脉络膜血流和结构与虚拟光学技术的研究进展
Research Progress on Choroidal Blood Flow and Structure with Virtual Optical Technology
摘要: 近视是一种常见眼病，近年来近视发病率逐年上升，近视所带来的并发症可引起巨大的经济和社会效益的损失，控制近视迫在眉睫。既往研究证明，脉络膜血流和结构的变化与眼轴增长有关，是近视发展的机制之一，另一个比较普遍认可的机制是视网膜周边离焦和对比度信号引起眼球轴向伸长不受控制。随着科技发展，越来越多的目光投向虚拟光学信号(模拟视网膜周边离焦、对比度信号、拉远距离、模拟日照等)，VR、虚拟远像技术等技术越来越多的应用于近视控制方面，现笔者将虚拟光学技术对脉络膜结构的影响进行综述，拟为延缓近视进展的治疗方案设计提供参考。
Abstract: Myopia is a common eye disease, and in recent years, its incidence has been rising year by year. The complications caused by myopia can lead to significant economic and social losses. Therefore, controlling myopia is an urgent matter. Previous studies have shown that changes in choroidal blood flow and structure are related to axial elongation of the eye and are one of the mechanisms for the development of myopia. Another widely accepted mechanism is that retinal defocus and contrast signals in the peripheral retina lead to uncontrolled axial elongation of the eyeball. With the development of technology, increasing attention has been directed towards virtual optical signals, and technologies such as VR are increasingly being applied to myopia control. In this context, the author reviews the effects of virtual optical technology on choroidal structure, with the aim of providing a theoretical basis for designing treatment strategies to slow the progression of myopia.
文章引用：唐源, 徐霁, 李华. 脉络膜血流和结构与虚拟光学技术的研究进展[J]. 临床医学进展, 2026, 16(3): 242-247. https://doi.org/10.12677/acm.2026.163785

参考文献

[1] Pan, C., Ramamurthy, D. and Saw, S. (2011) Worldwide Prevalence and Risk Factors for Myopia. Ophthalmic and Physiological Optics, 32, 3-16. [Google Scholar] [CrossRef] [PubMed]
[2] Wang, W., Zhu, L., Zheng, S., Ji, Y., Xiang, Y., Lv, B., et al. (2021) Survey on the Progression of Myopia in Children and Adolescents in Chongqing during COVID-19 Pandemic. Frontiers in Public Health, 9, Article ID: 646770. [Google Scholar] [CrossRef] [PubMed]
[3] Flitcroft, D.I. (2012) The Complex Interactions of Retinal, Optical and Environmental Factors in Myopia Aetiology. Progress in Retinal and Eye Research, 31, 622-660. [Google Scholar] [CrossRef] [PubMed]
[4] Ruiz-Medrano, J., Montero, J.A., Flores-Moreno, I., Arias, L., García-Layana, A. and Ruiz-Moreno, J.M. (2019) Myopic Maculopathy: Current Status and Proposal for a New Classification and Grading System (ATN). Progress in Retinal and Eye Research, 69, 80-115. [Google Scholar] [CrossRef] [PubMed]
[5] Ohno-Matsui, K. and Jonas, J.B. (2019) Posterior Staphyloma in Pathologic Myopia. Progress in Retinal and Eye Research, 70, 99-109. [Google Scholar] [CrossRef] [PubMed]
[6] Naidoo, K.S., Fricke, T.R., Frick, K.D., Jong, M., Naduvilath, T.J., Resnikoff, S., et al. (2019) Potential Lost Productivity Resulting from the Global Burden of Myopia: Systematic Review, Meta-Analysis, and Modeling. Ophthalmology, 126, 338-346. [Google Scholar] [CrossRef] [PubMed]
[7] Ciuffreda, K.J. and Vasudevan, B. (2008) Nearwork‐Induced Transient Myopia (NITM) and Permanent Myopia—Is There a Link? Ophthalmic and Physiological Optics, 28, 103-114. [Google Scholar] [CrossRef] [PubMed]
[8] Harb, E., Thorn, F. and Troilo, D. (2006) Characteristics of Accommodative Behavior during Sustained Reading in Emmetropes and Myopes. Vision Research, 46, 2581-2592. [Google Scholar] [CrossRef] [PubMed]
[9] Earl L. Smith, 谢培英. 视网膜对比度信号对近视控制作用的研究进展[J]. 中华眼科杂志, 2023, 59(6): 488-491.
[10] Huang, Y.Y., Ten, W.J., et al. (2024) Autostereoscopic 3D Viewing Can Change the Dimensions of the Crystalline Lens in Myopes. Ophthalmic and Physiological Optics, 44, 1309-1318.
[11] Wu, H., Zhang, G., Shen, M., Xu, R., Wang, P., Guan, Z., et al. (2021) Assessment of Choroidal Vascularity and Choriocapillaris Blood Perfusion in Anisomyopic Adults by SS-OCT/OCTA. Investigative Opthalmology & Visual Science, 62, Article No. 8. [Google Scholar] [CrossRef] [PubMed]
[12] Zhou, H., Dai, Y., Shi, Y., Russell, J.F., Lyu, C., Noorikolouri, J., et al. (2020) Age-Related Changes in Choroidal Thickness and the Volume of Vessels and Stroma Using Swept-Source OCT and Fully Automated Algorithms. Ophthalmology Retina, 4, 204-215. [Google Scholar] [CrossRef] [PubMed]
[13] Karapetyan, A., Ouyang, P., Tang, L.S., et al. (2016) Choroidal Thickness in Relation to Ethnicity Measured Using Enhanced Depth Imaging Optical Coherence Tomography. Retina, 36, 82-90.
[14] Kumar, V., Bhayana, A., Tayade, A., Chandra, M., Chandra, P. and Kumar, A. (2019) Choroidal Thickness in Normal Indian Eyes Using Swept-Source Optical Coherence Tomography. Indian Journal of Ophthalmology, 67, Article No. 252. [Google Scholar] [CrossRef] [PubMed]
[15] Jin, P., Zou, H., Zhu, J., Xu, X., Jin, J., Chang, T.C., et al. (2016) Choroidal and Retinal Thickness in Children with Different Refractive Status Measured by Swept-Source Optical Coherence Tomography. American Journal of Ophthalmology, 168, 164-176. [Google Scholar] [CrossRef] [PubMed]
[16] Wu, H., Chen, W., Zhao, F., Zhou, Q., Reinach, P.S., Deng, L., et al. (2018) Scleral Hypoxia Is a Target for Myopia Control. Proceedings of the National Academy of Sciences, 115, E7091-E7100. [Google Scholar] [CrossRef] [PubMed]
[17] Liu, L., Zhou, W., Fan, Y., Zhang, L., Liu, S., Song, S., et al. (2022) Effect of Interleukin 6 on Scleral Fibroblast Proliferation, Differentiation, and Apoptosis Involved in Myopic Scleral Remodeling. Ophthalmic Research, 65, 529-539. [Google Scholar] [CrossRef] [PubMed]
[18] Liu, Y., Wang, L., Xu, Y., Pang, Z. and Mu, G. (2021) The Influence of the Choroid on the Onset and Development of Myopia: From Perspectives of Choroidal Thickness and Blood Flow. Acta Ophthalmologica, 99, 730-738. [Google Scholar] [CrossRef] [PubMed]
[19] Zhang, S., Zhang, G., Zhou, X., Xu, R., Wang, S., Guan, Z., et al. (2019) Changes in Choroidal Thickness and Choroidal Blood Perfusion in Guinea Pig Myopia. Investigative Opthalmology & Visual Science, 60, 3074-3083. [Google Scholar] [CrossRef] [PubMed]
[20] Scherm, P., Pettenkofer, M., Maier, M., Lohmann, C.P. and Feucht, N. (2019) Choriocapillary Blood Flow in Myopic Subjects Measured with OCT Angiography. Ophthalmic Surgery, Lasers and Imaging Retina, 50, e133-e139. [Google Scholar] [CrossRef] [PubMed]
[21] 李疏凤, 李雪, 黄莹莹, 等. 儿童近视进展与眼底血流及脉络膜厚度的关系[J]. 中华眼视光学与视觉科学杂志, 2021, 23(10): 759-765.
[22] Chang, X., Li, M., Lv, L., Yan, X., Liu, Y., Zhu, M., et al. (2022) Assessment of Choroidal Vascularity and Choriocapillaris Blood Perfusion after Accommodation in Myopia, Emmetropia, and Hyperopia Groups among Children. Frontiers in Physiology, 13, Article ID: 854240. [Google Scholar] [CrossRef] [PubMed]
[23] Liu, M., Wang, Y., Li, H., Zhao, Y., Ma, M., Xu, S., et al. (2024) Differences in Choroidal Responses to near Work between Myopic Children and Young Adults. Eye and Vision, 11, Article No. 12. [Google Scholar] [CrossRef] [PubMed]
[24] Hao, Q. and Zhao, Q. (2021) Changes in Subfoveal Choroidal Thickness in Myopic Children with 0.01% Atropine, Orthokeratology, or Their Combination. International Ophthalmology, 41, 2963-2971. [Google Scholar] [CrossRef] [PubMed]
[25] Li, W., Jiang, R., Zhu, Y., Zhou, J. and Cui, C. (2020) Effect of 0.01% Atropine Eye Drops on Choroidal Thickness in Myopic Children. Journal Français d’Ophtalmologie, 43, 862-868. [Google Scholar] [CrossRef] [PubMed]
[26] Zhu, X. and Wallman, J. (2009) Temporal Properties of Compensation for Positive and Negative Spectacle Lenses in Chicks. Investigative Opthalmology & Visual Science, 50, 37-46. [Google Scholar] [CrossRef] [PubMed]
[27] 张瑞琪, 杨积文. 近视青少年单眼角膜塑形术后脉络膜厚度变化[J]. 中华眼视光学与视觉科学杂志, 2020, 22(8): 613-617.
[28] Chen, Z., Xue, F., Zhou, J., Qu, X. and Zhou, X. (2016) Effects of Orthokeratology on Choroidal Thickness and Axial Length. Optometry and Vision Science, 93, 1064-1071. [Google Scholar] [CrossRef] [PubMed]
[29] Bao, J., Huang, Y., Li, X., Yang, A., Zhou, F., Wu, J., et al. (2022) Spectacle Lenses with Aspherical Lenslets for Myopia Control vs Single-Vision Spectacle Lenses: A Randomized Clinical Trial. JAMA Ophthalmology, 140, 472-478. [Google Scholar] [CrossRef] [PubMed]
[30] Rastegarpour, A. and Rastegarpour, A. (2011) A Computer-Based Anaglyphic System for the Treatment of Amblyopia. Clinical Ophthalmology, 5, 1319-1323. [Google Scholar] [CrossRef] [PubMed]
[31] Smith, M.J., Fleming, M.F., Wright, M.A., Roberts, A.G., Humm, L.B., Olsen, D., et al. (2015) Virtual Reality Job Interview Training and 6-Month Employment Outcomes for Individuals with Schizophrenia Seeking Employment. Schizophrenia Research, 166, 86-91. [Google Scholar] [CrossRef] [PubMed]
[32] Shibata, T., Kawai, T., Otsuki, M., Miyake, N., Yoshihara, Y. and Iwasaki, T. (2005). Stereoscopic 3D Display with Dynamic Optical Correction for Recovering from Asthenopia. SPIE Proceedings, Vol. 5664, 1-9. [CrossRef] 
[33] Lv, Z., Tao, Z., Chu, H., Hu, G., Xu, Z., Zhong, H., et al. (2025) Efficacy of Naked-Eye 3D Technology in Mitigating Myopia Progression among Children. Translational Pediatrics, 14, 628-638. [Google Scholar] [CrossRef] [PubMed]
[34] Zhao, F., Chen, L., Ma, H. and Zhang, W. (2018) Virtual Reality: A Possible Approach to Myopia Prevention and Control? Medical Hypotheses, 121, 1-3. [Google Scholar] [CrossRef] [PubMed]
[35] Takada, H., Yamamoto, T., Sugiura, A. and Miyao, M. (2009) Effect of an Eyesight Recovering Stereoscopic Movie System on Visual Acuity of Middle-Aged and Myopic Young People. World Congress on Medical Physics and Biomedical Engineering, Munich, 7-12 September 2009, 331-334. [Google Scholar] [CrossRef] 
[36] Turnbull, P.R.K. and Phillips, J.R. (2017) Ocular Effects of Virtual Reality Headset Wear in Young Adults. Scientific Reports, 7, Article No. 16172. [Google Scholar] [CrossRef] [PubMed]
[37] Dolgin, E. (2015) The Myopia Boom. Nature, 519, 276-278. [Google Scholar] [CrossRef] [PubMed]
[38] Wu, P.C., Tsai, C.L., Wu, H.L., Yang, Y. and Kuo, H. (2013) Outdoor Activity during Class Recess Reduces Myopia Onset and Progression in School Children. Ophthalmology, 120, 1080-1085. [Google Scholar] [CrossRef] [PubMed]
[39] 黄梓庭, 袁进. 虚拟现实技术与视觉健康[J]. 中华实验眼科杂志, 2024, 42(12): 1155-1162.
[40] 甄毅, 张伟, 申婧, 等. 使用远像光屏进行阅读学习的临床价值[J]. 中华眼科杂志, 2022, 58(12): 1045-1050.
[41] Zhen, Y., Wang, N.L., Cao, K., Huang, Y. and Zhang, W. (2024) Effects of Virtual Distant Viewing Technology on Preventing Nearwork-Induced Ocular Parameter Changes. Digital Health, 10, 293-300. [Google Scholar] [CrossRef] [PubMed]
[42] Ma, L., Li, X., Hu, J., Li, Y., Wang, S., Wang, K., et al. (2023) Influence of a Long-Distance Optical Imaging Workbench on Accommodation and Choroidal Response in Myopic Children. Clinical and Experimental Optometry, 107, 420-427. [Google Scholar] [CrossRef] [PubMed]

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