关注低强度红光重复照射对近视进展防控的新方法

Repeated low-level red-light therapy:a novel method for myopia prevention and control

我国近视呈现高发病率、低龄化的严峻形势,儿童和青少年近视防控问题已上升为国家战略。近年来相关研究已提供了多种儿童近视进展防控措施和方法,如低浓度阿托品滴眼液点眼、角膜塑形镜配戴等,但均存在操作不便和一定的不良反应。大量证据已经表明,增加户外活动时间可有效降低儿童近视的发病率,其效应与光照量有关。然而,在实际工作和实践中,切实有效增加或控制儿童每天的户外活动时间存在各种困难,因此难以有效指导相关人群实施近视防控措施。一项由中山大学中山眼科中心主持的多中心随机临床试验(RCT)采用低强度红光重复照射(RLRL)对学龄儿童进行重复、短时、直接的视网膜照射,评估RLRL控制近视进展的疗效和安全性,证实了该疗法对学龄儿童轻中度近视进展有较好的防控作用,为RLRL安全、有效防控近视进展提供了高等级循证证据。本文对这项RCT研究的主要结果和可推广性进行解读,并提出了进一步探讨RLRL在近视防控中的实践要点,建议眼科工作者关注RLRL对近视防控的研究进展。

China has recently proposed a countrywide myopia control strategy for children and adolescents due to the rapidly increasing incidence and early onset of myopia.Recent studies have proposed interventions and methods for myopia prevention and control,such as low-dose atropine and orthokeratology lens,while the current strategies are subject to cause inconvenience and ineligible risks of side effects.Although accumulating evidence has shown that increased time outdoors is effective in reducing the risk of myopia development,its effect is closely related to light exposure.Interventions to enhance time spent outdoors or further increase on light exposure to prevent myopia are pragmatically challenging.A multicenter randomized controlled trial(RCT)led by Zhongshan Ophthalmic Center,adopted repeated low-level red-light(RLRL)to deliver light on the retina directly for a much shorter duration of exposure but repeatedly,and further assessed the efficacy and safety of RLRL therapy in myopia control among children.Findings from the RCT showed promising efficacy of RLRL therapy in slowing myopia progression among school-age children with mild to moderate myopia,providing high-level evidence for RLRL therapy as a safe and efficacious strategy for reducing myopia progression.This paper summarized the findings from the RCT,discussed how to adopt such a treatment for myopia control in clinical practice,and further suggested eye care service providers to follow the research progress of RLRL therapy for myopia prevention and control.