综述

昼夜节律与儿童近视发展机制的研究进展

Research progress on the mechanisms of circadian rhythms and the development of childhood myopia

:867-874
 
近视已成为全球性流行病,预计到2050年全球将有近半数人群发生近视,已成为全球性重大功能卫生问题。近视不仅影响视力,还增加黄斑病变、青光眼等致盲性疾病的风险。近视的发病机制尚未完全明确,但与环境、遗传因素及昼夜节律紊乱密切相关。昼夜节律通过调节光照、多巴胺代谢和视网膜信号传导等机制影响近视的发生和发展。光照是调节昼夜节律的关键,户外活动时的高光照强度能有效刺激多巴胺分泌,抑制眼轴增长,减少近视发生,而异常光照模式(如夜间光暴露)则会干扰此过程。其次,睡眠不足与儿童近视患病率呈负相关,眼部关键参数(如眼轴长度、玻璃体腔深度等)均呈现显著的昼夜节律性波动。多巴胺作为视网膜中的重要神经递质,受生物钟基因调控,具有抑制眼轴生长的作用。视网膜中的生物钟基因和光敏色素也参与调节眼球生长,自主神经系统则通过调节脉络膜厚度与血流灌注参与眼球生长调控。动物实验和临床研究表明,昼夜节律紊乱会导致眼轴增长和近视进展。未来研究应进一步探讨昼夜节律与近视的因果关系、多巴胺代谢的调控机制以及生物钟基因的功能,以制定有效的近视防控策略。
Myopia has become a global epidemic,with projections indicating that nearly half of the world’s population will be affected by myopia by 2050, positioning it has a significant global functional health concern.Beyond merely impairing vision, myopia also heightens the risk of blinding diseases such as macular degeneration and glaucoma. Although the pathogenesis of myopia is not yet fully elucidated, it is stongly associated with environmental factors, genetic predispositions, and circadian rhythm disruptions. The circadian rhythm plays a pivotal role in the onset and progression of myopia by goerning mechanism such as light exposure, dopamine metabolism, and retinal signaling. Light serves as a crucial regulator of the circadian rhythm. Specifically, high light intensity during outdoor activities can effectively stimulate dopamine secretion, thereby inhibiting axial elongaation and reducing the incidence of myopia. Conversely, abnormal light patterns, such as exposure to light at night, can disrupt this regulatory process. Moreover, insufficient sleep has been found to be negatively correlated with the incidence of myopia in children. Additionally, key ocular parameters, including axial length and vitreous cavity depth, exhibit pronounced diurnal rhythmic fluctuations. Dopamine,  an important neurotransmitter in the retina, is regulated by circadian clock genes and functions to inhibit axial elongation. Both the circadian clock genes and photosensitive pigments within the retina are involved in regulating eye growth. Meanwhile, the autonomic nervous system contributes to this regulation by modulating choroidal thickness and blood flow perfusion. Animal experiments and clinical studies have consistently demonstrated that disrupted circadian rhythms can lead to axial elongation and the progression of myopia. Future research should delve deeper into the causal relationship between circadian rhythm and myopia, the regulatory mechanisms underlying dopamine metabolism, and the functions of circadian clock genes. Such investigation will pave the way for the development of effective strategies for myopia prevention and control.
其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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