控制近视发生发展的干预措施对脉络膜厚度的影响及机制Effects of the Interventions of Controlling Myopia Onset and Progression on Choroidal Thickness and Their Mechanisms DOI: 10.12677/HJO.2020.92018, PDF, HTML,XML, 被引量 下载:699 浏览:3,440 作者: 崔晓剑, 李 林, 郭 疆：汕头大学医学院，广东 汕头；深圳市第二人民医院/深圳大学第一附属医院，广东 深圳 关键词: 脉络膜厚度；阿托品；角膜塑形镜；户外活动；Choroidal Thickness； Atropine； Orthokeratology Contact Lenses； Outdoor Activity 摘要: 近视是青少年中高发的屈光问题，随着度数的快速增长，可能会引起眼轴变长、豹纹状眼底、黄斑部出血等问题，同时因光学相干断层扫描(OCT)的技术发展，人们可以得到关于眼后段解剖更精确的图像，如脉络膜等。许多研究利用光学相干断层扫描深度成像(coherence tomography with enhanced depth imaging, OCT-EDI)的技术比较了近视与正视眼的脉络膜厚度，发现近视眼的脉络膜厚度显著变薄。目前大量研究开始探讨控制近视发生发展的不同干预措施对脉络膜厚度的影响。阿托品、角膜塑形镜等方法在控制眼轴增长中发挥了重大的作用，是控制近视进展的有效方法，同时户外活动对预防近视的作用也受到了广泛的关注。该文将主要对这些控制近视发生发展的干预措施对脉络膜厚度的影响及其可能的机制做一综述。 Abstract: Myopia is a kind of high-risk refractive problem in young children. With the rapid myopia progression, some complications may occur such as axial elongation, tigroid fundus, and macular hemorrhage. For the advancements in optical coherence tomography (OCT), more accurate image of the posterior segment can be analysed, such as choroid. Many studies compared the choroidal thickness between myopia and emmetropia by means of enhanced depth imaging optical coherence tomography (EDI-OCT), and discovered that the choroidal thickness in myopia eyes was thinner than that of emmetropia eyes. A large number of studies began to explore the effects of different interventions of controlling myopia progression on choroidal thickness. Atropine eye drops and orthokeratology contact lenses, as effective means of controlling progression of myopia, play an important role in controlling axial elongation. And outdoor activities also get attention in preventing the onset of myopia. The aim of this review was to summarize the effects of different interventions of controlling myopia onset and progression on choroidal thickness and their mechanisms. 文章引用：崔晓剑, 李林, 郭疆. 控制近视发生发展的干预措施对脉络膜厚度的影响及机制[J]. 眼科学, 2020, 9(2): 149-156. https://doi.org/10.12677/HJO.2020.92018 1. 引言
近视眼是一种常见的屈光不正，根据近视流行病学的趋势分析，到2050年近视可影响全球约50%的人口，而近视度数的增长，可导致病理性近视眼，引起眼轴变长、豹纹状眼底、黄斑部出血或形成新生血管膜等病理改变，同时相对于正视眼，近视眼脉络膜厚度还可出现变薄的表现 [1] [2] [3] [4]。脉络膜厚度指的是视网膜色素上皮层与脉络膜、巩膜交界处之间的距离，组织上从外向内主要包括脉络膜上组织(构成脉络膜上腔)、大血管层(Haller’s layer)与中血管层(Sattler’s layer)、脉络膜毛细血管层、Bruch膜 [5]。在高度近视患者中，脉络膜明显变薄，其与等效球镜度及后巩膜葡萄肿高度相关 [3] [6]。脉络膜厚度在控制近视发生发展的过程中发生的变化引起了人们的关注。近年来，大量研究观察了控制近视发生发展过程中脉络膜厚度的变化。因此