Logan Nicola S, Radhakrishnan Hema, Cruickshank Fiona E, Allen Peter M, Bandela Praveen K, Davies Leon N, Hasebe Satoshi, Khanal Safal, Schmid Katrina L, Vera-Diaz Fuensanta A, Wolffsohn James S
School of Optometry, Aston University, Birmingham, United Kingdom.
Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.
Invest Ophthalmol Vis Sci. 2021 Apr 28;62(5):4. doi: 10.1167/iovs.62.5.4.
The role of accommodation in myopia development and progression has been debated for decades. More recently, the understanding of the mechanisms involved in accommodation and the consequent alterations in ocular parameters has expanded. This International Myopia Institute white paper reviews the variations in ocular parameters that occur with accommodation and the mechanisms involved in accommodation and myopia development and progression. Convergence is synergistically linked with accommodation and the impact of this on myopia has also been critiqued. Specific topics reviewed included accommodation and myopia, role of spatial frequency, and contrast of the task of objects in the near environment, color cues to accommodation, lag of accommodation, accommodative-convergence ratio, and near phoria status. Aspects of retinal blur from the lag of accommodation, the impact of spatial frequency at near and a short working distance may all be implicated in myopia development and progression. The response of the ciliary body and its links with changes in the choroid remain to be explored. Further research is critical to understanding the factors underlying accommodative and binocular mechanisms for myopia development and its progression and to guide recommendations for targeted interventions to slow myopia progression.
调节在近视发生发展中的作用已争论了数十年。最近，对调节所涉及的机制以及随之而来的眼参数变化的理解有所扩展。这份国际近视研究所白皮书回顾了调节时发生的眼参数变化以及调节与近视发生发展所涉及的机制。集合与调节协同相关，其对近视的影响也受到了批评。所回顾的具体主题包括调节与近视、空间频率的作用、近环境中物体任务的对比度、调节的颜色线索、调节滞后、调节性集合比率以及近隐性斜视状态。调节滞后导致的视网膜模糊、近距离和短工作距离下空间频率的影响等方面都可能与近视的发生发展有关。睫状体的反应及其与脉络膜变化的联系仍有待探索。进一步的研究对于理解近视发生发展的调节和双眼机制背后的因素以及指导减缓近视进展的针对性干预建议至关重要。
