title: Is myopia another clinical manifestation of insulin resistance?
abstract: Myopia is a multifactorial visual refraction disease, in which the light rays from distant objects are focused in front of retina, causing blurry vision. Myopic eyes are characterized by an increased corneal curvature and/or ocular axial length. The prevalence of myopia has increased in recent decades, a trend that cannot be attributed exclusively to genetic factors. Low and middle income countries have a higher burden of refractive error, which we propose could be a consequence of a shorter exposure time to a westernized lifestyle, a phenomenon that may also explain the rapid increase in cardiometabolic diseases, such as diabetes, among those populations. We suggest that interactions between genetic, epigenetic and a rapidly changing environment are also involved in myopia onset and progression. Furthermore, we discuss several possible mechanisms by which insulin resistance may promote abnormal ocular growth and myopia to support the hypothesis that insulin resistance and hyperinsulinemia are involved in its pathogenesis, providing a link between trends in myopia and those of cardiometabolic diseases. There is evidence that insulin have direct ocular growth promoting effects as well an indirect effect via the induction of insulin-like growth factors leading to decreases insulin-like growth factor-binding protein, also implicated in ocular growth.
authors.affiliation: Centro Oftalmológico Virgilio Galvis, Floridablanca, Santander, Colombia; Fundación Oftalmológica de Santander - FOSCAL, Floridablanca, Santander, Colombia.
authors.forename: Virgilio
authors.initials: V
authors.lastname: Galvis
authors.affiliation: Fundación Oftalmológica de Santander - FOSCAL, Floridablanca, Santander, Colombia; Instituto MASIRA, Facultad de Ciencias de la Salud, Universidad de Santander (UDES), Bucaramanga, Santander, Colombia. Electronic address: jplopezj@gmail.com.
authors.forename: Patricio
authors.initials: P
authors.lastname: López-Jaramillo
authors.affiliation: Centro Oftalmológico Virgilio Galvis, Floridablanca, Santander, Colombia; Departamento de Cirugía, Escuela de Medicina, Facultad de Ciencias de la Salud, Universidad Autónoma de Bucaramanga (UNAB), Bucaramanga, Santander, Colombia.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Tello
authors.affiliation: Fundación Oftalmológica de Santander - FOSCAL, Floridablanca, Santander, Colombia.
authors.forename: Yuly Andrea
authors.initials: YA
authors.lastname: Castellanos-Castellanos
authors.affiliation: Fundación Oftalmológica de Santander - FOSCAL, Floridablanca, Santander, Colombia.
authors.forename: Paul Anthony
authors.initials: PA
authors.lastname: Camacho
authors.affiliation: Fundación Oftalmológica de Santander - FOSCAL, Floridablanca, Santander, Colombia; Instituto MASIRA, Facultad de Ciencias de la Salud, Universidad de Santander (UDES), Bucaramanga, Santander, Colombia.
authors.forename: Daniel Dylan
authors.initials: DD
authors.lastname: Cohen
authors.affiliation: Fundación Oftalmológica de Santander - FOSCAL, Floridablanca, Santander, Colombia.
authors.forename: Diego
authors.initials: D
authors.lastname: Gómez-Arbeláez
authors.affiliation: Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Merayo-Lloves
mesh_terms: D000818:Animals; D003710:Demography; D003906:Developing Countries; D048909:Diabetes Complications / Q000503:physiopathology; D066273:Diet, Western / Q000009:adverse effects; D059647:Gene-Environment Interaction; D014943:Global Health; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000503:physiopathology; D006946:Hyperinsulinism / Q000150:complications / Q000503:physiopathology; D007333:Insulin Resistance / Q000502:physiology*; D018969:Insulin-Like Growth Factor Binding Proteins / Q000502:physiology; D008019:Life Style; D008954:Models, Biological; D009216:Myopia / Q000139:chemically induced / Q000453:epidemiology / Q000209:etiology*; D009765:Obesity / Q000150:complications / Q000503:physiopathology; D015995:Prevalence; D012307:Risk Factors; D012922:Social Change; D013002:Somatomedins / Q000502:physiology / Q000633:toxicity
chemical_list: D018969:Insulin-Like Growth Factor Binding Proteins; D013002:Somatomedins