Abstract

Scleral Crosslinking by an Innovative Substance and Irradiation System - A Novel Medical Device for a New Therapeutic Approach

Mike Francke, Investigator, TRM Leipzig

Millions of people worldwide suffer from pathologic myopia which is a degenerative subtype of axial myopia associated with severe visual impairment and blindness caused by a pathological axial eye elongation. An efficient treatment of this pathology is still missing. Therefore, collagen cross linking of scleral tissue (SXL) by riboflavin and blue light application was suggested as a possible treatment and was proved in an animal model as a method to increase scleral stiffness and to inhibit eye growth. SXL treatment with higher blue light intensities induces an activation of fibroblasts associated with morphological changes of the cells. Furthermore, we observed the disorganisation of bundle structures and quantified changes of the collagen fibril structures by means of electron microscopy. Many tiny collagen fibrils with thinner diameters compared with normal collagen fibrils of untreated eyes appeared in the environment of activated fibroblast. Preliminary measurements aim to correlate the structural changes with biomechanical properties. Currently, we investigate relevant enzymes involved in composition and degradation of collagen and extracellular matrix structures (e.g. MMPs, TIMPS, ADAMs) in isolated tissue and scleral cell cultures. It is important to indentify the involved enzymes and to characterize the remodelling processes and their consequences for the biomechanical properties after SXL treatment because this knowledge helps to estimate the long term effects of the new therapeutic approach.