In the face of an “epidemic” increase in myopia over the last decades and myopia prevalence predicted to reach 2.5 billion people by the end of this decade, there is an urgent need to develop effective and safe therapeutic interventions to slow down this “myopia booming” and prevent myopia-related complications and vision loss. Dopamine (DA) is an important neurotransmitter in the retina and mediates diverse functions including retina development, visual signaling, and refractive development. Inspired by the convergence of epidemiological and animal studies in support of the inverse relationship between outdoor activity and risk of developing myopia and by the close biological relationship between light exposure and dopamine release/signaling, we felt it is timely and important to critically review the role of DA in myopia development. This review will revisit several key points of evidence for and against DA mediating light control of myopia: 1) the causal role of extracellular retinal DA levels, 2) the mechanism and action of dopamine D1 and D2 receptors and 3) the roles of cellular/circuit retinal pathways. We examine the experiments that show causation by altering DA, DA receptors and visual pathways using pharmacological, transgenic, or visual environment approaches. Furthermore, we critically evaluate the safety issues of a DA-based treatment strategy and some approaches to address these issues. The review identifies the key questions and challenges in translating basic knowledge on DA signaling and myopia from animal studies into effective pharmacological treatments for myopia in children.

面对近十年来“近视”的“流行性”增长，预计到本世纪末，近视流行率将达到25亿，迫切需要制定有效且安全的治疗措施，以减缓这种“近视的蓬勃发展”并预防与近视有关的并发症和视力丧失。多巴胺（DA）是视网膜中的重要神经递质，可介导多种功能，包括视网膜发育，视觉信号和屈光发育。受到流行病学和动物研究的融合的启发，以支持户外活动与发展近视风险之间的反比关系，以及受光照和多巴胺释放/信号之间的密切生物学关系的启发，我们认为批判性地回顾这一作用是及时且重要的在近视发展中的作用 这篇综述将重新审视支持和反对DA介导近视光控制的几个关键点：1）细胞外视网膜DA水平的因果关系； 2）多巴胺D1和D2受体的机制和作用； 3）细胞/视网膜回路。我们检查了通过使用药理学，转基因或视觉环境方法改变DA，DA受体和视觉途径显示因果关系的实验。此外，我们严格评估基于DA的治疗策略的安全性问题以及解决这些问题的一些方法。该综述确定了将DA信号和近视的基础知识从动物研究转化为儿童近视的有效药物治疗的关键问题和挑战。