青少年近视的预防及研究进展

Prevention and Research Progress of Myopia in Adolescents

摘要: 近视是一种全球性的屈光不正问题，由于眼轴增长而导致，现已成为重要的公共卫生议题。随着近视患病率的不断上升，其导致的病理后果，如近视黄斑病变和高度近视相关性视神经病变，已成为不可逆性失明的主要原因之一。因此，早期发现和诊断近视对于实施有效的控制策略至关重要。特别是在东亚和东南亚地区，近视患病率显著上升，亟需采取措施降低近视率和减缓其发展为高度近视，因为高度近视是病理性近视的主要危险因素。研究表明，增加户外活动时间是减少儿童近视发展的关键策略。在临床上，可采用多种方法来减缓近视进展，如使用0.01%至0.05%低剂量阿托品滴眼液(尽管存在轻微副作用)，佩戴多焦点眼镜、周边近视离焦隐形眼镜，以及夜间佩戴角膜透气隐形眼镜进行角膜塑形术。在选择近视控制措施时，需综合考虑患者的年龄、健康状况和生活方式。这些措施并非互斥，而是可以综合考虑甚至联合研究，为患者提供更全面的近视防控方案。

Abstract: Myopia, a global refractive error issue caused by axial elongation of the eye, has emerged as a significant public health concern. With the escalating prevalence of myopia, its pathological consequences, such as myopic macular degeneration and high myopia-related optic neuropathy, have become one of the leading causes of irreversible blindness. Consequently, early detection and diagnosis of myopia are crucial for implementing effective control strategies. Particularly in East and Southeast Asia, where the prevalence of myopia has increased dramatically, urgent measures are needed to reduce myopia rates and mitigate its progression to high myopia, which is a major risk factor for pathologic myopia. Studies have shown that increasing outdoor activity time is a key strategy for reducing the development of myopia in children. Clinically, various methods can be employed to slow the progression of myopia, including the use of low-dose atropine eyedrops ranging from 0.01% to 0.05% (despite mild side effects), wearing multifocal glasses, peripheral defocus soft contact lenses, and overnight orthokeratology with gas permeable contact lenses. When selecting myopia control measures, comprehensive consideration of the patient’s age, health status, and lifestyle is necessary. These measures are not mutually exclusive but can be considered comprehensively and even studied in combination to provide patients with a more holistic myopia prevention and control program.