[关键词]
[摘要]
近年来,点扩散光学技术(DOT)镜片在控制近视的研究中取得了重要进展。近视已成为全球性公共卫生挑战,影响全球近半数人口,其中儿童青少年近视率持续上升。DOT镜片作为基于视网膜对比度信号理论的新兴近视控制手段,通过在镜片表面分布微小光散射点,降低视网膜成像对比度,调节视觉输入对眼轴增长的影响,从而延缓近视进展。其核心机制在于通过折射率差异(基片1.53,散射点1.50)产生光学散射效应,保持中央5 mm光学区清晰视力的同时,有效降低周边视网膜的对比度信号强度。CYPRESS等大规模随机对照试验证实,DOT镜片在6-10岁儿童中表现出显著的近视控制效果,12 mo随访显示近视进展减缓74%,眼轴增长延缓50%,且在4 a长期随访中维持良好的安全性和视觉质量。然而,DOT技术在不同年龄段的适用性、最佳散射点密度配置、与其他近视控制方法的联合应用效果,以及长期使用的视觉适应性等方面仍存在争议,需要进一步的临床验证。文章系统综述了DOT技术的理论基础、设计特点、临床应用进展及未来发展方向,为临床近视防控策略的制定提供科学依据。
[Key word]
[Abstract]
Recent years have witnessed significant advancements in myopia control research through the application of diffuse optical technology(DOT)spectacle lenses. Myopia has emerged as a global public health challenge, affecting nearly half of the world's population, with childhood and adolescent myopia rates continuing to rise. DOT lenses represent an innovative myopia control intervention based on retinal contrast signal theory. These lenses incorporate micro-light scattering dots distributed across the lens surface to reduce retinal imaging contrast and modulate the influence of visual input on axial elongation, thereby slowing myopia progression. The core mechanism operates through refractive index differences between the lens substrate(1.53)and scattering dots(1.50), which generate optical scattering effects. This design maintains clear vision through a central 5 mm optical zone while effectively reducing contrast signal intensity in the peripheral retina. Large-scale randomized controlled trials, including the CYPRESS study, have demonstrated significant myopia control efficacy in children aged 6-10 years: 12-month follow-up data revealed a 74% reduction in myopia progression and a 50% reduction in axial elongation, with sustained safety and visual quality maintained over 4-year long-term follow-up. However, several aspects of DOT technology remain contentious and require further clinical validation, including its applicability across different age groups, optimal scattering dot density configurations, combined application effects with other myopia control methods, and long-term visual adaptation during extended use. This review systematically examines the theoretical foundations, design characteristics, clinical application progress, and future development directions of DOT technology, providing scientific evidence for clinical myopia prevention and control strategy formulation.
[中图分类号]
[基金项目]
杭州医学院本科教学改革创新项目(No.FYJG202224)