought to a focus in front of the retina resulting in blurred vision. In the vast majority of cases the structural cause of myopia is an excessive axial length of the eye, or more specifically the vitreous chamber depth. In about 2% of the general population, the degree of myopia is above 6 dioptres (D) and is termed high myopia. The prevalence of sight-threatening ocular pathology is markedly increased in eyes with high degrees of myopia ( > -6 D). This results from the excessive axial elongation of the eye which, by necessity, must involve the outer coat of the eye, the sclera. Consequently, high myopia is reported as a leading cause of registered blindness and partial sight. Current theories of refractive development acknowledge the pivotal role of the sclera in the control of eye size and the development of myopia. This review considers the major biochemical mechanisms that underlie the normal development of the mammalian sclera and how the scleral structure influences the rate of eye growth during development. The review will characterise the aberrant mechanisms of scleral remodelling which underlie the development of myopia. In describing these mechanisms we highlight how certain critical events in both the early and later stages of myopia development lead to scleral thinning, the loss of scleral tissue, the weakening of the scleral mechanical properties and, ultimately, to the development of posterior staphyloma. This review aims to build on existing models to illustrate that the prevention of aberrant scleral remodelling must be the goal of any long-term therapy for the amelioration of the permanent vision loss associated with high myopia.

中文翻译：

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巩膜在近视发展和病理并发症中的作用。

近视是最普遍的眼部疾病之一，是眼睛的力量和眼睛的轴向长度不匹配的结果。结果，远处物体的图像被聚焦在视网膜前，导致视力模糊。在大多数情况下，近视的结构性原因是眼睛的轴向长度过长，或更具体地说是玻璃体腔的深度。在大约2％的总人口中，近视度数超过6屈光度（D），被称为高度近视。在高度近视（> -6 D）的眼睛中，威胁视力的眼部病理学的患病率明显增加。这是由于眼睛的过度轴向伸长所引起的，该轴向伸长必然必须涉及眼睛的外层巩膜。所以，据报道，高度近视是导致失明和部分视力的主要原因。当前的屈光发育理论承认巩膜在控制眼睛大小和近视发展中的关键作用。这篇综述考虑了哺乳动物巩膜正常发育的主要生化机制，以及巩膜结构如何影响发育过程中眼睛的生长速度。审查将表征巩膜重塑的异常机制，其是近视发展的基础。在描述这些机制时，我们强调了近视发展早期和晚期的某些关键事件如何导致巩膜变薄，巩膜组织丢失，巩膜机械性能减弱，并最终导致后葡萄球菌的发展。