高度近视的病因学研究进展

The study of the intrinsic and extrinsic factor of high myopia

高度近视发生的内因、外因 ,包括遗传倾向 ,相关基因定位 ,巩膜胶原自体免疫学说 ,视网膜生物活性物质失调学说 ,环境因素等 ,本研究就这些因素对高度近视发病的影响做一综述。现统一的认识有 :①高度近视具有明显的遗传倾向。②迄今为止 ,已找到 4个高度近视相关基因 ,它们的遗传方式均为常染色体显性遗传。③高度近视的巩膜组织病理改变和胶原代谢障碍引发了人们对高度近视免疫相关基因的深入研究。已发现HLAII类基因与部分高度近视具有相关性。④视网膜中存在的生物活性物质直接或间接参与了形觉剥夺性近视的形成。⑤环境因素并非高度近视发病的决定因素 ,它仅起一定程度的促进作用。将今后的工作重点放在高度近视基因定位的研究 ,基因表达的调控及巩膜胶原代谢、网膜生物活性物质之间的关系研究上 ,无疑会进一步揭示高度近视的病因 ,为防治高度近视开辟新途径。

The intrinsic and extrinsic factor of high myopia,including inheritance tendency,gene localization,immune reactions to sclera collagen,disorder of the active medium in retina,the effect of the enviromental factors were reviewed. Previous study shows:①Genetic factors are of decisive importance in the etiology of familial high myopia.②To date,four loci for familial high myopia were reported. The modes of inheritance are autosomal dominance.③Immune reactions to sclera collagen are possibly related with HLA gene.④The disorder of the active medium in retina could be involved in development of high myopia directly or indirectly.⑤The enviromental factors play a poor role in determining high myopia than low myopia. They exert partly auxo action on high myopia. The study focused on gene mapping,gene express,the association of sclera collagen metabolism with medium in retina will contribute to revealing cause of high myopia,and will open up a new way of prevention of high myopia.[