Influence of light and defocus on the choroid during emmetropization and myopia development in children and young adults

儿童和青少年正视化和近视发展过程中光线和散焦对脉络膜的影响

• 批准号: 10172912
• 负责人: Lisa A Ostrin
• 金额: $ 37.13万
• 依托单位: UNIVERSITY OF HOUSTON
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-01 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10172912
• 关键词: Adult; Affect; Animal Model; Animals; Blood Vessels; Child; Choroid; Choroidal Neovascularization; Circadian Rhythms; Clinical Treatment; Cone; Contact Lenses; Country; Development; Dose; Economic Burden; Epidemic; Exposure to; Eye; Glaucoma; Goals; Growth; Heart Rate; Hour; Human; Laboratories; Lead; Learning; Light; Link; Longitudinal Studies; Macaca mulatta; Measures; Mediating; Melatonin; Myopia; Optics; Pattern; Peripheral; Phase; Physiologic Intraocular Pressure; Play; Population; Positioning Attribute; Prevalence; Process; Refractive Errors; Regulation; Research; Retina; Retinal Detachment; Role; Source; Structure; Structure of choroid plexus; Techniques; Testing; Therapeutic; Thick; Time; Tupaiidae; Vascular blood supply; Visual; age effect; age related; base; circadian; effective therapy; emmetropization; health economics; innovation; lens; nonhuman primate; novel; prevent; response; sensor technology; socioeconomics; targeted treatment; treatment effect; treatment strategy; young adult

PROJECT SUMMARY/ABSTRACT Myopia, or nearsightedness, is an epidemic, with up to 90% of the population in some urbanized countries affected. Efforts have increased to understand the regulatory mechanisms underlying myopic eye growth due to the potentially blinding complications and socio-economic health problems associated with myopia. The choroid, a dynamic vascular structure posterior to the retina, has been implicated in eye growth control. Our long term goal is to elucidate the role of the choroid in myopia progression and treatment. Our central hypothesis is that the choroid is locally regulated by optical factors and visual input to influence thickness, modulate the position of the retina, and compensate for defocus in children. Evidence from animal studies suggests that diurnal patterns of choroidal thickness, which can be influenced by light exposure, are altered in myopic eye growth. Animal studies have also shown that narrow band long wavelength light (i.e. “red”) thickens the choroid and ultimately prevents myopic axial elongation. However, potential effects of narrow band light have not been tested in humans. In adults, recent studies have shown that imposed full field spectacle lens defocus modulates choroidal thickness in a bidirectional manner. The observed choroidal changes to myopic and hyperopic blur may contribute to treatment effects from currently used optical strategies to slow myopia progression in children. Here, we will examine the choroid in children to understand how circadian rhythm, light exposure, and defocus modulate choroidal thickness through the following specific aims: 1) we will investigate the influence of light exposure and refractive error on diurnal patterns of choroidal thickness and relationships with other known light-dependent ocular and systemic diurnal processes in non- myopic and myopic children, including intraocular pressure, heart rate, and systemic melatonin concentration, 2) we will determine the operational range, dose-response relationship, sensitive period, and time-of-day effects of the choroid to imposed full field myopic and hyperopic defocus, as well as changes in choroidal thickness induced by peripheral myopic defocus, using soft multifocal contact lenses similar to those currently utilized for myopia control, and 3) we will determine the capacity to which narrow band long wavelength light drives choroidal thickness changes in humans, as demonstrated in animal models, and determine whether changes are dependent on defocus mechanisms induced by longitudinal chromatic aberrations. These finding will be significant because the proposed studies will fill a critical void in our understanding of the role of visual input on choroidal modulation in children, shed light on mechanisms underlying optical treatment strategies for myopia control, and aid in the development of novel myopia treatment options. The research is innovative because findings will contribute to the development of targeted treatment options to prevent myopia and slow progression.

项目总结/摘要 近视是一种流行病，在一些城市化国家， 影响。人们越来越多地努力了解近视眼生长的调节机制， 与近视相关的潜在致盲并发症和社会经济健康问题。的 脉络膜是视网膜后面的动态血管结构，与眼睛生长控制有关。我们 长期目标是阐明脉络膜在近视进展和治疗中的作用。我们的中央 假设脉络膜受光学因素和视觉输入的局部调节以影响厚度， 调节视网膜的位置，补偿儿童的散焦。来自动物研究的证据 表明，脉络膜厚度的昼夜模式，这可能会受到光照的影响，改变了 近视眼生长。动物研究还表明，窄带长波长光（即“红色”） 增厚脉络膜并最终防止近视眼轴向延长。然而，狭窄的潜在影响 带状光还没有在人体上进行过测试。在成年人中，最近的研究表明， 眼镜透镜散焦以双向方式调节脉络膜厚度。观察到的脉络膜 近视和远视模糊的变化可能有助于目前使用的光学 减缓儿童近视进展的策略。在这里，我们将检查儿童的脉络膜， 昼夜节律、光照和散焦如何通过以下特定的方式调节脉络膜厚度 目的：1）探讨光照和屈光不正对脉络膜昼夜节律的影响 厚度和与其他已知的光依赖性的眼睛和系统的昼夜过程的关系，在非 近视和近视儿童，包括眼内压、心率和全身褪黑激素浓度， 2)我们将确定有效范围、剂量-反应关系、敏感期和时间 脉络膜对全视野近视和远视散焦的影响，以及脉络膜的变化， 周边近视散焦引起的厚度，使用与目前类似的软性多焦点接触镜 用于近视控制，以及3）我们将确定窄带长波长光 驱动人类脉络膜厚度的变化，如动物模型所示，并确定是否 变化取决于由纵向色差引起的散焦机制。这些发现 将是重要的，因为拟议的研究将填补一个关键的空白，在我们的理解的作用，视觉 儿童脉络膜调节的输入，阐明了光学治疗策略的机制， 近视控制，并帮助开发新的近视治疗方案。研究具有创新性 因为研究结果将有助于开发有针对性的治疗方案，以预防近视和减缓近视。 进展