# Scleral Remodeling in Myopia

> **NIH NIH R01** · UNIVERSITY OF ALABAMA AT BIRMINGHAM · 2023 · $569,136

## Abstract

Project Summary/Abstract
 The prevalence of myopia in the U.S. population and globally is constantly growing, increasing the risk for
associated blinding diseases such as glaucoma and retinal detachment. Evidence from animal studies
indicates that locally modulated biomechanical weakening of the sclera underlies accelerated scleral
remodeling and axial elongation in myopia. Our goal is to elucidate the mechanisms that control scleral
remodeling and evaluate their potential to control all forms of myopia. Our central hypothesis is that scleral
remodeling in myopia is controlled by two interacting mechanisms: (i) vision-guided, aggrecan-mediated scleral
weakening that promotes collagen sliding, and (ii) natural collagen crosslinking that accumulates with age and
limits the biomechanical effects of the first mechanism. We will use our close-to-primate animal model, the tree
shrew, and innovative tools to decipher the interacting mechanism between aggrecan and crosslinking in
myopia, hyperopia, and aging. In the previous project period, we have shown that artificial crosslinking using
genipin can effectively strengthen the biomechanical weakened sclera and slow myopia progression but may
cause adverse effects. We will evaluate a new, safer mechanism to induce crosslinking using copper salt,
which increases lysyl oxidase activity and accelerates natural crosslinking. Recent findings suggest that
peripheral retinal signals play a key role in myopia, but how these signals lead to local scleral changes remains
unknown due to missing biomarkers. We will establish two locally sensitive biomarkers of scleral weakening:
direct measurements of micro-scale collagen fiber crimp using polarized light microscopy and point-by-point
tissue-scale stiffness measurements using nanoindentation. These biomarkers will allow us to (i) gain
fundamental understanding of the spatial distribution of biomechanical weakening in myopia and (ii) verify
effective biomechanical treatment with our new crosslinking approach across the entire sclera. This
mechanism discovery grant will provide fundamental insight into the multi-scale mechanisms that control
scleral biomechanics and remodeling; the role of aggrecan in myopia; the interactions between collagen
crosslinking, aging, and aggrecan; establish local biomarkers of biomechanical weakening; and evaluate lysyl
oxidase activity and aggrecan as potential new treatment targets.

## Key facts

- **NIH application ID:** 10594663
- **Project number:** 2R01EY026588-06A1
- **Recipient organization:** UNIVERSITY OF ALABAMA AT BIRMINGHAM
- **Principal Investigator:** Rafael Grytz
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $569,136
- **Award type:** 2
- **Project period:** 2016-09-01 → 2027-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10594663

## Citation

> US National Institutes of Health, RePORTER application 10594663, Scleral Remodeling in Myopia (2R01EY026588-06A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10594663. Licensed CC0.

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