A new theory of refractogenesis and development of myopia

Purpose. To present for the discussion the new theory of the influence of light, visual loads and mitogenetic radiation of the retina on the genetically programmed code of refractogenesis and myopia development. Material and methods. Studies on experimental modeling of axial myopia, refractogenesis and theories of myopia pathogenesis were analyzed. Our own material included diverse studies of patients with myopia, which were conducted for more than 50 years. Results. In experimental studies, the hereditary factor was excluded and it was established that various light effects cause axial myopia only in newborns and young individuals. However, the mechanism of the effect of light photons on the axial elongation of the eye remained unclear. The new theory of refractogenesis considers mitogenetic growth fields in eye tissues. These are fields of weak ultraviolet radiation in the range of 190–330 nm, formed during the replication of DNA chromosomes in the nuclei of cells, the division of which is stimulated by somatotropic growth hormone. The strongest mitogenetic field is formed in the retina with hyperopic defocus of light rays that pass through all its layers and are maximally absorbed by photoreceptors. This increases the activity of the mitogenetic field of the retina, which becomes the leading one and predetermines the preferential growth of the posterior part of the eye. The iridocyclocrystalline lens complex optimizes the focusing of light rays in the fovea, stimulates hydrodynamics and hemodynamics in the eye, which activates transretinal dialysis of intraocular fluid and weakens the mitogenetic field of the retina. Long-term accommodation and convergence stresses lead to the accumulation of microdeformations in the sclera, disrupt the work of mechanosensitive aquaporins, transmembrane exchange of intraocular fluid in the tissues of the eye and its transretinal dialysis, which enhances the mitogenetic potential of the retina. Conclusion. In the postnatal period, visible light, hyperopic defocus of light rays, prolonged accommodative and convergent loads enhance the mitogenetic field of the retina, which disrupts the hereditary code of refractogenesis, leading to the development and progression of myopia.