The mechanism of presbyopia
The mechanism of presbyopia
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DOI：
10.1016/j.preteyeres.2004.11.001
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发表时间：
2005-05-01
影响因子：
17.8
通讯作者：
Koretz, JF
中科院分区：
文献类型：
--
作者：
Strenk, SA;Strenk, LM;Koretz, JF
人类的适应能力是指晶状体改变形状以使近距离物体聚焦的能力。适应性丧失开始于儿童时期，伴随有症状的老花眼，或影响日常活动的老花眼，在中年发作。虽然有症状的老花眼传统上是用老花镜或隐形眼镜治疗的，但目前正在积极开发一些手术干预和设备，试图恢复至少某种程度的适应性。这发生在老花眼的根本原因尚不清楚的时候，甚至调节机制偶尔也有争议。虽然Helmholtz关于调节机制的理论在广泛的问题上被普遍接受，但更多的细节仍在不断出现。与调节相关的年龄相关的前段结构变化已被证明，通常是通过体外和/或恒河猴研究。对这些发现的回顾表明，与非人类灵长类动物相比，人类老花眼的发展非常不同。聚焦于非侵入性人体成像技术，包括Scheimpflug摄影和高分辨率磁共振成像（MRI），数据表明人类虹膜束作为一个单元响应与年龄相关的晶状体厚度增加，并强烈暗示终身晶状体生长是老花眼发展的原因。(C) 2004 Elsevier Ltd.版权所有。
Accommodation in humans refers to the ability of the lens to change shape in order to bring near objects into focus. Accommodative loss begins during childhood, with symptomatic presbyopia, or presbyopia that affects one's day to day activities, striking during midlife. While symptomatic presbyopia has traditionally been treated with reading glasses or contact lenses, a number of surgical interventions and devices are being actively developed in an attempt to restore at least some level of accommodation. This is occurring at a time when the underlying cause of presbyopia remains unknown, and even the mechanism of accommodation is occasionally debated. While Helmholtz' theory regarding the mechanism of accommodation is generally accepted with regard to broad issues, additional details continue to emerge. Age-related changes in anterior segment structures associated with accommodation have been documented, often through in vitro and/or rhesus monkey studies. A review of these findings suggests that presbyopia develops very differently in humans compared to non-human primates. Focusing on non-invasive in vivo human imaging technologies, including Scheimpflug photography and high-resolution magnetic resonance imaging (MRI), the data suggest that the human uveal tract acts as a unit in response to age-related increasing lens thickness and strongly implicates lifelong lens growth as the causal factor in the development of presbyopia. (C) 2004 Elsevier Ltd. All rights reserved.