Abstract：
BACKGROUND: Myopia and especially high myopia are recognised as major public health concerns. Although the prevalence of high myopia in young children is low, 10-20% of high school children in Asia have high myopia, with many still progressing, and one in three patients with high myopia develop visual impairment with age. Most participants in myopia control studies have low and moderate myopia; relatively little is known about myopia control in high myopia.
METHODS: Literature searches were undertaken in MEDLINE and EMBASE to identify publications in English, investigating (Aim 1) the efficacy of myopia control strategies (environmental, pharmacological and optical) in high myopia (≤-6.00 D) and (Aim 2) the complications of high myopia using keywords. Outcomes included change in spherical equivalent refractive error (SE) and/or axial length (AL) to evaluate progression in high myopia.
RESULTS: Aim 1: Twelve studies were identified that reported the efficacy of optical and pharmacological (none on environmental) interventions on AL and SE for high myopia control. A statistically significant reduction in progression of SE and AL in high myopes was reported with 1% and 0.5% atropine. Defocus Incorporated Multiple Segment spectacle lenses had lower efficacy in slowing high myopia progression compared to moderate and low myopia. Ortho-K lenses were equally effective in reducing myopia progression in low, moderate and high myopia. Aim 2: Myopic patients have an increased risk of myopic macular degeneration, retinal detachment, cataract and glaucoma, with the risk increasing with the level of myopia.
CONCLUSIONS: High myopia has significant effects on quality of life, risk of pathological complications and vision impairment. Young children, excluding those with some syndromic associations, who are fast progressing moderate and high myopes require early intervention and close monitoring. Further research investigating the efficacy of myopia control strategies in highly myopic patients, both independently and through combination treatments, are necessary.
METHODS: Literature searches were undertaken in MEDLINE and EMBASE to identify publications in English, investigating (Aim 1) the efficacy of myopia control strategies (environmental, pharmacological and optical) in high myopia (≤-6.00 D) and (Aim 2) the complications of high myopia using keywords. Outcomes included change in spherical equivalent refractive error (SE) and/or axial length (AL) to evaluate progression in high myopia.
RESULTS: Aim 1: Twelve studies were identified that reported the efficacy of optical and pharmacological (none on environmental) interventions on AL and SE for high myopia control. A statistically significant reduction in progression of SE and AL in high myopes was reported with 1% and 0.5% atropine. Defocus Incorporated Multiple Segment spectacle lenses had lower efficacy in slowing high myopia progression compared to moderate and low myopia. Ortho-K lenses were equally effective in reducing myopia progression in low, moderate and high myopia. Aim 2: Myopic patients have an increased risk of myopic macular degeneration, retinal detachment, cataract and glaucoma, with the risk increasing with the level of myopia.
CONCLUSIONS: High myopia has significant effects on quality of life, risk of pathological complications and vision impairment. Young children, excluding those with some syndromic associations, who are fast progressing moderate and high myopes require early intervention and close monitoring. Further research investigating the efficacy of myopia control strategies in highly myopic patients, both independently and through combination treatments, are necessary.
摘要：
背景：近视，尤其是高度近视被认为是主要的公共卫生问题。尽管幼儿高度近视的患病率较低,亚洲10-20%的高中生患有高度近视，许多人仍在进步，三分之一的高度近视患者会随着年龄的增长而出现视觉障碍。近视控制研究的大多数参与者患有中度和低度近视；对高度近视的近视控制知之甚少。
方法：在MEDLINE和EMBASE中进行文献检索，以确定英文出版物，调查(目标1)近视控制策略的有效性(环境，药理学和光学）高度近视（≤-6.00D）和（目的2）使用关键词的高度近视并发症。结果包括球面等效屈光不正（SE）和/或眼轴长度（AL）的变化，以评估高度近视的进展。
结果：目的1：确定了12项研究，报道了光学和药理学（无环境）干预对高度近视控制的AL和SE的有效性。据报道，使用1％和0.5％阿托品的高度近视患者SE和AL的进展具有统计学意义。与中度和低度近视相比，包含散焦的多段眼镜片在减缓高度近视发展方面的功效较低。Ortho-K晶状体同样有效地减少了低近视的发展，中度和高度近视。目的2：近视患者患近视性黄斑变性的风险增加，视网膜脱离,白内障和青光眼，随着近视程度的增加，风险也随之增加。
结论：高度近视对生活质量有显著影响，病理并发症和视力障碍的风险。年幼的孩子,排除那些有一些综合征关联的人，快速发展的中度和高度近视者需要早期干预和密切监测。进一步研究高度近视患者近视控制策略的有效性，无论是独立治疗还是通过联合治疗，是必要的。
方法：在MEDLINE和EMBASE中进行文献检索，以确定英文出版物，调查(目标1)近视控制策略的有效性(环境，药理学和光学）高度近视（≤-6.00D）和（目的2）使用关键词的高度近视并发症。结果包括球面等效屈光不正（SE）和/或眼轴长度（AL）的变化，以评估高度近视的进展。
结果：目的1：确定了12项研究，报道了光学和药理学（无环境）干预对高度近视控制的AL和SE的有效性。据报道，使用1％和0.5％阿托品的高度近视患者SE和AL的进展具有统计学意义。与中度和低度近视相比，包含散焦的多段眼镜片在减缓高度近视发展方面的功效较低。Ortho-K晶状体同样有效地减少了低近视的发展，中度和高度近视。目的2：近视患者患近视性黄斑变性的风险增加，视网膜脱离,白内障和青光眼，随着近视程度的增加，风险也随之增加。
结论：高度近视对生活质量有显著影响，病理并发症和视力障碍的风险。年幼的孩子,排除那些有一些综合征关联的人，快速发展的中度和高度近视者需要早期干预和密切监测。进一步研究高度近视患者近视控制策略的有效性，无论是独立治疗还是通过联合治疗，是必要的。
