Aqueous Humour Cytokines as Predictors of Axial Elongation in High Myopia: A 2‐Year Longitudinal Cohort Study

ABSTRACT Background To investigate the predictive value of aqueous humour cytokines for axial elongation. Methods This was a prospective longitudinal observational study. 72 high myopia patients (72 eyes) who received implantable collamer lens (ICL) implantation surgery with at least 2 years of follow‐up were included. Aqueous humour samples were collected pre‐operatively, and six cytokines were measured using a Luminex bead‐based multiplex assay. Various ocular parameters such as axial length (AL), corneal curvature, and choroidal thickness were assessed. Data analysis included descriptive statistics, normality testing, group comparisons using parametric or non‐parametric tests, and correlation analyses using Pearson or Spearman methods. Results Baseline AL demonstrated significant correlations with aqueous interleukin‐8 (IL‐8, r = 0.335, p = 0.004), matrix metalloproteinase‐2 (MMP‐2, r = 0.323, p = 0.006), and vascular endothelial growth factor (VEGF, r = −0.358, p = 0.002). AL elongation over 2 years was significantly associated with baseline AL ( r = 0.254, p = 0.032), parafoveal retinal thickness ( r = −0.239, p = 0.044), and choroidal thickness ( r = −0.270, p = 0.022). Baseline levels of transforming growth factor‐beta2 (TGF‐β2) had a significantly independent positive correlation with axial elongation ( p = 0.017) and were significantly higher in the rapid elongation group ( p = 0.014). The receiver operating curve (ROC) analysis showed that TGF‐β2 yielded an AUC of 0.67 for discriminating axial elongation. Significant differences in MMP‐2 ( p = 0.019) and TGF‐β2 ( p = 0.001) levels were detected among the four subgroups stratified by baseline AL and elongation rate. Conclusions TGF‐β2 was significantly associated with axial elongation in high myopic patients receiving ICL implantation surgery and may serve as a candidate biomarker and therapeutic target for myopia progression; however, its predictive value requires further validation.