Citicoline Restores Endoplasmic Reticulum Homeostasis by Regulating Oxidative Stress Through CDO1 to Reverse Myopia Progression

OBJECTIVE: To investigate whether citicoline alleviates endoplasmic reticulum (ER) stress by modulating oxidative stress in myopia. RESULTS: A form-deprivation myopia model in guinea pigs and a hypoxia-induced model in human scleral fibroblasts revealed that citicoline downregulated cysteine dioxygenase 1 (CDO1) expression, increased glutathione, and reduced reactive oxygen species. These changes mitigated oxidative stress, suppressed ER stress, maintained cellular homeostasis, and inhibited extracellular matrix remodeling, leading to reduced axial elongation. INNOVATION: Transcriptomic profiling identified CDO1 as a novel downstream effector of citicoline, linking cysteine metabolism to oxidative and ER stress regulation in myopia. CONCLUSION: 00, 000-000.