周边视网膜相对屈光度与近视进展的关系

The relationship between relative peripheral refractive error and the progression of myopia

在正视眼或者低度远视眼中，周边视网膜呈相对远视屈光状态者比周边视网膜呈相对近视屈光状态者更容易发展为近视眼。正视眼周边视网膜呈轻度相对近视屈光状态，未矫正的远视眼周边视网膜呈稍大程度的相对近视屈光状态，未矫正的近视眼周边视网膜呈轻度相对远视屈光状态或比正视眼程度轻的相对近视状态。这两种观点已经被学者广泛接受。动物实验也证明异常视觉信号不仅能引起中央视网膜屈光不正，也能改变眼球后极部眼球形态和周边视网膜相对屈光不正的类型，并且黄斑切除并不影响正视化过程。相反，周边视网膜能单独调控眼球正视化过程并能对异常视觉信号起作用进而发展为各种屈光不正。临床研究表明，矫正视网膜周边远视性离焦的框架镜片对近视眼进展能起到一定的控制作用。虽然，周边视网膜远视性离焦是否促进近视进展的确切原因还不能肯定．但目前的研究倾向于认为两者之间可能有某种关系。

It has been shown that emmetropic and low hyperopic eyes in which eyes with relative hyperopic peripheral refractive error may be at greater risk of developing myopia than those with similar refractions but relative myopic peripheral refractive errors. Emmetropic eyes show slightly ,relative myopic peripheral refractive errors; uncorrected hyperopie eyes show more significant relative myopic peripheral refractive errors. However, uncorrected myopes show slight relative hyperopic peripheral refractive errors or smaller myopic shifts in the periphery than emmetropes. These two ideas are widely accepted by scientists. Animal studies have proven that in addition to producing central refractive errors, abnormal visual signals can alter the shape of the posterior globe of the eye and the type of peripheral refractive errors. In addition, foveal ablation has little influence on emmetropization. On the contrary, the peripheral retina can regulate emmetropizing responses independently and produce refractive errors in response to abnormal visual experience. Clinical research has suggested that spectacles designed to correct peripheral hyperopic defocus could be of some help in controlling the progression of myopia. Whether peripheral hyperopic defoeus can drive the development of myopia is uncertain but current studies support an interaction between relative peripheral refractive error and the progression of myopia.