Singapore Eye Research Insitute, Singapore.
Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
Invest Ophthalmol Vis Sci. 2019 Feb 1;60(2):488-499. doi: 10.1167/iovs.18-25221.
Myopia is fast becoming a global public health burden with its increasing prevalence, particularly in developed countries. Globally, the prevalence of myopia and high myopia (HM) is 28.3% and 4.0%, respectively, and these numbers are estimated to increase to 49.8% for myopia and 9.8% for HM by 2050 (myopia defined as -0.50 diopter [D] or less, and HM defined as -5.00 D or less). The burden of myopia is tremendous, as adults with HM are more likely to develop pathologic myopia (PM) changes that can lead to blindness. Accordingly, preventive measures are necessary for each step of myopia progression toward vision loss. Approaches to prevent myopia-related blindness should therefore attempt to prevent or delay the onset of myopia among children by increased outdoor time; retard progression from low/mild myopia to HM, through optical (e.g., defocus incorporated soft contact lens, orthokeratology, and progressive-additional lenses) and pharmacological (e.g., low dose of atropine) interventions; and/or retard progression from HM to PM through medical/surgical treatments (e.g., anti-VEGF therapies, macula buckling, and scleral crosslinking). Recent clinical trials aiming for retarding myopia progression have shown encouraging results. In this article, we highlight recent findings on preventive and early interventional measures to retard myopia, and current and novel treatments for PM.
近视正在成为一个全球性的公共卫生负担，其患病率不断上升，尤其是在发达国家。全球近视和高度近视（HM）的患病率分别为 28.3%和 4.0%，预计到 2050 年，近视和 HM 的患病率将分别增加到 49.8%和 9.8%（近视定义为 -0.50 屈光度[D]或更低，HM 定义为 -5.00 D 或更低）。近视的负担是巨大的，因为高度近视的成年人更容易发生病理性近视（PM）变化，从而导致失明。因此，对于近视进展导致视力丧失的每一步都需要采取预防措施。预防近视相关失明的方法因此应该通过增加户外活动时间来预防或延缓儿童近视的发生；通过光学（例如，离焦软接触镜、角膜塑形术和渐进式附加镜片）和药物（例如，低剂量阿托品）干预来延缓从低度/轻度近视到 HM 的进展；并通过医疗/手术治疗（例如，抗血管内皮生长因子治疗、黄斑扣带术和巩膜交联术）来延缓从 HM 到 PM 的进展。最近旨在延缓近视进展的临床试验取得了令人鼓舞的结果。在本文中，我们重点介绍了预防和早期干预措施的最新发现，以延缓近视，并介绍了 PM 的现有和新型治疗方法。
