Department of Pediatric Ophthalmology, Affiliated Hospital of Yunnan University, Kunming 650021, China.
Department of Ophthalmology, the First Affiliated Hospital of Kunming Medical University, Kunming 650031, China.
Int J Med Sci. 2023 Sep 4;20(10):1363-1376. doi: 10.7150/ijms.85746. eCollection 2023.
Repeated low-level red-light (RLRL), characterized by increased energy supply and cellular metabolism, thus enhancing metabolic repair processes, has gained persistent worldwide attention in recent years as a new novel scientific approach for therapeutic application in myopia. This therapeutic revolution led by RLRL therapy is due to significant advances in bioenergetics and photobiology, for instance, enormous progresses in photobiomodulation regulated by cytochrome oxidase, the primary photoreceptor of the light in the red to near infrared regions of the electromagnetic spectrum, as the primary mechanism of action in RLRL therapy. This oxidase is also a key mitochondrial enzyme for cellular bioenergetics, especially for the nerve cells in the retina and brain. In addition, dopamine (DA)-enhanced release of nitric oxide may also be involved in controlling myopia by activation of nitric oxide synthase, enhancing cGMP signaling. Recent evidence has also suggested that RLRL may inhibit myopia progression by inhibiting spherical equivalent refraction (SER) progression and axial elongation without adverse effects. In this review, we provide scientific evidence for RLRL therapy as a unique paradigm to control myopia and support the theory that targeting neuronal energy metabolism may constitute a major target for the neurotherapeutics of myopia, with emphasis on its molecular, cellular, and nervous tissue levels, and the potential benefits of RLRL therapy for myopia.
反复低水平红光(RLRL),其特征为增加能量供应和细胞代谢,从而增强代谢修复过程,近年来作为近视治疗应用的一种新的科学方法,在全球范围内引起了持续关注。RLRL 治疗引领的这种治疗革命,源于生物能量学和光生物学的重大进展,例如,细胞色素氧化酶调节的光生物调节取得了巨大进展,细胞色素氧化酶是电磁光谱中红到近红外区域光的主要光感受器,是 RLRL 治疗的主要作用机制。这种氧化酶也是细胞生物能量学的关键线粒体酶,特别是在视网膜和大脑的神经细胞中。此外,多巴胺(DA)增强一氧化氮的释放也可能通过激活一氧化氮合酶来控制近视,增强 cGMP 信号。最近的证据还表明,RLRL 可能通过抑制等效球镜(SER)进展和轴向伸长来抑制近视进展,而没有不良反应。在这篇综述中,我们提供了 RLRL 治疗作为控制近视的独特范例的科学证据,并支持了靶向神经元能量代谢可能构成近视神经治疗的主要目标的理论,重点介绍了其在分子、细胞和神经组织水平上的作用,以及 RLRL 治疗对近视的潜在益处。