Xu Mengyao, Zhang Fengju
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Lab Beijing 100730, China.
Am J Transl Res. 2025 Apr 15;17(4):2422-2433. doi: 10.62347/GZUA2622. eCollection 2025.
Myopia in children has become a global public health concern due to its increasing prevalence and potential long-term complications. Optical interventions, including single-vision lenses (SVL), bifocal/progressive addition lenses (PALs), peripheral defocus-incorporated multiple segments (DIMS) glasses, and orthokeratology (OK) lenses have shown varying success in slowing progression, though long-term safety and efficacy remain under investigation. Pharmacological treatments, including low-dose atropine (0.01%), pirenzepine, apomorphine, and 7-methylxanthine (7-MX), offer additional options. Low-dose atropine is the most effective, significantly reducing myopia progression with minimal side effects. Pirenzepine, though promising in animal models, faces challenges due to poor corneal permeability. Apomorphine shows potential but requires further clinical testing. 7-MX has demonstrated dose-dependent effects in slowing progression, yet its efficacy needs validation in broader populations. Emerging therapies like low-level red-light therapy (LLRT) and Diffusion Optics Technology (DOT) lenses also show promise, reducing axial elongation and refractive progression. However, their long-term safety and mechanisms remain unclear. In conclusion, while several interventions show potential, further long-term studies and personalized treatment strategies are needed to optimize outcomes. Future research should focus on new drug targets, technologies, and global collaboration to address the myopia crisis in children.
由于儿童近视患病率不断上升及其潜在的长期并发症，儿童近视已成为一个全球公共卫生问题。光学干预措施，包括单焦点镜片（SVL）、双焦点/渐进多焦点镜片（PALs）、周边离焦多区域（DIMS）眼镜和角膜塑形术（OK）镜片，在减缓近视进展方面已显示出不同程度的成功，不过其长期安全性和有效性仍在研究中。药物治疗，包括低浓度阿托品（0.01%）、哌仑西平、阿扑吗啡和7-甲基黄嘌呤（7-MX），提供了更多选择。低浓度阿托品最为有效，能显著减缓近视进展且副作用最小。哌仑西平虽然在动物模型中前景良好，但由于角膜通透性差而面临挑战。阿扑吗啡显示出潜力，但需要进一步的临床试验。7-MX已证明在减缓近视进展方面有剂量依赖性作用，但其有效性需要在更广泛的人群中得到验证。低强度红光疗法（LLRT）和扩散光学技术（DOT）镜片等新兴疗法也显示出前景，可减少眼轴伸长和屈光进展。然而，它们的长期安全性和作用机制仍不清楚。总之，虽然几种干预措施显示出潜力，但仍需要进一步的长期研究和个性化治疗策略来优化治疗效果。未来的研究应聚焦于新的药物靶点、技术以及全球合作，以应对儿童近视危机。
