Smith Earl L
College of Optometry, University of Houston, Houston, Texas 77204-2020, USA.
Optom Vis Sci. 2011 Sep;88(9):1029-44. doi: 10.1097/OPX.0b013e3182279cfa.
It is well established that refractive development is regulated by visual feedback. However, most optical treatment strategies designed to reduce myopia progression have not produced the desired results, primarily because some of our assumptions concerning the operating characteristics of the vision-dependent mechanisms that regulate refractive development have been incorrect. In particular, because of the prominence of central vision in primates, it has generally been assumed that signals from the fovea determine the effects of vision on refractive development. However, experiments in laboratory animals demonstrate that ocular growth and emmetropization are mediated by local retinal mechanisms and that foveal vision is not essential for many vision-dependent aspects of refractive development. However, the peripheral retina, in isolation, can effectively regulate emmetropization and mediate many of the effects of vision on the eye's refractive status. Moreover, when there are conflicting visual signals between the fovea and the periphery, peripheral vision can dominate refractive development. The overall pattern of results suggests that optical treatment strategies for myopia that take into account the effects of peripheral vision are likely to be more successful than strategies that effectively manipulate only central vision.
众所周知，屈光发育受视觉反馈调节。然而，大多数旨在减缓近视进展的光学治疗策略并未产生预期效果，主要是因为我们对调节屈光发育的视觉依赖机制的运行特性的一些假设是错误的。特别是，由于中央视觉在灵长类动物中的突出地位，人们通常认为来自中央凹的信号决定了视觉对屈光发育的影响。然而，实验动物实验表明，眼球生长和正视化是由局部视网膜机制介导的，并且中央凹视觉对于屈光发育的许多视觉依赖方面并非必不可少。然而，孤立的周边视网膜可以有效地调节正视化，并介导视觉对眼睛屈光状态的许多影响。此外，当中央凹和周边之间存在相互冲突的视觉信号时，周边视觉可以主导屈光发育。总体结果模式表明，考虑周边视觉影响的近视光学治疗策略可能比仅有效操纵中央视觉的策略更成功。
