Fig. 7: Model of keratoconus-related changes across cell types in the central cornea.

In the cornea inflicted with keratoconus, mechanical stretch promotes the expression of several protease genes in stromal cells and aggravates ECM degradation, and the abnormal differentiation of corneal epithelial cells and elevated inflammatory signals were also detected (middle panel). Moreover, the dysregulated cell–cell communications occur in keratoconus corneas, especially for ligand-receptor pairs related to protease inhibiting and anti-inflammatory processes (right panel). The mechanical stretch exerted on cells was indicated by red arrows.