儿童近视 第一部分:当代治疗选择

Childhood Myopia Part I: Contemporary Treatment Options.

作者信息

Khanal Safal, Tomiyama Erin S, Harrington Síofra C

机构信息

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.

出版信息

Invest Ophthalmol Vis Sci. 2025 Jun 5;66(7):6. doi: 10.1167/iovs.66.7.6.

Abstract

Childhood myopia is a growing global public health concern. Treatments to control myopia are a priority because myopia, particularly high myopia, poses significant lifelong risks of vision loss from myopia-associated ocular pathologies. Intensive research efforts over the past two decades have led to the development of several effective strategies for controlling myopia in children: increased time outdoors, atropine eye drops, dual-focus and multifocal contact lenses, orthokeratology lenses, and specialized spectacle lenses. While the efficacy of these strategies is variable, evidence is growing regarding the potential benefits of applying these interventions in children with myopia, although none completely halt myopia progression. Despite this evidence, dual-focus contact lenses remain the only myopia treatment in the United States approved by the US Food and Drug Administration. This critical review article provides an evidence-based overview of treatment options currently available to prevent the onset of myopia and slow its progression in children. It is the first 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." Readers are referred to Part II for a review of treatment mechanisms, emerging and experimental treatments, and patient, treatment, and clinical trial considerations. Findings from this article demonstrate a growing body of strong evidence supporting the use of contemporary treatments in childhood myopia management. Regulatory approvals of these proven treatments worldwide would allow widespread, early intervention in at-risk children and potentially reduce the risk of vision loss from myopia-related complications later in life.

摘要

儿童近视是一个日益严重的全球公共卫生问题。控制近视的治疗是当务之急,因为近视,尤其是高度近视,会因与近视相关的眼部病变而带来严重的终身视力丧失风险。在过去二十年中,大量的研究工作促成了几种控制儿童近视的有效策略的发展:增加户外活动时间、使用阿托品滴眼液、双焦点和多焦点隐形眼镜、角膜塑形镜以及特殊的眼镜镜片。虽然这些策略的效果各不相同,但越来越多的证据表明,对近视儿童应用这些干预措施具有潜在益处,尽管没有一种能完全阻止近视进展。尽管有这些证据,但在美国,双焦点隐形眼镜仍然是唯一获得美国食品药品监督管理局批准的近视治疗方法。这篇综述文章基于证据,概述了目前可用于预防儿童近视发生和减缓其进展的治疗选择。它是提交给美国国家科学院、工程院和医学院进行“关注近视——发病机制与发病率上升”共识研究的委托论文《儿童近视的治疗》的第一部分。读者可参考第二部分,以了解治疗机制、新兴和实验性治疗方法以及患者、治疗和临床试验方面的考虑因素。本文的研究结果表明,越来越多的有力证据支持在儿童近视管理中使用当代治疗方法。这些经过验证的治疗方法在全球范围内获得监管批准,将允许对高危儿童进行广泛的早期干预,并有可能降低日后因近视相关并发症导致视力丧失的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd82/12151248/dc0c0393103b/iovs-66-7-6-f001.jpg

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