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

项目摘要/摘要 近视是一种流行病，在一些城市化国家，近视的人口比例高达90% 受影响。为了了解近视眼睛发育的调节机制，人们已经做出了更多的努力 与近视相关的潜在致盲并发症和社会经济健康问题。这个 脉络膜是视网膜后面的一种动态血管结构，与眼睛生长控制有关。我们的 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 假设脉络膜局部受光学因素和视觉输入的调节以影响厚度， 调节视网膜的位置，补偿儿童的散焦。来自动物研究的证据 提示脉络膜厚度的昼夜模式会受到光照的影响，在 近视眼球发育。动物研究也表明，窄带长波长光(即“红色”) 增厚脉络膜，最终防止近视眼轴延长。然而，狭隘的潜在影响 带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，施加全场 眼镜镜片离焦以双向方式调节脉络膜厚度。观察到的脉络膜 近视和远视模糊的改变可能有助于当前使用的眼镜的治疗效果 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以了解 昼夜节律、光照和离焦是如何通过下列特定因素调节脉络膜厚度的 目的：1)研究光照和屈光不正对脉络膜昼夜节律的影响 厚度及其与其他已知的光依赖的眼和系统日进程的关系 近视和近视儿童，包括眼压、心率和全身褪黑素浓度， 2)我们将确定作业范围、剂量-反应关系、敏感期和时间 脉络膜对实施全视野近视和远视离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隐形眼镜 用于近视控制，以及3)我们将确定窄带长波长光的容量 驱动人类脉络膜厚度的变化，正如动物模型所证明的那样，并决定是否 变化依赖于由纵向色差引起的离焦机制。这些发现 将具有重大意义，因为拟议的研究将填补我们对视觉作用的理解的一个关键空白 关于儿童脉络膜调制的输入，揭示了光学治疗策略的潜在机制 近视控制，并协助开发新的近视治疗方案。本研究具有创新性。 因为研究结果将有助于制定预防近视和减缓近视的靶向治疗方案 进步。

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.