黑暗环境智能手机使用的视觉健康风险：从眼表到眼底的潜在影响与机制探讨

Visual Health Risks of Smartphone Use in Dark Environments: Potential Impacts and Mechanisms from Ocular Surface to Fundus

摘要: 随着智能手机的普及，在黑暗环境中使用手机已成为普遍现象，由此引发的视觉健康问题已成为公共卫生领域和眼科学界关注的焦点。目前研究多集中于长期暴露对眼表(如干眼、视疲劳)及黄斑区的影响，而关于黑暗这一特殊视觉环境对眼底微血管结构，特别是黄斑区血管密度(Vascular density, VD)及脉络膜结构：包括脉络膜厚度(Choroidal thickness, CT)、脉络膜毛细血管密度(Choroidal capillary density CCD)及脉络膜血管指数(Choroidal vascular index, CVI)的短期影响，尚缺乏系统性的研究。光学相干断层扫描血管成像(Optical coherence tomography angiography, OCTA)技术为无创、精准量化这些微观变化提供了可能。本综述旨在系统梳理黑暗环境下的视觉生理改变，从机制上推演其对眼表(泪膜稳定性、主观视疲劳)及眼底(黄斑区血管密度、脉络膜厚度、脉络膜毛细血管密度及脉络膜血管指数)可能产生的短期影响。

Abstract: With the widespread use of smartphones, mobile phone usage in dark environments has become a common practice. The resulting visual health issues have drawn increasing attention in the field of public health and ophthalmology. Current research has largely focused on the long-term effects of such exposure on the ocular surface (such as dry eye and visual fatigue) and the macular region. However, there remains a lack of systematic investigation into the short-term effects of the specific visual environment of darkness on the microvascular structure of the fundus—particularly on vascular density (VD) in the macular region—as well as on choroidal structures, including choroidal thickness (CT), choroidal capillary density (CCD), and the choroidal vascular index (CVI). Optical coherence tomography angiography (OCTA) offers a non-invasive and precise method for quantifying these microstructural changes. This review aims to systematically outline the physiological visual changes that occur in dark environments and theoretically examine their potential short-term impacts on the ocular surface (such as tear film stability and subjective visual fatigue) and the fundus (including macular VD, CT, CCD, and CVI).