低能量红光在儿童青少年近视弱视中的应用

章歆梓; 黄建南; 许迅; 何鲜桂

doi:10.16835/j.cnki.1000-9817.2022.07.036

低能量红光在儿童青少年近视弱视中的应用

doi: 10.16835/j.cnki.1000-9817.2022.07.036

上海市眼病防治中心/上海市眼科医院/上海市视觉健康中心(儿童青少年近视防治技术中心)/上海交通大学第一人民医院/国家眼部疾病临床医学研究中心/上海市眼底病重点实验室/上海眼视觉与光医学工程技术研究中心，上海 201103

基金项目:

国家重点研发计划资助 2021YFC2702100

国家重点研发计划资助 2021YFC2702104

国家重点研发计划资助 2019YFC0840607

上海市“科技创新行动计划”医学创新研究专项项目 21Y11910000

上海市加强公共卫生体系建设优秀学科带头人培养计划 GWV-10.2-XD09

详细信息

作者简介:
章歆梓(1999-)，女，浙江诸暨人，大学本科，主要研究方向为近视眼科学

通讯作者:
何鲜桂，E-mail：xianhezi@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 R778 R779.7
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- 被引次数: 0
出版历程
- 收稿日期: 2022-03-25
- 修回日期: 2022-04-15
- 网络出版日期: 2022-07-27
- 刊出日期: 2022-07-25

Application of low-level red light in myopia and amblyopia in children and adolescents

Shanghai Eye Disease Prevention and Treatment Center/Shanghai Eye Hospital/Shanghai Vision Health Center and Shanghai Children Myopia Institute/Shanghai General Hospital Affiliated with Shanghai Jiao Tong University/National Clinical Research Center for Eye Diseases/Shanghai Key Laboratory of Ocular Fundus Diseases/Shanghai Engineering Center for Visual Science and Photomedicine(201103), Shanghai, China

摘要

摘要: 近视与弱视是威胁儿童青少年眼健康的重要疾病，红光用于弱视治疗已有几十年历史，近年来逐渐应用于儿童青少年近视防控，成为新热点。通过从低能量红光治疗的干预方式、治疗效果、影响因素、可能机制及安全性方面阐述其在儿童青少年近视弱视中的应用，以期为下一步研究与实践提供参考。
- 近视 /
- 弱视 /
- 光疗法 /
- 儿童 /
- 青少年
Abstract: Low-level light therapy utilizes the photochemical effect of red light to induce reactions in the irradiated body tissue to achieve the therapeutic effect. Myopia and amblyopia are diseases which threaten the eye health of children and adolescents. Red light has been used to treat amblyopia for decades. Recently, its application in myopia prevention and control has become a new hotspot. This review summarizes the application of low-level red light in children and adolescents with myopia and amblyopia from the aspects of intervention mode, effect, factors, mechanism and safety to provide reference for future researches.
- Myopia /
- Amblyopia /
- Phototherapy /
- Child /
- Adolescent
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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表 1 红光控制近视相关研究的光源参数及照射方案

Table 1. Light source parameters and irradiation regimens of red light controlling myopia

第一作者	试验方法	年龄/岁	样本量	红光波长/nm	输出功率/mW	光标直径/mm	照射方案
Jiang^[15]	多中心随机对照试验	8~13	264	650±10	2.0±0.5	未描述	2次/d，3 min/次；5 d/周
陈培正^[16]	回顾性观察对照	3~15	120	650±10	2.0±0.5	10±3	2次/d，3 min/次；7 d/周
闫艺^[17]	随机对照试验	7~12	120	650±10	2.0±0.5	10±3	2次/d，3 min/次；7 d/周
Xiong^[18]	随机对照试验	6~16	300	650±5	2.0±0.5	5	2次/d，3 min/次；7 d/周
Zhou^[19]	回顾性观察对照	3~14	161	635±2	0.4	未描述	2次/d，3 min/次；7 d/周

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表 2 氦氖激光照射治疗弱视的研究设计、光源参数及照射方案

Table 2. Study design, light source parameters and irradiation regimens of He-Ne laser treating amblyopia

第一作者	眼数	干预组	对照组	功率/mW	光源距离	照射时间	照射方案
林再雄^[33]	340	氦氖激光+弱视综合治疗仪	弱视综合治疗仪	0.8	10 cm	3 min/d	20 d/疗程，若6月后未愈可行第2疗程
陆莉^[34]	127	氦氖激光+综合弱视协调仪	未设置	0.8	未描述	3 min/d	连续20 d
杨蕴华^[35]	787	氦氖激光+视觉生理刺激仪+海丁格光刷	未设置	0.3	未描述	3 min/d	连续20 d
杨小梅^[36]	146	氦氖激光+视觉生理刺激仪+海丁格光刷	未设置	0.8~1.0	5~10 cm	3 min/d	20 d/疗程, 若未愈继续行综合治疗仪治疗
王爽^[37]	884	氦氖激光+传统综合治疗	传统综合治疗	0.3	35 cm	3 min/d	连续20 d
潘冰心^[38]	56	氦氖激光+后像法+弱视治疗仪	未设置	0.9~1.0	未描述	3 min/d	21 d/疗程，6月后根据情况重复疗程，期间行弱视治疗仪巩固治疗

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参考文献(44)

[1]	KUFFLER D P. Photobiomodulation in promoting wound healing: a review[J]. Regen Med, 2016, 11(1): 107-122. doi: 10.2217/rme.15.82
[2]	SALEHPOUR F, MAHMOUDI J, KAMARI F, et al. Brain photobiomodulation therapy: a narrative review[J]. Mol Neurobiol, 2018, 55(8): 6601-6636. doi: 10.1007/s12035-017-0852-4
[3]	EELLS J T, GOPALAKRISHNAN S, CONNOR T B, et al. 670 nm photobiomodulation as a therapy for diabetic macular edema: a pilot study[J]. Invest Ophthalmol Vis Sci, 2017, 58(8): 932.
[4]	SHEN W, TEO K Y C, WOOD J P M, et al. Preclinical and clinical studies of photobiomodulation therapy for macular oedema[J]. Diabetologia, 2020, 63(9): 1900-1915. doi: 10.1007/s00125-020-05189-2
[5]	TANG J, HERDA A A, KERN T S. Photobiomodulation in the treatment of patients with non-center-involving diabetic macular oedema[J]. Br J Ophthalmol, 2014, 98(8): 1013-1015. doi: 10.1136/bjophthalmol-2013-304477
[6]	MERRY G F, MUNK M R, DOTSON R S, et al. Photobiomodulation reduces drusen volume and improves visual acuity and contrast sensitivity in dry age-related macular degeneration[J]. Acta Ophthalmol, 2017, 95(4): e270-e277. doi: 10.1111/aos.13354
[7]	MARKOWITZ S N, DEVENYI R G, MUNK M R et al. A double-masked, randomized, sham-controlled, single-center study with photobiomodulation for the treatment of dry age-related macular degeneration[J]. Retina, 2020, 40(8): 1471-1482. doi: 10.1097/IAE.0000000000002632
[8]	MERRY G, DOTSON R, DEVENYI R, et al. Photobiomodulation as a New Treatment for Dry Age Related Macular Degeneration. Results from the Toronto and Oak Ridge Photobimodulation Study in AMD (TORPA)[J]. Invest Ophthalmol Vis Sci, 2012, 53(14): 2049-2049.
[9]	BAIRD P N, SAW S M, LANCA C, et al. Myopia[J]. Nat Rev Dis Prim, 2020, 6(1): 99. doi: 10.1038/s41572-020-00231-4
[10]	樊泽民, 刘立京, 王海涛. 扎实推进全国儿童青少年近视防控工作[J]. 中国学校卫生, 2018, 39(11): 1605-1608, 1612. doi: 10.16835/j.cnki.1000-9817.2018.11.002 FAN Z M, LIU L J, WANG H T. Increased efforts to myopia prevention and control among children and adolescents in China[J]. Chin J Sch Health, 2018, 39(11): 1605-1608, 1612. doi: 10.16835/j.cnki.1000-9817.2018.11.002
[11]	何鲜桂, 潘臣炜. 儿童青少年近视防控需要更高质量的研究证据[J]. 中国学校卫生, 2021, 42(2): 161-164, 169. doi: 10.16835/j.cnki.1000-9817.2021.02.001 HE X G, PAN C W. Prevention and control of children and adolescents myopia needs more high-quality research evidence[J]. Chin J Sch Health, 2021, 42(2): 161-164, 169. doi: 10.16835/j.cnki.1000-9817.2021.02.001
[12]	JONAS J B, ANG M, CHO P, et al. IMI Prevention of myopia and its progression[J]. Invest Ophthalmol Vis Sci, 2021, 62(5): 6. doi: 10.1167/iovs.62.5.6
[13]	ANG M, FLANAGAN J L, WONG C W, et al. Review: myopia control strategies recommendations from the 2018 WHO/IAPB/BHVI meeting on myopia[J]. Br J Ophthalmol, 2020, 104(11): 1482-1487.
[14]	LI S M, KANG M T, WU S S, et al. Studies using concentric ring bifocal and peripheral add multifocal contact lenses to slow myopia progression in school-aged children: a Meta-analysis[J]. Ophthalmic Physiol Opt, 2017, 37(1): 51-59. doi: 10.1111/opo.12332
[15]	JIANG Y, ZHU Z, TAN X, et al. Effect of repeated low-level red-light therapy in myopia control in children: a multicenter randomized controlled trial[J]. Ophthalmology, 2021, 129(5) : 509-519.
[16]	陈培正, 张宏亮, 王晶晶, 等. 艾尔兴哺光仪控制青少年、儿童近视疗效分析[J]. 实用中西医结合临床, 2018, 18(10): 63-64, 106. https://www.cnki.com.cn/Article/CJFDTOTAL-SZXL201810031.htm CHEN P Z, ZHANG H L, WANG J J, et al. Effect of eyerising in myopia control in adolescents and children[J]. Pract Clin Journal of Integrat Tradit Chin Western Med, 2018, 18(10): 63-64, 106. https://www.cnki.com.cn/Article/CJFDTOTAL-SZXL201810031.htm
[17]	闫艺, 薛文娟, 赵延军, 等. 650 nm半导体激光控制青少年近视进展的研究[J]. 临床眼科杂志, 2021, 29(2): 132-137. doi: 10.3969/j.issn.1006-8422.2021.02.009 YAN Y, XUE W J, ZHAO Y J, et al. Effect of 650 nm semiconductor laser on juvenile myopia control[J]. J Clin Ophthalmol, 2021, 29(2): 132-137. doi: 10.3969/j.issn.1006-8422.2021.02.009
[18]	XIONG F, MAO T, LIAO H, et al. Orthokeratology and low-intensity laser therapy for slowing the progression of myopia in children[J]. Biomed Res Int, 2021, 2021: 8915867.
[19]	ZHOU L, XING C, QIANG W, et al. Low-intensity, long-wavelength red light slows the progression of myopia in children: an Eastern China-based cohort[J]. Ophthalmic Physiol Opt, 2022, 42(2): 335-344. doi: 10.1111/opo.12939
[20]	LIU Y, WANG L, XU Y, et al. The influence of the choroid on the onset and development of myopia: from perspectives of choroidal thickness and blood flow[J]. Acta Ophthalmol, 2021, 99(7): 730-738. doi: 10.1111/aos.14773
[21]	WU H, CHEN W, ZHAO F, et al. Scleral hypoxia is a target for myopia control[J]. Proc Natl Acad Sci USA, 2018, 115(30): E7091-E7100.
[22]	DOMPE C, MONCRIEFF L, MATYS J, et al. Photobiomodulation: underlying mechanism and clinical applications[J]. J Clin Med, 2020, 9(6): 1724. doi: 10.3390/jcm9061724
[23]	ZAMANI A R N, SABERIANPOUR S, GERANMAYEH M H, et al. Modulatory effect of photobiomodulation on stem cell epigenetic memory: a highlight on differentiation capacity[J]. Lasers Med Sci, 2020, 35(2): 299-306. doi: 10.1007/s10103-019-02873-7
[24]	WANG W Y, CHEN C, CHANG J, et al. Pharmacotherapeutic candidates for myopia: a review[J]. Biomed Pharmacother, 2021, 133: 111092. doi: 10.1016/j.biopha.2020.111092
[25]	MIGLIARIO M, PITTARELLA P, FANULI M, et al. Laser-induced osteoblast proliferation is mediated by ROS production[J]. Lasers Med Sci, 2014, 29(4): 1463-1467. doi: 10.1007/s10103-014-1556-x
[26]	WALLACE D K, REPKA M X, LEE K A, et al. Amblyopia preferred practice pattern[J]. Ophthalmology, 2018, 125(1): P105-P142. doi: 10.1016/j.ophtha.2017.10.008
[27]	HOLMES J M, CLARKE M P. Amblyopia[J]. Lancet, 2006, 367(9519): 1343-1351. doi: 10.1016/S0140-6736(06)68581-4
[28]	REPKA M X. Amblyopia outcomes through clinical trials and practice measurement: room for improvement: the LXXVⅡ Edward Jackson Memorial Lecture[J]. Am J Ophthalmol, 2020, 219: A1-A26. doi: 10.1016/j.ajo.2020.07.053
[29]	PARROZZANI A, FEDRIGA P, FERRARI E, et al. A new hypothesis for the treatment of amblyopia: the flicker stimulator[J]. J Franc D'ophtalmol, 1984, 7(3): 233-236.
[30]	FEDRIGA P, PARROZZANI A, BRODA M, et al. Treatment with flicker stimulation of lesions of the visual cortex surface[J]. J Franc D'ophtalmol, 1986, 9(11): 701-706.
[31]	李永昌, 陈树容. 闪烁红色光刺激疗法治疗儿童弱视的疗效观察[J]. 中华眼科杂志, 1989, 25(5): 311. LI Y C, CHEN S R. Effect of Red light flicker stimulation in treating amblyopia in children[J]. Chin J Ophthalmol, 1989, 25(5): 311.
[32]	王尔光, 阎爱珍, 梁中英. 小功率氦氖激光治疗功能性弱视[J]. 眼科新进展, 1986(3): 35-37. https://www.cnki.com.cn/Article/CJFDTOTAL-XKJZ198603013.htm WANG E G, YAN A Z, LIANG Z Y. Low-power He-Ne laser in treating functional amblyopia[J]. Recent Adv Ophthalmol, 1986(3): 35-37. https://www.cnki.com.cn/Article/CJFDTOTAL-XKJZ198603013.htm
[33]	林再雄, 符曼雅, 唐平, 等. 氦氖激光联合弱视综合治疗仪治疗儿童弱视[J]. 中国斜视与小儿眼科杂志, 2007, 16(1): 22-25. doi: 10.3969/j.issn.1005-328X.2007.01.007 LIN Z X, FU M Y, TANG P, et al. Low energy He-Ne laser combined with the synthetic amblyopia treatment instrument in treating amblyopia[J]. Chin J Strabismus Pediatr Ophthalmol, 2007, 16(1): 22-25. doi: 10.3969/j.issn.1005-328X.2007.01.007
[34]	陆莉, 唐剑波, 娄志武, 等. 氦氖激光联合综合疗法治疗儿童弱视的疗效观察[J]. 中国儿童保健杂志, 2009, 17(1): 115-116. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO200901054.htm LU L, TANG J B, LOU Z W, et al. Effect of He-Ne laser combined with comprehensive therapy on treating amblyopia in children[J]. Chin J Child Health Care, 2009, 17(1): 115-116. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO200901054.htm
[35]	杨蕴华, 何静宜. 氦氖激光在综合弱视治疗中的应用和安全性研究[J]. 中国斜视与小儿眼科杂志, 2013, 21(1): 53-54, 52. doi: 10.3969/j.issn.1005-328X.2013.01.018 YANG Y H, HE J Y. Application and safety of He-Ne laser in the comprehensive treatment of amblyopia[J]. Chin J Strabismus Pediatr Ophthalmol, 2013, 21(1): 53-54, 52. doi: 10.3969/j.issn.1005-328X.2013.01.018
[36]	杨小梅, 师文, 左芸, 等. 低功率氦氖激光在儿童弱视治疗中的应用[J]. 中国斜视与小儿眼科杂志, 2011, 19(2): 61-63, 79. doi: 10.3969/j.issn.1005-328X.2011.02.004 YANG X M, SHI W, ZUO Y, et al. Low power He-Ne laser in the treatment of amblyopia in children[J]. Chin J Strabismus Pediatr Ophthalmol, 2011, 19(2): 61-63, 79. doi: 10.3969/j.issn.1005-328X.2011.02.004
[37]	王爽, 何静宜, 杨蕴华. He-Ne激光在综合治疗弱视中的应用[J]. 中国激光医学杂志, 2014, 23(6): 345-349. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJG201406009.htm WANG S, HE J Y, YANG Y H. Application of low energy He-Ne laser in comprehensive amblyopia treatment[J]. Chin J Laser Med Surg, 2014, 23(6): 345-349. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJG201406009.htm
[38]	潘冰心, 楼倚天, 周武英, 等. 氦氖激光联合综合治疗仪治疗偏心注视性弱视[J]. 中国实用眼科杂志, 2012(4): 443-445. doi: 10.3760/cma.j.issn.1006-4443.2012.04.020 PAN B X, LOU Y T, ZHOU W Y, et al. Low energy He-Ne laser combined with the synthetic treatment amblyopia instrument in treating on eccentric fixation amblyopia[J]. Chin J Pract Ophthalmol, 2012, 30(4): 443-445. doi: 10.3760/cma.j.issn.1006-4443.2012.04.020
[39]	孙汉军, 蔡澍, 文杏惠, 等. 红光脉冲刺激合并遮盖治疗儿童弱视[J]. 实用眼科杂志, 1989, 7(3): 27-29. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZZY198903009.htm SUN H J, CAI S, WEN X H, et al. Red light pulse stimulation combined with patching in treating amblyopia in children[J]. Chin J Pract Ophthalmol, 1989, 7(3): 27-29. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZZY198903009.htm
[40]	蔡澍, 孙汉军, 文杏惠, 等. 儿童弱视新疗法—红光脉冲刺激法[J]. 眼科新进展, 1988, 8(2): 20-22. https://www.cnki.com.cn/Article/CJFDTOTAL-XKJZ198802009.htm CAI S, SUN H J, WEN X H, et al. A new therapy for amblyopia in children: red light pulse stimulation[J]. Recent Adv Ophthalmol, 1988, 8(2): 20-22. https://www.cnki.com.cn/Article/CJFDTOTAL-XKJZ198802009.htm
[41]	张振平, 杨少梅, 江翠萍, 等. 闪烁红光治疗弱视的疗效观察[J]. 眼科学报, 1988, 4(4): 232-237. https://www.cnki.com.cn/Article/CJFDTOTAL-YKXB198804009.htm ZHANG Z P, YANG S M, JIANG C P, et al. Clinical observation on treatment of amblyopia with red light flicker[J]. Eye Sci, 1988, 4(4): 232-237. https://www.cnki.com.cn/Article/CJFDTOTAL-YKXB198804009.htm
[42]	石广礼. 红光电子闪烁仪的研制及临床应用[J]. 实用眼科杂志, 1990, 8(8): 469-470. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZZY199008006.htm SHI G L. Manufacture and clinical application of red light electronic scintillator[J]. Chin J Pract Ophthalmol, 1990, 8(8): 469-470. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZZY199008006.htm
[43]	BARKANA Y, BELKIN M. Laser eye injuries[J]. Surv Ophthalmol, 2000, 44(6): 459-478. doi: 10.1016/S0039-6257(00)00112-0
[44]	工业和信息化部. 激光产品的安全第1部分: 设备分类、要求: GB 7247.1—2012[S]. 北京: 中国标准出版社, 2012. Ministry of Industry and Information Technology. Safety of laser products—Part 1: Equipment classification and requirements: GB 7247.1—2012[S]. Beijing: Standards Prass of China, 2012.