Department of Ophthalmology & Visual Sciences, Montefiore Medical Center, Bronx, New York, USA.
Curr Opin Ophthalmol. 2019 Jul;30(4):215-219. doi: 10.1097/ICU.0000000000000571.
Myopia refers to a refractive state of the eye that can predispose to visually significant ocular disease. The prevalence of myopia is increasing worldwide. Researchers internationally have been investigating methods to slow down its progression to prevent sight-threatening complications. In this article, we perform a review of the current literature discussing interventions for preventing pediatric myopic progression.
Various interventions, including lifestyle modification, optical methods, and pharmacologic approaches, have been proposed to help control myopic progression. Increasing time spent outdoors can help prevent myopia onset, but has a clinically questionable effect on progression of myopia. Contact lenses that reduce peripheral retinal hyperopic defocus represent a new area of research and may hold promise as an effective intervention in myopia control. Orthokeratology shows moderate reduction rates in myopic progression whereas atropine drops, even at low doses, show the most impressive effect on slowing myopia.
Atropine eye drops, followed by orthokeratology lenses, are the most effective in slowing down axial elongation and myopic progression. Guidelines for use and the target populations for such interventions have not been well established and more research is warranted in these areas. Treatment should be tailored to each patient.
近视是一种眼的屈光状态,可使眼部发生严重疾病的风险增加。近视的患病率在全球范围内呈上升趋势。国际研究人员一直在研究减缓近视进展的方法,以预防威胁视力的并发症。本文就目前关于预防儿童近视进展的干预措施的文献进行综述。
各种干预措施,包括生活方式的改变、光学方法和药物方法,已被提出用于帮助控制近视进展。增加户外活动时间有助于预防近视的发生,但对近视进展的临床效果存在疑问。减少周边视网膜远视离焦的接触镜代表了一个新的研究领域,作为近视控制的有效干预措施可能具有很大的潜力。角膜塑形术显示出对近视进展适度的减缓作用,而低浓度阿托品滴眼液的效果最为显著。
阿托品滴眼液,其次是角膜塑形术,是减缓眼轴伸长和近视进展最有效的方法。此类干预措施的使用指南和目标人群尚未得到很好的确立,这些领域还需要更多的研究。治疗应针对每个患者进行个体化。