短波长光在光-眼-脑轴中对近视眼与全身健康共同影响的研究进展

doi:10.3877/cma.j.issn.2095-2007.2025.06.008

近年来，随着近视眼患病率不断升高，环境光因素在屈光发育调控中的作用受到广泛关注。有研究结果表明，短波长光不仅可通过调节视网膜多巴胺释放抑制眼轴过度延长，还可通过内在光敏视网膜神经节细胞(IPRGC)介导的非成像视觉通路影响昼夜节律、代谢及情绪等全身生理功能，提示其可能通过统一的"光-眼-脑轴"发挥跨系统调控作用。本文综述短波长光对全身健康及近视眼调控的研究进展，重点分析视蛋白-多巴胺信号机制及光环境参数的影响特征，以期为基于光照干预的近视眼防控策略提供理论依据与研究方向。

关键词: 短波长光, 近视眼, 蓝光, 紫光

With the increasing prevalence of myopia, the role of environmental light in regulating refractive development has attracted growing attention. Emerging evidence indicates that short-wavelength light can inhibit excessive axial elongation by regulating retinal dopamine release and can also influence systemic physiological functions, including circadian rhythm, metabolism, and mood, through intrinsically photosensitive retinal ganglion cell (IPRGC)-mediated non-image-forming visual pathways. These findings suggest that short-wavelength light may exert cross-system regulatory effects through a unified " light-eye-brain axis". The recent advances in understanding the effects of short-wavelength light on systemic health and myopia regulation were reviewed, with particular emphasis on the opsin-dopamine signaling mechanisms and the influence of light environmental parameters. This integrative perspective may provide a theoretical basis for developing light-based strategies for myopia prevention and control.

Key words: Short-wavelength light, Myopia, Blue light, Violet light

表1 短波长光与近视眼相关模型研究的文献汇总

第一作者	波长	照射时长	光照强度	结果
以小鼠为研究对象，采用LIM造模，附加LED光源
Jiang等^[4]	紫光360~400 nm、蓝光440~480 nm、绿光500~540 nm或红光610~650 nm	05：00-08：00、08：00-20：00、00：00-24：00、17：00-20：00或20：00-23：00	400 μW/cm²	与蓝光相比，紫光显著上调雏鸡视网膜中的早期生长反应因子1，并预防了小鼠的透镜诱导性近视眼。其保护作用取决于一天中的时间和视网膜神经视蛋白的表达
Strickland等^[39]	白光420~680 nm、绿光(525±40)nm、紫光(400±20)nm	12 h	50 cd/m²	短波长光减缓屈光性眼轴生长，在小鼠中产生远视反应并抑制透镜诱导性近视眼。在视锥细胞功能失调的小鼠中缺乏抑制作用，表明视锥细胞信号传导在短波长(紫光)的远视反应中起作用
Jeong等^[27]	紫光360~400 nm	8：00-20：00	40 μW/cm²	紫光透射率通过影响小鼠LIM模型的眼轴长度和脉络膜厚度来影响近视眼进展；降低透镜透射率会削弱紫光的近视眼抑制效果
以雏鸡为研究对象，采用LIM造模，附加LED光源
Nickla等^[21]	蓝光460 nm；每个LED的半高全宽带宽为±10 nm	07：30-11：30或15：30-19：30	200 lx和600 lx	傍晚200 lx蓝光促进眼轴生长，而600 lx蓝光短暂减缓眼轴生长。早晨蓝光影响较小，但与相同光照水平的傍晚暴露相比显示出相反趋势
Nickla等^[19]	蓝光(460 ±10) nm	7：30-11：30或15：30-19：30	0.15、200、600、1000 lx	在低光照强度下，傍晚和早晨的蓝光暴露刺激雏鸡眼轴生长，而高光照强度则无此效应。早晨暴露还导致脉络膜增厚和节律紊乱
Foulds等^[60]	红光波长600~680 nm，峰值641 nm，包含550~600 nm的黄绿波长；蓝光波长440~495 nm，峰值477 nm	07：30-11：30或15：30-19：30	红光LED 33.37 cd/m²，蓝光LED 34.44 cd/m²	在红光LED下饲养的雏鸡出现进行性轴向近视眼，而蓝光LED诱导远视，~28 d时屈光度相差7.00 D。在红光和蓝光之间切换能迅速逆转这些效应
Rucker等^[20]	红光615 nm，半带宽20 nm；绿光515 nm，半带宽35 nm及蓝光465 nm，半带宽35 nm	8 h	777 lx	在低频、低对比度蓝光下，雏鸡向远视偏移，而高频、低对比度蓝光导致向近视眼偏移
以豚鼠为研究对象，采用LIM造模，附加LED光源
Wang等^[28]	蓝光420~430nm	3、6、9及12 h	700 lx	前2周蓝光照射增加了脉络膜血流灌注和厚度，有助于减缓近视眼。但到第4周，长时间暴露减少了视网膜厚度，并且早期的增加停滞
Yu等^[50]	峰值440 nm，半带宽10 nm	6：00-18：00	500 lx	短波长光可通过降低视网膜视黄酸水平并影响眼轴生长来减缓透镜诱导性近视眼。视黄酸促进眼轴生长，而视黄酸抑制剂肉桂醛则减缓近视眼，可能通过不同于白光的途径
Qian等^[63]	蓝光波长430 nm，半带宽20 nm、绿光波长530 nm，半带宽30 nm及白光色温5000 K	8：00-20：00	177 μW/cm²、70 μW/cm²、74 μW/cm²	暴露于绿光的豚鼠发生近视眼，而暴露于蓝光的豚鼠发生远视。转移到白光后2周内屈光部分恢复，但与白光组的差异仍然存在
以树鼩为研究对象，采用LIM＋FDM造模，附加LED光源
Norton等^[34]	青光峰值波长(505±17)nm	14 h	1500 lx	窄带青光破坏了树鼩的正视维持，导致近视眼。与全光谱光条件相比，透镜诱导性近视眼也有所减少
Gawne等^[61]	闪烁(457±10)nm窄带光、闪烁(464±10)nm窄带光和稳态(464±10)nm光	14 h	/	蓝光处理导致所有动物的屈光状态超出群体光照动物的95%置信区间。窄带蓝光刺激了长波长和短波长敏感视锥细胞，但相对激活度随屈光状态保持不变
以雏鸡为研究对象，采用FDM造模，附加LED光源
Wang等^[38]	紫外光峰值375 nm，半带宽5 nm；蓝光465 nm，半带宽15 nm；红光620 nm，半带宽10 nm	30 min/5 d	蓝光435 lx、红光453 lx、白光室光468 lx	蓝光和紫外光减少了雏鸡的近视眼并降低了多巴胺水平
以虹鳟鱼为研究对象，采用LIM＋FDM造模，附加LED光源
Timucin等^[64]	日光、红光600~650 nm、绿光495~570 nm及蓝光420~495 nm	6：00-18：00	50 lx	短波长蓝光抑制了虹鳟鱼的眼轴伸长，而红光促进了眼轴伸长。室内日光与红光类似，未能阻止眼轴伸长

表1 短波长光与近视眼相关模型研究的文献汇总

第一作者	波长	照射时长	光照强度	结果
以小鼠为研究对象，采用LIM造模，附加LED光源
Jiang等^[4]	紫光360~400 nm、蓝光440~480 nm、绿光500~540 nm或红光610~650 nm	05：00-08：00、08：00-20：00、00：00-24：00、17：00-20：00或20：00-23：00	400 μW/cm²	与蓝光相比，紫光显著上调雏鸡视网膜中的早期生长反应因子1，并预防了小鼠的透镜诱导性近视眼。其保护作用取决于一天中的时间和视网膜神经视蛋白的表达
Strickland等^[39]	白光420~680 nm、绿光(525±40)nm、紫光(400±20)nm	12 h	50 cd/m²	短波长光减缓屈光性眼轴生长，在小鼠中产生远视反应并抑制透镜诱导性近视眼。在视锥细胞功能失调的小鼠中缺乏抑制作用，表明视锥细胞信号传导在短波长(紫光)的远视反应中起作用
Jeong等^[27]	紫光360~400 nm	8：00-20：00	40 μW/cm²	紫光透射率通过影响小鼠LIM模型的眼轴长度和脉络膜厚度来影响近视眼进展；降低透镜透射率会削弱紫光的近视眼抑制效果
以雏鸡为研究对象，采用LIM造模，附加LED光源
Nickla等^[21]	蓝光460 nm；每个LED的半高全宽带宽为±10 nm	07：30-11：30或15：30-19：30	200 lx和600 lx	傍晚200 lx蓝光促进眼轴生长，而600 lx蓝光短暂减缓眼轴生长。早晨蓝光影响较小，但与相同光照水平的傍晚暴露相比显示出相反趋势
Nickla等^[19]	蓝光(460 ±10) nm	7：30-11：30或15：30-19：30	0.15、200、600、1000 lx	在低光照强度下，傍晚和早晨的蓝光暴露刺激雏鸡眼轴生长，而高光照强度则无此效应。早晨暴露还导致脉络膜增厚和节律紊乱
Foulds等^[60]	红光波长600~680 nm，峰值641 nm，包含550~600 nm的黄绿波长；蓝光波长440~495 nm，峰值477 nm	07：30-11：30或15：30-19：30	红光LED 33.37 cd/m²，蓝光LED 34.44 cd/m²	在红光LED下饲养的雏鸡出现进行性轴向近视眼，而蓝光LED诱导远视，~28 d时屈光度相差7.00 D。在红光和蓝光之间切换能迅速逆转这些效应
Rucker等^[20]	红光615 nm，半带宽20 nm；绿光515 nm，半带宽35 nm及蓝光465 nm，半带宽35 nm	8 h	777 lx	在低频、低对比度蓝光下，雏鸡向远视偏移，而高频、低对比度蓝光导致向近视眼偏移
以豚鼠为研究对象，采用LIM造模，附加LED光源
Wang等^[28]	蓝光420~430nm	3、6、9及12 h	700 lx	前2周蓝光照射增加了脉络膜血流灌注和厚度，有助于减缓近视眼。但到第4周，长时间暴露减少了视网膜厚度，并且早期的增加停滞
Yu等^[50]	峰值440 nm，半带宽10 nm	6：00-18：00	500 lx	短波长光可通过降低视网膜视黄酸水平并影响眼轴生长来减缓透镜诱导性近视眼。视黄酸促进眼轴生长，而视黄酸抑制剂肉桂醛则减缓近视眼，可能通过不同于白光的途径
Qian等^[63]	蓝光波长430 nm，半带宽20 nm、绿光波长530 nm，半带宽30 nm及白光色温5000 K	8：00-20：00	177 μW/cm²、70 μW/cm²、74 μW/cm²	暴露于绿光的豚鼠发生近视眼，而暴露于蓝光的豚鼠发生远视。转移到白光后2周内屈光部分恢复，但与白光组的差异仍然存在
以树鼩为研究对象，采用LIM＋FDM造模，附加LED光源
Norton等^[34]	青光峰值波长(505±17)nm	14 h	1500 lx	窄带青光破坏了树鼩的正视维持，导致近视眼。与全光谱光条件相比，透镜诱导性近视眼也有所减少
Gawne等^[61]	闪烁(457±10)nm窄带光、闪烁(464±10)nm窄带光和稳态(464±10)nm光	14 h	/	蓝光处理导致所有动物的屈光状态超出群体光照动物的95%置信区间。窄带蓝光刺激了长波长和短波长敏感视锥细胞，但相对激活度随屈光状态保持不变
以雏鸡为研究对象，采用FDM造模，附加LED光源
Wang等^[38]	紫外光峰值375 nm，半带宽5 nm；蓝光465 nm，半带宽15 nm；红光620 nm，半带宽10 nm	30 min/5 d	蓝光435 lx、红光453 lx、白光室光468 lx	蓝光和紫外光减少了雏鸡的近视眼并降低了多巴胺水平
以虹鳟鱼为研究对象，采用LIM＋FDM造模，附加LED光源
Timucin等^[64]	日光、红光600~650 nm、绿光495~570 nm及蓝光420~495 nm	6：00-18：00	50 lx	短波长蓝光抑制了虹鳟鱼的眼轴伸长，而红光促进了眼轴伸长。室内日光与红光类似，未能阻止眼轴伸长

表2 短波长光与近视眼相关临床研究的文献汇总

第一作者	研究对象	年龄(岁)	干预细节	末次随访持续时间	结果
Torii等^[6]	睫状肌麻痹后验光超过-1.00 D	10~15岁	不透紫光眼镜；部分阻挡紫光的隐形眼镜；透紫光隐形眼镜	1年	透紫光隐形眼镜对近视眼进展的抑制效果最好
Torii等^[55]	睫状肌麻痹后验光超过-6.00 D	> 25岁	不透紫光和有晶体眼人工晶体植入术	5年以上	与不透紫光的有晶体眼人工晶体相比，透紫光的有晶体眼人工晶体抑制了近视眼进展和眼轴长度增长
Mori等^[57]	睫状肌麻痹后验光-1.50 D~-4.50 D	6~12岁	比较紫光眼镜与传统框架眼镜不透紫光)的近视眼抑制效果	2年	当近距离工作时间低于180 min且从未戴过眼镜的受试者中，紫光眼镜组的眼轴长度变化显著小于安慰剂组(p < 0.01)。两年间，紫光眼镜组抑制了21.4%的眼轴增长
Torii等^[66]	睫状肌麻痹后验光-1.50 D~-4.50 D	6~12岁	配载发射310 μW/cm²紫光的眼镜架与发射极微量紫光<10 μW/cm²的传统眼镜架比较	24周	在8~10岁儿童中观察到眼轴增长、脉络膜厚度和睫状肌麻痹后屈光度的显著变化，而在其他组别中无差异
Zhao等^[67]	睫状肌麻痹后验光-1.00 D~-5.00 D	11~15岁	配载蓝紫光滤过镜片与配载普通非球面镜片比较	1年	短波长滤光镜片改善了对比敏感度和调节功能，有效缓解了视疲劳且无严重不良反应，但并未显著减缓近视眼进展。

表2 短波长光与近视眼相关临床研究的文献汇总

第一作者	研究对象	年龄(岁)	干预细节	末次随访持续时间	结果
Torii等^[6]	睫状肌麻痹后验光超过-1.00 D	10~15岁	不透紫光眼镜；部分阻挡紫光的隐形眼镜；透紫光隐形眼镜	1年	透紫光隐形眼镜对近视眼进展的抑制效果最好
Torii等^[55]	睫状肌麻痹后验光超过-6.00 D	> 25岁	不透紫光和有晶体眼人工晶体植入术	5年以上	与不透紫光的有晶体眼人工晶体相比，透紫光的有晶体眼人工晶体抑制了近视眼进展和眼轴长度增长
Mori等^[57]	睫状肌麻痹后验光-1.50 D~-4.50 D	6~12岁	比较紫光眼镜与传统框架眼镜不透紫光)的近视眼抑制效果	2年	当近距离工作时间低于180 min且从未戴过眼镜的受试者中，紫光眼镜组的眼轴长度变化显著小于安慰剂组(p < 0.01)。两年间，紫光眼镜组抑制了21.4%的眼轴增长
Torii等^[66]	睫状肌麻痹后验光-1.50 D~-4.50 D	6~12岁	配载发射310 μW/cm²紫光的眼镜架与发射极微量紫光<10 μW/cm²的传统眼镜架比较	24周	在8~10岁儿童中观察到眼轴增长、脉络膜厚度和睫状肌麻痹后屈光度的显著变化，而在其他组别中无差异
Zhao等^[67]	睫状肌麻痹后验光-1.00 D~-5.00 D	11~15岁	配载蓝紫光滤过镜片与配载普通非球面镜片比较	1年	短波长滤光镜片改善了对比敏感度和调节功能，有效缓解了视疲劳且无严重不良反应，但并未显著减缓近视眼进展。

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Recent advances in the impact of short-wavelength light on systemic health and myopia in the light-eye-brain axis

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Recent advances in the impact of short-wavelength light on systemic health and myopia in the light-eye-brain axis