紫光影响脉络膜厚度与血流动态平衡抑制近视的机制研究及近视防控新策略

Research on the Mechanisms of Violet Light Influencing Choroidal Thickness and Choroidal Blood Perfusion to Inhibit Myopia and New Strategies for Myopia Prevention and Control

摘要: 近视是常见的全球公共性卫生问题，影响了全世界近三分之一的人，已成为全球第六大致盲原因。儿童青少年近视的发生发展是遗传和环境多因素综合作用的结果，仅遗传因素已不能解释儿童青少年近视高发以及进展快的特点，且遗传因素目前仍无法加以干预以延缓近视进展。户外活动的减少是目前已知最主要的环境危险因素之一，而户外活动对近视的保护与光线水平，光的光谱组成有关。其机制涉及强光刺激视网膜多巴胺释放及动态光谱的综合效应，其中紫光(360~400 nm)展现出独特的抑制作用。最新研究表明，紫光通过激活视网膜OPN5光感受器，上调EGR-1基因表达，刺激多巴胺释放，不仅能抑制实验动物近视模型眼轴增长，在临床随机对照试验中可使儿童眼轴增长率降低21.4%，并显著增厚脉络膜。这提示紫光可能通过影响脉络膜厚度及血流动态平衡，为开发非侵入性近视防控手段提供新方向。

Abstract: Myopia, a prevalent global public health issue, affects nearly one-third of the world’s population and has become the sixth leading cause of blindness worldwide. The development of myopia in children and adolescents results from a combination of genetic and environmental factors. Genetic factors alone cannot explain the high prevalence or rapid progression of myopia in this population, and they remain non-modifiable for delaying disease progression. Reduced outdoor activity is one of the most well-documented environmental risk factors, with the protective effect of outdoor exposure linked to light intensity and spectral composition. The underlying mechanisms involve the synergistic effects of bright light-induced retinal dopamine release and dynamic light spectra. Notably, violet light (360~400 nm) exhibits unique inhibitory properties. Recent studies demonstrate that violet light activates retinal OPN5 photoreceptors, upregulates EGR-1 gene expression, and stimulates dopamine release. This pathway not only suppresses axial length growth in experimental animal models but also reduces axial length growth rate by 21.4% in clinical randomized controlled trials among children, accompanied by significant choroidal thickening. These findings suggest that violet light may influence choroidal thickness and blood perfusion balance, offering a novel direction for developing non-invasive strategies for myopia prevention and control.