[Strengthening the understanding of the pathological evolution of myopia].

The concern of high myopia in adolescents is increasingly prominent, because of the high prevalence and early onset of myopia in younger children. High myopia increases the risk of various fundus complications, resulting in serious damage to the vision of the working population. The mechanisms underlying the fundus pathology in high myopia remain unknown, although some studies have indicated the initial thinning of the choroid during the myopia progression might count a lot. The thinning of the choroid would influence the blood supply of the retina and sclera and accelerate the progression of myopia to high myopia, inducing the pathologic changes of the fundus. Since the treatment for pathological myopia is limited and cannot reverse the already existed visual impairment, preventive measures are necessary, including the attempts to delay the onset of myopia, to retard progression from mild myopia to high myopia and to retard the pathological changes of high myopia. Future researches should strengthen the understanding of the characteristics of pathologic changes of myopia, establish a predictive index system and a health management system to monitor early pathological changes, and promote early detection and intervention, so as to prevent fundus complications related to high myopia in multiple ways and avoid blindness and visual impairment caused by pathological fundus changes of myopia. (Chin J Ophthalmol, 2019, 55:721-725).随着近视眼高发以及低龄化，青少年高度近视眼问题日益凸显。高度近视眼眼底发生病理性改变的风险增加，其并发症会对视觉质量造成严重影响。高度近视眼眼底并发症的发生机制尚不明确。在近视眼发展过程中，脉络膜变薄可能最先发生，并可能通过影响视网膜和巩膜的血液供应，刺激近视眼向高度近视眼发展，诱发眼底的病理性转变。目前病理性近视眼的治疗方法有限且无法逆转视觉损伤，因此对于高度近视眼眼底并发症需从预防源头做起，以预防近视眼发生、控制近视眼进展以及抑制单纯性高度近视眼病理性转变为主攻方向。本文提出应加强对近视眼病理性演变规律的认识，从而探索建立近视眼眼底病变预警指标体系及高度近视眼健康管理模式，促进早期发现和干预，多管齐下防控高度近视眼眼底并发症的发生和发展，避免因近视眼病理性眼底改变导致盲和视力损伤，提高大众的生活质量。（中华眼科杂志，2019，55：721-725）.