近视患者Schlemm管及小梁网变化的研究进展

doi:10.11958/20260419

天津医药 ›› 2026, Vol. 54 ›› Issue (10): 1115-1120.doi: 10.11958/20260419

• 综述 • 上一篇

近视患者Schlemm管及小梁网变化的研究进展

郝倩¹^,²(), 李菊²^,³, 何紫叶¹^,², 樊芳²^,^△()

¹ 华北理工大学临床医学院（邮编 063210）
² 河北省人民医院眼科
³ 河北医科大学

收稿日期:2026-02-05 修回日期:2026-04-02 出版日期:2026-10-15 发布日期:2026-10-10
通讯作者: △E-mail：fanfang2004@sina.com
作者简介:郝倩（1998），女，硕士在读，主要从事近视与青光眼方面研究。E-mail：2810331834@qq.com
基金资助:
河北省医学科学研究课题计划项目(20220830)

Research progress on Schlemm canal and trabecular meshwork changes in myopic patients

HAO Qian¹^,²(), LI Ju²^,³, HE Ziye¹^,², FAN Fang²^,^△()

¹ College of Clinical Medicine, North China University of Science and Technology, Tangshan 063210, China
² Department of Ophthalmology, Hebei General Hospital
³ Hebei Medical University

Received:2026-02-05 Revised:2026-04-02 Published:2026-10-15 Online:2026-10-10
Contact: △E-mail：fanfang2004@sina.com

郝倩, 李菊, 何紫叶, 樊芳. 近视患者Schlemm管及小梁网变化的研究进展[J]. 天津医药, 2026, 54(10): 1115-1120.

HAO Qian, LI Ju, HE Ziye, FAN Fang. Research progress on Schlemm canal and trabecular meshwork changes in myopic patients[J]. Tianjin Medical Journal, 2026, 54(10): 1115-1120.

摘要/Abstract

摘要：

Schlemm管（SC）与小梁网（TM）是实现房水外流功能的解剖与功能基础。文章重点分析了近视，尤其是高度近视状态下两者呈现的“腔大网薄”形态重塑特征。进一步从生物力学机制、机械牵拉及炎症微环境3个层面，阐述了上述结构改变的潜在机制，并揭示了房角微结构的改变与原发性开角型青光眼风险升高及“低眼压性青光眼”表型之间的临床关联。该综述旨在整合当前影像学、组织学及生物力学研究证据，明确近视相关房水流出通道的病理特征，推动建立近视特异性影像评估标准与更严格的个体化眼压管理策略，从而为高度近视人群青光眼风险的早期识别与干预提供理论依据。

关键词: 近视, 青光眼, 小梁网, 巩膜, Schlemm管, 睫状肌

Abstract:

Schlemm canal (SC) and trabecular meshwork (TM) are the anatomical and functional basis for achieving the function of aqueous humor outflow. The article focuses on analyzing the morphological remodeling characteristics of "large cavity and thin mesh" presented by both under the state of myopia, especially high myopia. Further, the potential mechanisms of the above structural changes are expounded from three aspects: biomechanical mechanism, mechanical traction and inflammatory microenvironment, and the clinical associations between the changes in the anterior chamber angle microstructure and the increased risk of primary open-angle glaucoma as well as the phenotype of "low intraocular pressure glaucoma" are revealed. This review aims to integrate current imaging, histological and biomechanical research evidence, clarify the pathological characteristics of myopia-related aqueous humor outflow channels, promote the establishment of myopia-specific imaging assessment standards and more rigorous individualized intraocular pressure management strategies, and thereby provide a theoretical basis for the early identification and intervention of glaucoma risk in the population with high myopia.

Key words: myopia, glaucoma, trabecular meshwork, sclera, Schlemm canal, ciliary muscle

中图分类号:

R778.11

参考文献 36

[1]	Holden B A, Fricke T R, Wilson D A, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050[J]. Ophthalmology, 2016, 123(5):1036-1042. doi:10.1016/j.ophtha.2016.01.006.
[2]	Park K H. Glaucoma and myopia[J]. Indian J Ophthalmol, 2024, 72(3):309-310. doi:10.4103/IJO.IJO_170_24.
[3]	Zhang X, Jiang J, Kong K, et al. Optic neuropathy in high myopia:glaucoma or high myopia or both?[J]. Prog Retin Eye Res, 2024, 99:101246. doi:10.1016/j.preteyeres.2024.101246.
[4]	Karimi A, Razaghi R, D'Costa S D, et al. Implementing new computational methods for the study of JCT and SC inner wall basement membrane biomechanics and hydrodynamics[J]. Comput Methods Programs Biomed, 2024, 243:107909. doi:10.1016/j.cmpb.2023.107909.
[5]	Zhou Y, Liu Z, Gao W, et al. Pathological mechanism and clinical therapy progress of Schlemm's canal[J]. J Ophthalmol, 2024, 2024:9978312. doi:10.1155/2024/9978312.
[6]	Swain D L, Le T D, Lam C, et al. Investigation of two pore types in Schlemm's canal inner wall endothelium in flow-type areas using serial block-face scanning electron microscopy[J]. Exp Eye Res, 2025, 259:110577. doi:10.1016/j.exer.2025.110577.
[7]	Heo Y, Cai J W, Perkumas K, et al. Expression changes of human Schlemm's canal endothelial cells in response to cyclic mechanical stretch[J]. Exp Eye Res, 2026, 262:110747. doi:10.1016/j.exer.2025.110747.
[8]	Karimi A, Razaghi R, Kelley M J, et al. Biomechanics of the JCT and SC inner wall endothelial cells with their basement membrane using 3D serial block-face scanning electron microscopy[J]. Bioengineering (Basel), 2023, 10(9):1038. doi:10.3390/bioengineering10091038.
[9]	Faralli J A, Filla M S, Peters D M. Integrin crosstalk and its effect on the biological functions of the trabecular meshwork/Schlemm's canal[J]. Front Cell Dev Biol, 2022, 10:886702. doi:10.3389/fcell.2022.886702.
[10]	Karimi A, Aga M, Khan T, et al. Comparative analysis of traction forces in normal and glaucomatous trabecular meshwork cells within a 3D,active fluid-structure interaction culture environment[J]. Acta Biomater, 2024, 180:206-229. doi:10.1016/j.actbio.2024.04.021.
[11]	Karimi A, Razaghi R, Rahmati S M, et al. Modeling the biomechanics of the conventional aqueous outflow pathway microstructure in the human eye[J]. Comput Methods Programs Biomed, 2022, 221:106922. doi:10.1016/j.cmpb.2022.106922.
[12]	Wan Y, Guo X, Wang N. Trabecular meshwork:a pivotal target for evolving glaucoma treatments[J]. Surv Ophthalmol, 2025, 70(6):1043-1060. doi:10.1016/j.survophthal.2025.07.001.
[13]	Buffault J, Labbé A, Hamard P, et al. The trabecular meshwork:Structure,function and clinical implications. A review of the literature[J]. J Fr Ophtalmol, 2020, 43(7):e217-e230. doi:10.1016/j.jfo.2020.05.002.
[14]	Kelly R A, Perkumas K M, Campbell M, et al. Fibrotic changes to Schlemm's canal endothelial cells in glaucoma[J]. Int J Mol Sci, 2021, 22(17):9446. doi:10.3390/ijms22179446.
[15]	Li Z, Wu X, Ji X, et al. The change of ciliary muscle-trabecular meshwork-Schlemm canal complex after phacoemulsification using swept-source-optical coherence tomography[J]. Ophthalmic Res, 2025, 68(1):100-107. doi:10.1159/000543303.
[16]	Yan X, Li M, Chen Z, et al. Schlemm's canal and trabecular meshwork in eyes with primary open angle glaucoma:a comparative study using high-frequency ultrasound biomicroscopy[J]. PLoS One, 2016, 11(1):e0145824. doi:10.1371/journal.pone.0145824.
[17]	Chen Z, Song Y, Li M, et al. Schlemm's canal and trabecular meshwork morphology in high myopia[J]. Ophthalmic Physiologic Optic, 2018, 38(3):266-272. doi:10.1111/opo.12451.
[18]	Jonas J B, Panda-Jonas S, Mehta J S, et al. Anatomic relationship among descemet's membrane,trabecular meshwork,scleral spur,and ciliary muscle[J]. Invest Ophthalmol Vis Sci, 2025, 66(2):8. doi:10.1167/iovs.66.2.8.
[19]	Xie X, Sultan W, Corradetti G, et al. Assessing accommodative presbyopic biometric changes of the entire anterior segment using single swept-source OCT image acquisitions[J]. Eye (Lond), 2022, 36(1):119-128. doi:10.1038/s41433-020-01363-3.
[20]	Shan S, Wu J, Cao J, et al. Global incidence and risk factors for glaucoma:a systematic review and meta-analysis of prospective studies[J]. J Glob Health, 2024, 14:04252. doi:10.7189/jogh.14.04252.
[21]	Woodman-Pieterse E C, Read S A, Collins M J, et al. Anterior scleral thickness changes with accommodation in myopes and emmetropes[J]. Exp Eye Res, 2018, 177:96-103. doi:10.1016/j.exer.2018.07.023.
[22]	Tan J C K, Montesano G, Bell K, et al. Refining visual field trend progression criteria in glaucoma:impact of significance thresholds and test frequency[J]. Ophthalmol Glaucoma, 2026:S2589-4196(26)00004-9. doi:10.1016/j.ogla.2026.01.004.
[23]	Esen Baris M, Guven S. Anatomic features of the lamina cribrosa and optic disc in ocular hypertension,glaucoma and healthy eyes[J]. J Glaucoma, 2024, 33(11):823-827. doi:10.1097/IJG.0000000000002470.
[24]	Kang E, Park J H, Yoo C, et al. The association between asymmetric stress distribution on the lamina cribrosa and glaucoma progression[J]. Graefes Arch Clin Exp Ophthalmol, 2025, 263(3):819-828. doi:10.1007/s00417-024-06670-z.
[25]	Kang E, Park J, Yoo C, et al. Asymmetric stress distribution on lamina cribrosa in glaucoma patients with high myopia[J]. Graefes Arch Clin Exp Ophthalmol, 2025, 263(7):1985-1995. doi:10.1007/s00417-025-06809-6.
[26]	Enomoto N, Saito H, Araie M, et al. Effect of deep optic nerve head morphology on lamina cribrosa and peripapillary scleral configurations in healthy eyes[J]. Invest Ophthalmol Vis Sci, 2025, 66(9):66. doi:10.1167/iovs.66.9.66.
[27]	Wang X, Beotra M R, Tun T A, et al. In vivo 3-dimensional strain mapping confirms large optic nerve head deformations following horizontal eye movements[J]. Invest Ophthalmol Vis Sci, 2016, 57(13):5825-5833. doi:10.1167/iovs.16-20560.
[28]	Tian H, Li L, Song F. Study on the deformations of the lamina cribrosa during glaucoma[J]. Acta Biomater, 2017, 55:340-348. doi:10.1016/j.actbio.2017.03.028.
[29]	Xiong J P, Lu H S, Zhou N, et al. Possible extension of inner scleral fibers into the peripapillary sclera detected by polarization-sensitive OCT[J]. Invest Ophthalmol Vis Sci, 2026, 67(1):13. doi:10.1167/iovs.67.1.13.
[30]	Pan M Q, Chen Z H, Pan X L, et al. Peripapillary scleral stiffening increases optic nerve head shear deformation in porcine eyes during IOP elevation[J]. Exp Eye Res, 2025, 261:110692. doi:10.1016/j.exer.2025.110692.
[31]	Medina A. The cause of myopia development and progression:theory,evidence,and treatment[J]. Surv Ophthalmol, 2022, 67(2):488-509. doi:10.1016/j.survophthal.2021.06.005.
[32]	Sheppard A L, Davies L N. In vivo analysis of ciliary muscle morphologic changes with accommodation and axial ametropia[J]. Invest Ophthalmol Vis Sci, 2010, 51(12):6882-6889. doi:10.1167/iovs.10-5787.
[33]	Benozzi G, Quinteros Villarruel E, Zuluaga A F, et al. Mechanisms of pilocarpine-induced nitric oxide and prostaglandin production in porcine ciliary muscle[J]. FASEB Bioadv, 2025, 7(11):e70064. doi:10.1096/fba.2025-00161.
[34]	Kaphle D, Schmid K L, Davies L N, et al. Ciliary muscle dimension changes with accommodation vary in myopia and emmetropia[J]. Invest Ophthalmol Vis Sci, 2022, 63(6):24. doi:10.1167/iovs.63.6.24.
[35]	Yu Q, Wang C, Liu Z, et al. Association between inflammatory cytokines and oxidative stress levels in aqueous humor with axial length in human myopia[J]. Exp Eye Res, 2023, 237:109670. doi:10.1016/j.exer.2023.109670.
[36]	Xin J, Bao B, Liu J, et al. Crosstalk between myopia and inflammation:a mini review[J]. Int J Med Sci, 2024, 21(9):1589-1603. doi:10.7150/ijms.94826.

近视患者Schlemm管及小梁网变化的研究进展

Research progress on Schlemm canal and trabecular meshwork changes in myopic patients

引用本文

RichHTML

PDF (PC)

可视化

摘要/Abstract

使用本文

参考文献 36

相关文章 15

编辑推荐

Metrics

本文评价

[1]	许衍辉, 孟克青, 刘晓静, 张鑫, 翟欣然, 甄宇涵, 陈志敏. CASIA 2测量的晶状体等效直径评估白内障囊袋张力环植入后Toric人工晶状体旋转稳定性[J]. 天津医药, 2026, 54(8): 858-864.
[2]	张阳, 段颖, 崔明霞, 树玲博. 内路小梁切开术对原发性开角型青光眼患者眼压及视力的影响[J]. 天津医药, 2025, 53(1): 85-87.
[3]	孟克青, 张武林, 董玮, 许衍辉, 李楠. 超声乳化白内障吸出联合CTR植入对高度近视白内障术后囊袋稳定性的影响[J]. 天津医药, 2024, 52(10): 1056-1060.
[4]	肖博文, 曹维, 刘莉静, 赵香, 王昕. 糖皮质激素联合降眼压药物治疗病理性近视合并多灶性脉络膜炎的临床疗效观察[J]. 天津医药, 2023, 51(1): 54-57.
[5]	金颖, 王雁, 杨坤, 王璐, 赵金荣, 耿维莉. 去上皮瓣LASEK与飞秒激光辅助LASIK矫治中低度近视的比较[J]. 天津医药, 2018, 46(9): 978-982.
[6]	苏龙 , 汤欣 . 微创引流植入物在青光眼手术中的应用进展[J]. 天津医药, 2018, 46(7): 780-784.
[7]	赵亮, 刘爱华, 郭如如, 孙丰源. 药物诱发急性闭角型青光眼发作的临床分析[J]. 天津医药, 2018, 46(7): 712-715.
[8]	张姝贤，张缨，杨晓艳，李丽华△. Toric设计角膜塑形镜矫正青少年近视合并中高度散光的近期疗效[J]. 天津医药, 2018, 46(11): 1217-1221.
[9]	李文博，胡博杰，李筱荣△. 高度近视的组织学改变研究进展[J]. 天津医药, 2017, 45(6): 657-659.
[10]	齐艳,赵秀娟,徐琳琪,等.. 白藜芦醇对H2O2 及TGF-β2诱导人小梁网细胞的影响及机制探讨[J]. 天津医药, 2016, 44(8): 978-983.
[11]	裴锦云，林羽,杨海燕. 超声乳化联合房角分离术治疗闭角型青光眼合并白内障的临床效果分析[J]. 天津医药, 2016, 44(7): 906-909.
[12]	刘海凤. 葛根素对青光眼视网膜氧化应激损伤的保护作用[J]. , 2013, (12): 1199-1201 .
[13]	丁娟,马伊,张岩. 丝裂霉素C在单切口晶状体超声乳化联合小梁切除术中的应用[J]. , 2012, (10): 1049-1051 .
[14]	范虹. 色素性青光眼—例报告[J]. , 2011, 39(5): 473-474 .
[15]	崔靖1 ,贺忠江2 ,高慧娟3 . 老年硬化性青光眼的临床研究[J]. , 2010, 38(5): 0-0 .