Khanal Safal, Tomiyama Erin S, Harrington Síofra C
Department of Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, Alabama, United States.
Southern California College of Optometry, Marshall B. Ketchum University, Fullerton, California, United States.
Invest Ophthalmol Vis Sci. 2025 Jun 5;66(7):7. doi: 10.1167/iovs.66.7.7.
The rapidly increasing prevalence of myopia and its association with vision-threatening complications in later life has intensified efforts to identify treatments that can prevent the onset and slow the progression of myopia in children. These efforts have led to the development of several optical, environmental, and pharmacological myopia control treatments. Investigations of additional treatment options are ongoing and have shown great promise for clinical translation. Although significant progress has been made in identifying potential pathways and modes of action of these treatments, a complete mechanistic understanding is still lacking. This critical review article explores the potential mechanisms underlying the myopia control effects of contemporary treatments for childhood myopia. It also provides an evidence-based overview of emerging and experimental myopia control therapies. Additionally, the article addresses key considerations, including patient-related factors, treatment limitations, clinical trial designs, efficacy, and cost-effectiveness. This article is the second part of the commissioned paper "Treatment of Childhood Myopia" submitted to the National Academies of Sciences, Engineering, and Medicine for the consensus study Focus on Myopia-Pathogenesis and Rising Incidence. For a comprehensive overview of contemporary treatments for childhood myopia in and outside the United States, readers are referred to Childhood Myopia Part I: Contemporary Treatment Options. The findings in this review article underscore the need for continued research to deepen our understanding of the mechanisms underlying myopia treatments, evaluate the long-term safety and efficacy of current and emerging therapies, and identify patient- and treatment-related factors to optimize treatment outcomes in the clinical care of children with myopia.
近视患病率的迅速上升及其与后期生活中威胁视力的并发症的关联，促使人们加大力度寻找能够预防儿童近视发病并减缓其进展的治疗方法。这些努力催生了多种光学、环境和药物性近视控制疗法。对其他治疗选择的研究正在进行中，并且在临床转化方面显示出巨大潜力。尽管在确定这些治疗方法的潜在途径和作用模式方面已经取得了重大进展，但仍缺乏完整的机制理解。这篇批判性综述文章探讨了当代儿童近视治疗方法的近视控制效果背后的潜在机制。它还基于证据概述了新兴和实验性近视控制疗法。此外，文章讨论了关键考量因素，包括患者相关因素、治疗局限性、临床试验设计、疗效和成本效益。本文是提交给美国国家科学院、工程院和医学院的共识研究“关注近视——发病机制与发病率上升”的委托论文《儿童近视的治疗》的第二部分。有关美国国内外当代儿童近视治疗方法的全面概述，读者可参考《儿童近视第一部分：当代治疗选择》。这篇综述文章中的研究结果强调，需要持续开展研究，以加深我们对近视治疗潜在机制的理解，评估现有和新兴疗法的长期安全性和疗效，并确定与患者和治疗相关的因素，以便在近视儿童的临床护理中优化治疗效果。
