Berkeley Myopia Research Group, School of Optometry and Vision Science Program, University of California Berkeley, Berkeley, California, United States.
Singapore Eye Research Institute and Singapore National Eye Center, Singapore.
Invest Ophthalmol Vis Sci. 2019 Feb 28;60(3):M106-M131. doi: 10.1167/iovs.18-25958.
Myopia has been predicted to affect approximately 50% of the world's population based on trending myopia prevalence figures. Critical to minimizing the associated adverse visual consequences of complicating ocular pathologies are interventions to prevent or delay the onset of myopia, slow its progression, and to address the problem of mechanical instability of highly myopic eyes. Although treatment approaches are growing in number, evidence of treatment efficacy is variable. This article reviews research behind such interventions under four categories: optical, pharmacological, environmental (behavioral), and surgical. In summarizing the evidence of efficacy, results from randomized controlled trials have been given most weight, although such data are very limited for some treatments. The overall conclusion of this review is that there are multiple avenues for intervention worthy of exploration in all categories, although in the case of optical, pharmacological, and behavioral interventions for preventing or slowing progression of myopia, treatment efficacy at an individual level appears quite variable, with no one treatment being 100% effective in all patients. Further research is critical to understanding the factors underlying such variability and underlying mechanisms, to guide recommendations for combined treatments. There is also room for research into novel treatment options.
基于近视患病率的趋势预测，全球约有 50%的人口将会受到近视的影响。为了尽量减少与复杂眼部病变相关的不良视觉后果，关键是要采取干预措施来预防或延迟近视的发生，减缓其进展，并解决高度近视眼球机械不稳定的问题。尽管治疗方法不断增加，但治疗效果的证据却各不相同。本文综述了四类干预措施的研究进展：光学、药物、环境（行为）和手术。在总结疗效证据时，我们主要考虑了随机对照试验的结果，尽管对于某些治疗方法，此类数据非常有限。总的来说，本文的结论是，在所有类别中都有多种干预途径值得探索，尽管在光学、药物和行为干预预防或减缓近视进展方面，个体治疗的效果差异很大，没有一种治疗方法对所有患者都能达到 100%的有效率。为了理解这种变异性和潜在机制，从而为联合治疗提供建议，进一步的研究至关重要。对于新型治疗方法也有研究的空间。
