高度近视眼的结构与功能检查研究进展

Research Progress on Structural and Functional Examinations of High Myopia

摘要: 高度近视(≥−6.00 D)是致中青年视力残疾的主要眼病，其病理核心为眼轴过度延长导致视网膜、脉络膜、巩膜及视盘的结构重塑，并可继发黄斑劈裂、脉络膜新生血管等严重并发症。传统检查难以捕捉早期微观病变及隐匿性功能损伤。本文综述结构及功能检查进展：OCT与OCTA实现了视网膜、脉络膜微结构与微循环的精准量化；超广角成像、多模态影像及偏振敏感OCT等新技术拓展了评估维度。功能检查方面，微视野计及多焦视网膜电图可敏感检测早期视功能损伤。结构与功能相关性研究揭示黄斑血管密度与光敏感度定量关系。人工智能在自动化筛查、病变分级及定量分析中展现高准确率。未来应聚焦多模态数据融合、个体化预警模型及结构–功能定量映射体系的建立。

Abstract: High myopia (≥−6.00 D) is a major cause of visual disability in young and middle-aged adults. Its pathological core involves excessive axial elongation leading to structural remodeling of the retina, choroid, sclera, and optic disc, which may be complicated by severe conditions such as macular schisis and choroidal neovascularization. Conventional examinations are insufficient to detect early microstructural lesions and occult functional impairment. This article reviews advances in structural and functional assessments: OCT and OCTA enable precise quantification of retinal and choroidal microarchitecture and microcirculation; emerging technologies such as ultra-widefield imaging, multimodal imaging, and polarization-sensitive OCT expand the evaluation dimensions. Regarding functional assessments, microperimetry and multifocal electroretinography can sensitively detect early visual function impairment. Studies on structure-function correlations have revealed quantitative relationships between macular vessel density and light sensitivity. Artificial intelligence demonstrates high accuracy in automated screening, lesion grading, and quantitative analysis. Future efforts should focus on multimodal data integration, personalized risk prediction models, and the establishment of structure-function quantitative mapping systems.