Department of Ophthalmology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Department of Ophthalmology, Binzhou Medical University Hospital, Binzhou, China.
Acta Ophthalmol. 2021 Nov;99(7):730-738. doi: 10.1111/aos.14773. Epub 2021 Feb 7.
Myopia is the most common type of refractive errors characterized by excessive elongation of the ocular globe. With the increasing prevalence of myopia, improved knowledge of factors involved in myopia development is of particular importance. There are growing evidence suggesting that the choroid plays an important role in the regulation of eye growth and the development of myopia. Studies have demonstrated that thinning choroid is a structural feature of myopia, with a negative correlation between choroidal thickness and axial length, suggesting that the change in choroidal thickness may be a predictive biomarker for long-term changes in ocular elongation. Given the fact that the choroid is primarily a vascular structure capable of rapidly changing blood flow, variations of choroidal thickness might be primarily caused by changes in choroidal blood flow. Considering that hypoxia is associated with myopia and choroidal blood flow is the main source of oxygen and nourishment supply, apart from the effect on myopia possibly by changing choroidal thickness, decreasing choroidal blood flow may contribute to scleral ischaemia and hypoxia, resulting in alterations in the scleral structure and thus leading to myopia. This review aims to provide an overview of recent work exploring the influence of the choroid on myopia from perspectives of choroidal thickness and blood flow, which may present new predictive indicators for the onset of myopia and new targets for the development of novel therapeutic approaches for myopia.
近视是最常见的屈光不正类型，其特征是眼球过度伸长。随着近视患病率的不断增加，深入了解近视发展相关的因素尤为重要。越来越多的证据表明脉络膜在眼球生长和近视发展的调节中起着重要作用。研究表明，脉络膜变薄是近视的一个结构特征，脉络膜厚度与眼轴长度呈负相关，这表明脉络膜厚度的变化可能是眼轴长期伸长的预测生物标志物。鉴于脉络膜主要是一个能够快速改变血流的血管结构，脉络膜厚度的变化可能主要是由脉络膜血流的变化引起的。考虑到缺氧与近视有关，而脉络膜血流是提供氧气和营养的主要来源，除了通过改变脉络膜厚度可能对近视产生影响外，减少脉络膜血流可能导致巩膜缺血和缺氧，导致巩膜结构改变，从而导致近视。本综述旨在从脉络膜厚度和血流的角度概述最近探讨脉络膜对近视影响的研究工作，这可能为近视的发生提供新的预测指标，并为近视的新治疗方法的开发提供新的靶点。
