Efficacy and Safety Evaluation of Scleral Cross-Linking Using Genipin in the Treatment of Juvenile Guinea Pigs with High Myopia.

Purpose: To investigate the efficacy and safety of scleral cross-linking (CXL) using Genipin in the treatment of juvenile guinea pigs with high myopia. Methods: Twenty-four 4-week-old tricolor guinea pigs with high myopia of diopter ≤ -6.0 DS in the right eye were randomly divided into two groups: Genipin CXL group and control group ( n  = 12 for each group). They received separately form-deprivation (FD) combined with sub-tenon injection, and the former was 0.5% Genipin solution, while the latter was 0.9% saline solution. Refractive error, axial length (AL), intraocular pressure (IOP), and structural and vasculature optic disc changes in optical coherence tomography (OCT) and OCT angiography (OCTA) were analyzed at baseline and at 3 weeks after injection. Results: Baseline parameters were similar between the two groups ( P > 0.05). After 3 weeks of the intervention, the difference of AL between the two groups was statistically significant ( t  = -11.28, P  < 0.001). Besides, IOP increased in both groups, and the changes of IOP between the two groups were statistically significant ( t  = 2.80, P  = 0.01). The average cup-disc ratio ( C/D ) ( t  = 3.11, P  = 0.006) and the vertical C/D ( t  = 2.96, P  = 0.009) of OCT-related optic disc parameters in the Genipin CXL group increased, and the differences were statistically significant compared with the control group. Conclusion: The CXL method of sub-tenon injection of Genipin solution could effectively inhibit the progression of myopia in juvenile guinea pigs with highly myopic eyes combined with FD. The slightly elevated IOP and increased C/D of some fundus optic discs should be further assessed.