红光疗法在眼科疾病中的应用研究进展  

Research progress of red-light therapy in the treatment of ocular diseases

作　　者：张立(综述) 蒋海翔(审校) ZHANG Li;JIANG Haixiang(Department of Ophthalmology,The Central Hospital of Wuhan,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430014,China;Xi’an Eyeshine Ophthalmic Hospital,Xi’an 710032,China)

机构地区：[1]华中科技大学同济医学院附属武汉中心医院眼科,武汉430014 [2]西安海翔眼科医院,西安710032

出　　处：《眼科学报》2024年第9期471-480,共10页Eye Science

基　　金：湖北省卫生健康委员会联合基金(WJ2019H375);武汉市卫生健康委员会基金(WX19Q29);眼科学国家重点实验室开放课题基金(2020KF05)。

摘　　要：红光是波长范围在620~760 nm的可见光,兼有良好的光化学和热作用,其穿透力较强,能够达到皮肤深层及组织内部,从而产生一系列的生物效应。在眼科领域,红光疗法最初主要应用于弱视和眼睑皮肤相关疾病的治疗,随着研究的进一步深入,红光逐渐被应用于控制近视进展和视网膜相关疾病。目前,重复低强度红光(repeat low-level red-light,RLRL)在近视进展的控制效果得到充分肯定,成为红光疗法在眼科应用最受关注的热点之一,其主要可能机制包括红光照射能激活线粒体中的细胞色素C氧化酶的活性,促进三磷酸腺苷(adenosine triphosphate,ATP)生成,改善网膜缺氧状况;促进一氧化氮(NO)的合成和释放,引起脉络膜血管的扩张及血流量的增加;诱导巩膜细胞外基质的重塑,增加巩膜的强度。此外,红光疗法可抑制视网膜感光细胞调节通路中的氧化应激、炎症和细胞凋亡,减轻眼表炎症反应和疼痛,有助于周围神经损伤后修复等。文章针对红光疗法在近视、视网膜相关疾病、弱视及眼睑皮肤相关疾病的治疗机制、有效性及安全性进行综述,为红光疗法在眼科领域的应用提供重要的参考价值和依据。Red light is visible light with a wavelength range of 620-760 nm,which has excellent photochemical and thermal effects.It can penetrate deeply into the skin and tissues with strong power,resulting in a series of biological effects.In the field of ophthalmology,red-light therapy was initially mainly used in the treatment of amblyopia and eyelid skin-related diseases,and with the further development of research,red light has been gradually used in the myopia control and the study of retina-related diseases.At present,the effect of repeated low-intensity red light(RLRL) on myopia progression has been fully recognized,and it has become one of the most concerned hotspots in the application of red-light therapy in ophthalmology.The main possible mechanisms include that red light therapy can activate the activity of cytochrome C oxidase in mitochondria,promote ATP production,and improve retinal hypoxia.It can also induce the synthesis and release of NO,cause the expansion of choroidal vessels with improvement of blood flow,and increase scleral strength by remodeling of scleral extracellular matrix.In addition,red-light therapy can reduce oxidative stress,inflammation and apoptosis in the regulatory pathways of photoreceptor cells,reduce eye inflammation and pain,and help repair peripheral nerves after injury.This article will review the mechanism,effectiveness and safety of red-light therapy in myopia,retinal diseases,amblyopia,and eyelid skin-related diseases,in order to provide important reference value and basis for the application of red-light therapy in ophthalmology.

关 键 词：红光疗法 重复低强度红光 氦氖激光 近视防控 

分 类 号：R778.11[医药卫生—眼科] R318.51[医药卫生—临床医学]