{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T05:56:09Z","timestamp":1778219769196,"version":"3.51.4"},"reference-count":66,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T00:00:00Z","timestamp":1693267200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health","award":["RC 2779946"],"award-info":[{"award-number":["RC 2779946"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomolecules"],"abstract":"<jats:p>Inflammatory, vasculogenic, and profibrogenic factors have been previously reported in vitreous (VH) and aqueous (AH) humors in myopic patients who underwent cataract surgery. In light of this, we selected some mediators for AH and anterior-capsule-bearing lens epithelial cell (AC\/LEC) analysis, and AH expression was correlated with LEC activation (epithelial\u2013mesenchymal transition and EMT differentiation) and axial length (AL) elongation. In this study, AH (97; 41M\/56F) and AC\/LEC samples (78; 35M\/43F) were collected from 102 patients who underwent surgery, and biosamples were grouped according to AL elongation. Biomolecular analyses were carried out for AH and LECs, while microscopical analyses were restricted to whole flattened AC\/LECs. The results showed increased levels of interleukin (IL)-6, IL-8, and angiopoietin-2 (ANG)-2 and decreased levels of vascular endothelium growth factor (VEGF)-A were detected in AH depending on AL elongation. LECs showed EMT differentiation as confirmed by the expression of smooth muscle actin (\u03b1-SMA) and transforming growth factor (TGF)-\u03b2R1\/TGF\u03b2 isoforms. A differential expression of IL-6R\/IL-6, IL-8R\/IL-8, and VEGF-R1\/VEGF was observed in the LECs, and this expression correlated with AL elongation. The higher VEGF-A and lower VEGF-D transcript expressions were detected in highly myopic LECs, while no significant changes were monitored for VEGF-R transcripts. In conclusion, these findings provide a strong link between the AH protein signature and the EMT phenotype. Furthermore, the low VEGF-A\/ANG-2 and the high VEGF-A\/VEGF-D ratios in myopic AH might suggest a specific inflammatory and profibrogenic pattern in high myopia. The highly myopic AH profile might be a potential candidate for rating anterior chamber inflammation and predicting retinal distress at the time of cataract surgery.<\/jats:p>","DOI":"10.3390\/biom13091328","type":"journal-article","created":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T10:49:10Z","timestamp":1693306150000},"page":"1328","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Biomarker Signature in Aqueous Humor Mirrors Lens Epithelial Cell Activation: New Biomolecular Aspects from Cataractogenic Myopia"],"prefix":"10.3390","volume":"13","author":[{"given":"Maria","family":"De Piano","sequence":"first","affiliation":[{"name":"Research and Development Laboratory for Biochemical, Molecular and Cellular Applications in Ophthalmological Science, IRCCS-Fondazione Bietti, 00184 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1793-9842","authenticated-orcid":false,"given":"Andrea","family":"Cacciamani","sequence":"additional","affiliation":[{"name":"Surgical Retina Research Unit, IRCCS-Fondazione Bietti, 00184 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2254-1647","authenticated-orcid":false,"given":"Bijorn Omar","family":"Balzamino","sequence":"additional","affiliation":[{"name":"Research and Development Laboratory for Biochemical, Molecular and Cellular Applications in Ophthalmological Science, IRCCS-Fondazione Bietti, 00184 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Scarinci","sequence":"additional","affiliation":[{"name":"Surgical Retina Research Unit, IRCCS-Fondazione Bietti, 00184 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pamela","family":"Cosimi","sequence":"additional","affiliation":[{"name":"Surgical Retina Research Unit, IRCCS-Fondazione Bietti, 00184 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1401-8020","authenticated-orcid":false,"given":"Concetta","family":"Cafiero","sequence":"additional","affiliation":[{"name":"Anatomic Pathology Unit, Fabrizio Spaziani Hospital, 03100 Frosinone, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guido","family":"Ripandelli","sequence":"additional","affiliation":[{"name":"Surgical Retina Research Unit, IRCCS-Fondazione Bietti, 00184 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9375-6071","authenticated-orcid":false,"given":"Alessandra","family":"Micera","sequence":"additional","affiliation":[{"name":"Research and Development Laboratory for Biochemical, Molecular and Cellular Applications in Ophthalmological Science, IRCCS-Fondazione Bietti, 00184 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1016\/j.ophtha.2016.01.006","article-title":"Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050","volume":"123","author":"Holden","year":"2016","journal-title":"Ophthalmology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1016\/j.ophtha.2018.10.029","article-title":"Potential Lost Productivity Resulting from the Global Burden of Myopia: Systematic Review, Meta-analysis, and Modeling","volume":"126","author":"Naidoo","year":"2019","journal-title":"Ophthalmology"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Jiang, L., Goh, D.X., Koh, J.H.Z., Chan, X., Brennan, N.A., Barathi, V.A., and Hoang, Q.V. (2023). Applications of Genomics and Transcriptomics in Precision Medicine for Myopia Control or Prevention. Biomolecules, 13.","DOI":"10.3390\/biom13030494"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2192324","DOI":"10.1080\/15592294.2023.2192324","article-title":"Identification and characterization of extrachromosomal circular DNA in patients with high myopia and cataract","volume":"18","author":"Wen","year":"2023","journal-title":"Epigenetics"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"M89","DOI":"10.1167\/iovs.18-25965","article-title":"Myopia Genetics Report","volume":"60","author":"Tedja","year":"2019","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1001\/jamaophthalmol.2021.3303","article-title":"Continued Increase of Axial Length and Its Risk Factors in Adults With High Myopia","volume":"139","author":"Du","year":"2021","journal-title":"JAMA Ophthalmol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1111\/opo.12812","article-title":"Axial length targets for myopia control","volume":"41","author":"Chamberlain","year":"2021","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Khan, M.H., Lam, A., Armitage, J.A., Hanna, L., To, C.H., and Gentle, A. (2020). Impact of Axial Eye Size on Retinal Microvasculature Density in the Macular Region. J. Clin. Med., 9.","DOI":"10.3390\/jcm9082539"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"3517","DOI":"10.1038\/s41598-019-39652-x","article-title":"Inflammatory cytokines in highly myopic eyes","volume":"9","author":"Yuan","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"104088","DOI":"10.1016\/j.jprot.2020.104088","article-title":"Proteomic analysis of aqueous humor in patients with pathologic myopia","volume":"234","author":"Xue","year":"2021","journal-title":"J. Proteom."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e29961","DOI":"10.1097\/MD.0000000000029961","article-title":"Association between TGF-\u03b2 gene polymorphism and myopia: A systematic review and meta-analysis","volume":"101","author":"Zhu","year":"2022","journal-title":"Medicine"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"85","DOI":"10.4103\/ijo.IJO_863_16","article-title":"Insight into high myopia and the macula","volume":"65","author":"Kumar","year":"2017","journal-title":"Indian J. Ophthalmol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/j.jcrs.2015.09.027","article-title":"Elevated TGF-\u03b22 level in aqueous humor of cataract patients with high myopia: Potential risk factor for capsule contraction syndrome","volume":"42","author":"Zhu","year":"2016","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.exer.2013.01.014","article-title":"Regulation of scleral metabolism in myopia and the role of transforming growth factor-beta","volume":"114","author":"McBrien","year":"2013","journal-title":"Exp. Eye Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"3922","DOI":"10.1167\/iovs.14-13983","article-title":"MMP-2, MMP-3, TIMP-1, TIMP-2, and TIMP-3 protein levels in human aqueous humor: Relationship with axial length","volume":"55","author":"Jia","year":"2014","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.exer.2014.07.015","article-title":"The Dynamic Sclera: Extracellular Matrix Remodeling in Normal Ocular Growth and Myopia Development","volume":"133","author":"Harper","year":"2015","journal-title":"Exp. Eye Res."},{"key":"ref_17","first-page":"8863637","article-title":"Relationship between Axial Length and Levels of TGF-\u03b2 in the Aqueous Humor and Plasma of Myopic Patients","volume":"9","author":"Hsiao","year":"2021","journal-title":"BioMed Res. Int."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"8592729","DOI":"10.1155\/2022\/8592729","article-title":"Study on Factors Associated with High Myopia CNV in Aqueous Humor and Serum","volume":"2022","author":"Xia","year":"2022","journal-title":"BioMed Res. Int."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1016\/j.jfo.2022.05.014","article-title":"Association between transforming growth factors-\u03b2 and matrix metalloproteinases in the aqueous humor and plasma in myopic patients","volume":"45","author":"Yue","year":"2022","journal-title":"J. Fran\u00e7ais d\u2019Ophtalmol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.exer.2017.03.004","article-title":"Metabolic characterization of human aqueous humor in relation to high myopia","volume":"159","author":"Ji","year":"2017","journal-title":"Exp. Eye Res."},{"key":"ref_21","first-page":"2265","article-title":"Aqueous humor concentrations of vascular endothelial growth factor and pigment epithelium-derived factor in high myopic patients","volume":"18","author":"Shin","year":"2012","journal-title":"Mol. Vis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1614","DOI":"10.1097\/IAE.0000000000001227","article-title":"Myopic choroidal neovascularization: Diagnosis and Treatment","volume":"36","author":"Lai","year":"2016","journal-title":"Retina"},{"key":"ref_23","first-page":"574","article-title":"Inflammatory cytokines in aqueous humor of patients with choroidal neovascularization","volume":"18","author":"Miao","year":"2012","journal-title":"Mol. Vis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"4303","DOI":"10.3390\/cimb44090296","article-title":"Myopia Development in Tree Shrew Is Associated with Chronic Inflammatory Reactions","volume":"44","author":"Ku","year":"2022","journal-title":"Curr. Issues Mol. Biol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"155308","DOI":"10.1016\/j.cyto.2020.155308","article-title":"Proinflammatory and angiogenesis-related cytokines in vitreous samples of highly myopic patients","volume":"137","author":"Wei","year":"2021","journal-title":"Cytokine"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1029425","DOI":"10.3389\/fmed.2022.1029425","article-title":"Difference in aqueous concentration and vitreous mass of cytokines in high myopias with and without choroidal neovascularization","volume":"9","author":"Zhang","year":"2022","journal-title":"Front. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1159\/000524502","article-title":"Effect of Interleukin 6 on Scleral Fibroblast Proliferation, Differentiation, and Apoptosis Involved in Myopic Scleral Remodeling","volume":"65","author":"Liu","year":"2022","journal-title":"Ophthalmic Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"5","DOI":"10.17116\/oftalma201613255-14","article-title":"Role of immunological factors in the development of myopic choroidal neovascularization","volume":"132","author":"Shchuko","year":"2016","journal-title":"Vestn. Oftalmol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.ajo.2013.08.010","article-title":"Epidemiology and Disease Burden of Pathologic Myopia and Myopic Choroidal Neovascularization: An Evidence-Based Systematic Review","volume":"157","author":"Wong","year":"2014","journal-title":"Am. J. Ophthalmol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1159\/000455271","article-title":"Intraocular Cytokines and Their Correlations with Clinical Parameters in Patients with Myopic Choroidal Neovascularization","volume":"237","author":"Shchuko","year":"2017","journal-title":"Ophthalmologica"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e10204","DOI":"10.15252\/emmm.201810204","article-title":"Efficacy of simultaneous VEGF-A\/ANG-2 neutralization in suppressing spontaneous choroidal neovascularization","volume":"11","author":"Foxton","year":"2019","journal-title":"EMBO Mol. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1136\/bjophthalmol-2019-315763","article-title":"Risk factors for subretinal fibrosis after anti-VEGF treatment of myopic choroidal neovascularisation","volume":"105","author":"Xiao","year":"2021","journal-title":"Br. J. Ophthalmol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/s00417-022-05745-z","article-title":"Serum Ang-1\/Ang-2 ratio may be a promising biomarker for evaluating severity of diabetic retinopathy","volume":"261","author":"Wang","year":"2023","journal-title":"Graefe\u2019s Arch. Clin. Exp. Ophthalmol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e10362","DOI":"10.15252\/emmm.201910362","article-title":"Anti-VEGF-A\/ANG2 combotherapy limits pathological angiogenesis in the eye: A replication study","volume":"11","author":"Wolf","year":"2019","journal-title":"EMBO Mol. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.exer.2015.02.004","article-title":"Fibrosis in the lens. Sprouty regulation of TGF\u03b2-signaling prevents lens EMT leading to cataract","volume":"142","author":"Lovicu","year":"2016","journal-title":"Exp. Eye Res."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Kubo, E., Shibata, T., Singh, D.P., and Sasaki, H. (2018). Roles of TGF\u03b2 and FGF Signals in the Lens: Tropomyosin Regulation for Posterior Capsule Opacity. Int. J. Mol. Sci., 19.","DOI":"10.3390\/ijms19103093"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1016\/j.pbiomolbio.2003.11.012","article-title":"Ageing and vision: Structure, stability and function of lens crystallins","volume":"86","author":"Bloemendal","year":"2004","journal-title":"Prog. Biophys. Mol. Biol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1881","DOI":"10.1007\/s40123-023-00711-2","article-title":"Long-Term Outcomes of Posterior Capsular Opacification in Highly Myopic Eyes and Its Influencing Factors","volume":"12","author":"He","year":"2023","journal-title":"Ophthalmol. Ther."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.ebiom.2016.07.021","article-title":"Role of Chronic Inflammation in Myopia Progression: Clinical Evidence and Experimental Validation","volume":"10","author":"Lin","year":"2016","journal-title":"eBioMedicine"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1007\/s10384-011-0027-1","article-title":"Negative correlation between aqueous vascular endothelial growth factor levels and axial length","volume":"55","author":"Sawada","year":"2011","journal-title":"Jpn. J. Ophthalmol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e309","DOI":"10.1111\/aos.14248","article-title":"Implication of inflammatory cytokines in the aqueous humour for management of macular diseases","volume":"98","author":"Yi","year":"2020","journal-title":"Acta Ophthalmol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"15708","DOI":"10.1038\/s41598-019-52156-y","article-title":"Correlation of axial length and myopic macular degeneration to levels of molecular factors in the aqueous","volume":"9","author":"Wong","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"893","DOI":"10.17219\/acem\/125428","article-title":"High irisin and low BDNF levels in aqueous humor of high myopia","volume":"30","author":"Wang","year":"2021","journal-title":"Adv. Clin. Exp. Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.1016\/j.clinbiochem.2015.08.006","article-title":"Proteomic analysis of aqueous humor proteins associated with cataract development","volume":"48","author":"Ji","year":"2015","journal-title":"Clin. Biochem."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"107693","DOI":"10.1016\/j.exer.2019.107693","article-title":"Enhanced EGF receptor-signaling potentiates TGF\u03b2-induced lens epithelial-mesenchymal transition","volume":"185","author":"Shu","year":"2019","journal-title":"Exp. Eye Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1007\/s00417-003-0733-6","article-title":"Nerve growth factor (NGF) and lenses: Effects of NGF in an in vitro rat model of cataract","volume":"241","author":"Ghinelli","year":"2003","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Flokis, M., and Lovicu, F.J. (2023). FGF-2 Differentially Regulates Lens Epithelial Cell Behaviour during TGF-\u03b2-Induced EMT. Cells, 12.","DOI":"10.3390\/cells12060827"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"3111","DOI":"10.3892\/mmr.2017.6345","article-title":"Identification of proteins in the aqueous humor associated with cataract development using iTRAQ methodology","volume":"15","author":"Xiang","year":"2017","journal-title":"Mol. Med. Rep."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1046\/j.1442-9071.2000.00310.x","article-title":"Peter Bishop Lecture: Growth factors in lens development and cataract: Key roles for fibroblast growth factor and TGF-beta","volume":"28","author":"McAvoy","year":"2000","journal-title":"Clin. Exp. Ophthalmol."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Gao, C., Lin, X., Fan, F., Liu, X., Wan, H., Yuan, T., Zhao, X., and Luo, Y. (2022). Status of higher TGF-\u03b21 and TGF-\u03b22 levels in the aqueous humour of patients with diabetes and cataracts. BMC Ophthalmol., 22.","DOI":"10.1186\/s12886-022-02317-x"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1001\/jamaophthalmol.2023.1717","article-title":"Comparison of Optical Coherence Tomography Structural Parameters for Diagnosis of Glaucoma in High Myopia","volume":"141","author":"Jeong","year":"2023","journal-title":"JAMA Ophthalmol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1736","DOI":"10.18240\/ijo.2022.11.02","article-title":"Comprehensive assessment of growth factors, inflammatory mediators, and cytokines in vitreous from patients with proliferative diabetic retinopathy","volume":"15","author":"Gong","year":"2022","journal-title":"Int. J. Ophthalmol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1841","DOI":"10.1097\/IAE.0b013e31821800a4","article-title":"Intravitreal bevacizumab therapy on an as-per-needed basis in subfoveal choroidal neovascularization secondary to pathological myopia: 2-year outcomes of a prospective case series","volume":"31","author":"Iacono","year":"2011","journal-title":"Retina"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.18240\/ijo.2021.08.11","article-title":"Macular density alterations in myopic choroidal neovascularization and the effect of anti-VEGF on it","volume":"14","author":"Mao","year":"2021","journal-title":"Int. J. Ophthalmol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"2369","DOI":"10.1016\/S0042-6989(00)00075-4","article-title":"Changes in blood-retinal barrier permeability in form deprivation myopia in tree shrews","volume":"40","author":"Kitaya","year":"2000","journal-title":"Vis. Res."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1159\/000267886","article-title":"The blood-aqueous barrier in anisometropia and high myopia","volume":"28","author":"Shih","year":"1996","journal-title":"Ophthalmic Res."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1111\/j.1444-0938.2002.tb03014.x","article-title":"Cataract in the 21st Century: Lessons from previous epidemiological research","volume":"85","author":"McCarty","year":"2002","journal-title":"Clin. Exp. Optom."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Bhandary, S.K., Dhakal, R., Sanghavi, V., and Verkicharla, P.K. (2021). Ambient light level varies with different locations and environmental conditions: Potential to impact myopia. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0254027"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Braakhuis, A.J., Donaldson, C.I., Lim, J.C., and Donaldson, P.J. (2019). Nutritional Strategies to Prevent Lens Cataract: Current Status and Future Strategies. Nutrients, 11.","DOI":"10.3390\/nu11051186"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1016\/j.ophtha.2007.12.019","article-title":"Outdoor activity reduces the prevalence of myopia in children","volume":"115","author":"Rose","year":"2008","journal-title":"Ophthalmology"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.ebiom.2016.12.007","article-title":"Violet light exposure can be a preventive strategy against myopia progression","volume":"15","author":"Torii","year":"2017","journal-title":"eBiomedicine"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"e10282","DOI":"10.1016\/j.heliyon.2022.e10282","article-title":"A review of the current state of research on artificial blue light safety as it applies to digital devices","volume":"8","author":"Wong","year":"2022","journal-title":"Heliyon"},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Zhang, D., Zhu, H., Yu, X., Wang, L., Wen, Y., Zhang, L., Tong, J., and Shen, Y. (2022). Blue light attenuates TGF-\u03b22-induced epithelial-mesenchymal transition in human lens epithelial cells via autophagy impairment. BMC Ophthalmol., 22.","DOI":"10.1186\/s12886-022-02691-6"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1136\/bjophthalmol-2018-312866","article-title":"Imaging in myopia: Potential biomarkers, current challenges and future developments","volume":"103","author":"Ang","year":"2019","journal-title":"Br. J. Ophthalmol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"17974","DOI":"10.1038\/s41598-022-22746-4","article-title":"TGF-\u03b22 levels in the aqueous humor are elevated in the second eye of high myopia within two weeks after sequential cataract surgery","volume":"12","author":"Yan","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1007\/s00417-020-04639-2","article-title":"Quantitative assessment of the retinal microvasculature and choriocapillaris in myopic patients using swept-source optical coherence tomography angiography","volume":"258","author":"Su","year":"2020","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."}],"container-title":["Biomolecules"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2218-273X\/13\/9\/1328\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:41:56Z","timestamp":1760128916000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2218-273X\/13\/9\/1328"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,29]]},"references-count":66,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,9]]}},"alternative-id":["biom13091328"],"URL":"https:\/\/doi.org\/10.3390\/biom13091328","relation":{},"ISSN":["2218-273X"],"issn-type":[{"value":"2218-273X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,29]]}}}