巩膜交联在病理性近视和青光眼治疗中的应用进展  

Progress of scleral cross-linking in the treatment of pathological myopia and glaucoma

作　　者：蔡紫妍(综述) 刘可[1] 段宣初(审校) Cai Ziyan;Liu Ke;Duan Xuanchu(Department of Ophthalmology,The Second Xiangya Hospital of Central South University,Changsha 410000,China;Changsha Aier Eye Hospital,Aier Eye Academy of Central South University,Changsha 410000,China)

机构地区：[1]中南大学湘雅二医院眼科,长沙410000 [2]长沙爱尔眼科医院中南大学爱尔眼科学院,长沙410000

出　　处：《中华实验眼科杂志》2021年第12期1109-1114,共6页Chinese Journal Of Experimental Ophthalmology

基　　金：国家自然科学基金项目(81670859、81970801);湖南省自然科学基金项目(2019JJ40001);长沙市科技局重点项目(kh1801229);湖南省重点领域研发计划资助项目(2020SK2133);爱尔眼科医院集团科研基金项目(AR1906D1、AM1906D2)。

摘　　要：近视是常见的眼部疾病之一,病理性近视主要由眼轴的异常增长引起,其中巩膜生物力学减弱是病理性近视的重要特征之一。近年来,通过加固后巩膜提高巩膜硬度来防止眼轴增长已成为治疗病理性近视的一个重要方法。通过巩膜交联来直接加强巩膜硬度是一种新的治疗方法,目前尚处于动物实验和体外研究阶段。主要的巩膜交联方式包括核黄素加紫外线A光照射交联法和化学交联剂交联法。通常情况下,近视,尤其是高度近视患者更易罹患原发性开角型青光眼。青光眼和近视早期临床表现相似,发病机制亦有相同之处,两者之间具有相互促进和相互影响的关系,而强化巩膜、改善巩膜的生物力学特性以减少眼轴增长和巩膜形变的机制在这2种疾病的治疗方面存在共同之处。此外,巩膜交联法是否在治疗青光眼、减少视网膜神经节细胞损伤方面有一定的作用已经成为新的研究热点。本文就巩膜交联在青光眼、近视治疗中的动物实验、体外研究进展以及存在的争议进行综述,并分析巩膜交联治疗未来的发展方向。Myopia is a common eye disease,and pathological myopia is mainly caused by abnormal axial elongation.The weakening of scleral biomechanics is one of the important characteristics of pathological myopia.In recent years,preventing the growth of the eyeball through strengthening the posterior sclera and improving the scleral stiffness has become a primary method to treat pathological myopia.Direct enhancement of scleral stiffness by scleral cross-linking is a new treatment under study,and the main methods of it include scleral collagen crosslinking induced by the photosensitizer riboflavin and ultraviolet-A irradiation,and induced by chemical reagent.People with myopia,especially high myopia,are more likely to suffer from primary open angle glaucoma.Glaucoma and myopia in the early stage are similar in clinical manifestations as well as the pathogenesis,which can promote and influence each other.There are some similarities in strengthening sclera,improving the scleral biomechanical properties,reducing axial elongation and scleral deformation in the treatment of the two diseases.Whether scleral cross-linking can be used as a new treatment of glaucoma and to reduce retinal ganglion cells damage has become a new research hotspot.In this article,the research progress in scleral cross-linking for the treatment of myopia and glaucoma were summarized,and the existing disputes were discussed in order to analyze the future of scleral cross-linking therapy.

关 键 词：近视 青光眼 疗法 巩膜交联 生物力学 后巩膜加固 

分 类 号：R778.11[医药卫生—眼科] R775[医药卫生—临床医学]