Integrated analysis of the aqueous humor microbiome and lens capsule transcriptome in high myopia cataract: a pilot study.

INTRODUCTION

High myopia is a critical risk factor that accelerates cataract onset and increases surgical complexity, yet the underlying mechanisms remain incompletely understood.

METHODS

In this study, we collected aqueous humor samples (6 from high myopia cataract patients and 6 from age-related cataract controls) and lens capsule samples (3 per group). 2bRAD-M gene sequencing was used to characterize the aqueous humor microbiome, while RNA-seq was performed to profile transcriptomic changes in the lens capsule.

RESULTS

Patients with high myopia cataract exhibited significant alterations in aqueous humor microbial diversity, with decreased abundance of Escherichia and increased abundance of Neisseria, Capnocytophaga, Veillonella, Rhodococcus, Jensenia, and Corynebacterium. Functional predictions suggested shifts in local metabolic pathways. Transcriptomic analysis revealed reprogramming of metabolism-related genes in the lens capsule and activation of downstream signaling pathways including ErbB and HIF-1, which are associated with lens epithelial cell apoptosis.

DISCUSSION: These findings suggest that alterations in the aqueous humor microbial community may be associated with the lens metabolic microenvironment and apoptotic pathway activation, thereby linking to cataract progression in high myopia. This study provides a novel perspective on the pathogenesis of high myopia-associated cataract.