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儿童近视:流行病学、遗传学以及治疗与预防的新兴疗法

Myopia in Children: Epidemiology, Genetics, and Emerging Therapies for Treatment and Prevention.

作者信息

Surico Pier Luigi, Parmar Uday Pratap Singh, Singh Rohan Bir, Farsi Yeganeh, Musa Mutali, Maniaci Antonino, Lavalle Salvatore, D'Esposito Fabiana, Gagliano Caterina, Zeppieri Marco

机构信息

Schepens Eye Research Institute of Mass Eye and Ear, Harvard Medical School, Boston, MA 02114, USA.

Department of Ophthalmology, Campus Bio-Medico University, 00128 Rome, Italy.

出版信息

Children (Basel). 2024 Nov 27;11(12):1446. doi: 10.3390/children11121446.

Abstract

Refractive errors, particularly myopia, are among the most prevalent visual impairments globally, with rising incidence in children and adolescents. This review explores the epidemiology and risk factors associated with the development of refractive errors, focusing on the environmental and lifestyle factors contributing to the current surge in myopia. We provide an overview of key genetic factors and molecular pathways driving the pathogenesis of myopia and other refractive errors, emphasizing the complex interplay between genetic predisposition and environmental triggers. Understanding the underlying mechanisms is crucial for identifying new strategies for intervention. We discuss current approaches to slow myopia progression in pediatric populations, including pharmacological treatment regimens (low-dose atropine), optical interventions, and lifestyle modifications. In addition to established therapies, we highlight emerging innovations, including new pharmacological agents and advanced optical devices, and insights into potential future treatments. Cutting-edge research into gene therapy, molecular inhibitors, and neuroprotective strategies may yield novel therapeutic targets that address the root causes of refractive errors. This comprehensive review underscores the importance of early intervention and highlights promising avenues for future research, aiming to provide pediatricians with guidance to ultimately improve clinical outcomes in managing and preventing myopia progression in children and young adults.

摘要

屈光不正,尤其是近视,是全球最普遍的视力障碍之一,在儿童和青少年中的发病率呈上升趋势。本综述探讨了与屈光不正发生相关的流行病学和危险因素,重点关注导致当前近视激增的环境和生活方式因素。我们概述了驱动近视和其他屈光不正发病机制的关键遗传因素和分子途径,强调了遗传易感性与环境触发因素之间的复杂相互作用。了解潜在机制对于确定新的干预策略至关重要。我们讨论了目前在儿科人群中减缓近视进展的方法,包括药物治疗方案(低剂量阿托品)、光学干预和生活方式改变。除了既定疗法外,我们还强调了新兴创新,包括新的药物制剂和先进的光学设备,以及对潜在未来治疗方法的见解。对基因治疗、分子抑制剂和神经保护策略的前沿研究可能会产生解决屈光不正根本原因的新治疗靶点。这篇全面的综述强调了早期干预的重要性,并突出了未来研究的有前景的途径,旨在为儿科医生提供指导,最终改善儿童和年轻人近视管理和预防方面的临床结果。

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