论著

新疆喀什地区英吉沙县儿童青少年弱视患病率和影响因素分析

Analysis of the prevalence and influencing factors of amblyopia among children and adolescents in Yingjisha County, Kashgar Prefecture, Xinjiang

:807-819
 
目的:了解新疆喀什地区英吉沙县7~16岁儿童青少年弱视患病情况及其相关因素,为制定科学有效的眼健康防控策略提供依据。方法:选取新疆喀什地区英吉沙县3 261名在校儿童青少年,对其进行裸眼视力、最佳矫正视力、屈光度、眼位和眼底情况等检查,并通过问卷调查收集其基本人口学信息、近视家族史、用眼情况和睡眠情况,采用Logistic回归分析7~16岁儿童青少年弱视患病的相关因素。结果:英吉沙县儿童青少年弱视的患病率为1.99%(95%·CI: 1.51~2.47)。弱视患病率在学生类型、性别、近视家族史、主观睡眠质量、每天写作业时间、每天睡眠时间等方面比较差异无统计学意义(P>0.05),在斜视、近视、远视、屈光参差、每天使用电子产品时间等方面比较差异有统计学意义(P<0.05)。多因素回归分析结果显示,斜视、远视、屈光参差及每天使用电子产品时间与弱视相关,对应的OR值相应为3.82(95%CI: 1.93~7.58,P<0.001)、10.88(95%CI: 4.85~24.40,P<0.001)、13.54(95%CI:6.84~26.78,P<0.001)和0.25(95%CI: 0.12~0.54, P<0.001),合并斜视、远视或屈光参差的儿童青少年患弱视的风险增加。每天使用电子产品时间>60 min的儿童青少年患弱视风险较使用时间≤60 min降低。弱视类型以屈光不正性弱视和屈光参差性弱视为主。结论:在新疆喀什地区英吉沙县7~16岁儿童青少年人群中,屈光不正和屈光参差是弱视患病的主要原因。斜视、远视、屈光参差、每天使用电子产品时间是弱视的影响因素。
Objective: To conduct a comprehensive investigation into the prevalence of amblyopia and its influencing factors among children and adolescents aged 7-16 in Yingjisha County, Kashgar Prefecture, Xinjiang. The ojective is to furnish a solid basis for formulating scientific and effective eye health prevention and control strategies. Methods: A total of 3,261 school-aged children and adolescents in Yingjisha County, Kashgar Prefecture, Xinjiang, were selected for this study. The examinations included uncorrected visual acuity, best-corrected visual acuity, refractive error, ocular alignment, and fundus condition. A questionnaire was used to collect demographic information, family history of myopia, daily eye-use habits, and sleep status. The data were analyzed using SPSS statistical software, and logistic regression was employed to explore factors associated with amblyopia in children and adolescents aged 7-16. Results: The study revealed that the prevalence of amblyopia among children and adolescents in Yingjisha County was 1.99% (95% CI: 1.51-2.47). There were no significant differences (P > 0.05) in the prevalence of amblyopia across student type, sex, family history of myopia, subjective sleep quality, daily homework duration, or daily sleep duration. However, significant differences (P < 0.05) were observed in cases involving strabismus, myopia, hyperopia, anisometropia, and daily screen time. Multivariate regression analysis indicated that strabismus (OR = 3.82, 95% CI: 1.93-7.58, P < 0.001), hyperopia (OR = 10.88, 95% CI: 4.85-24.40, P < 0.001), and anisometropia (OR = 13.54, 95% CI: 6.84–26.78, P < 0.001) were positively correlated with amblyopia. Conversely, children and adolescents who used electronic devices for >60 minutes per day had a lower risk of amblyopia (OR = 0.25, 95% CI: 0.12-0.54, P < 0.001) compared to those with ≤60 minutes or less of daily screen time. The most common type of amblyopia was mixed amblyopia (60.00%), followed by anisometropic amblyopia (23.08%), refractive amblyopia (12.31%), and strabismic amblyopia (4.62%). Among mixed amblyopia cases, the combination of refractive amblyopia and anisometropic amblyopia was the predominant pattern (64.10%). Conclusions: Refractive errors and anisometropia are the main causes of amblyopia. Strabismus, myopia, hyperopia, anisometropia and the duration of electronic device use are identified as influencing factors for amblyopia.
综述

青少年弱视康复治疗研究进展

Research progress on rehabilitation treatment of adolescent amblyopia

:52-62
 
眼健康是国民健康的重要组成部分,包括盲在内的视觉损伤严重影响人民群众的身体健康和生活质量,加重家庭和社会负担,威胁社会经济生产活动,是涉及民生的重大公共卫生问题和社会问题。弱视作为幼儿期起病的主要视觉障碍性疾病之一,是致使青少年低视力的首要因素,影响青少年自身学业和心理健康,增加致盲风险,故做好弱视的预防及康复工作刻不容缓。通过梳理研究发现,国内外对弱视的传统治疗方法有遮盖疗法、屈光矫正、压抑疗法等,知觉学习、视功能训练、电子视频游戏、针灸等则是近年逐渐新兴起并被广泛运用的弱视康复治疗方法,近年来关于年龄对弱视康复治疗影响的相关研究也较多。通过整理前人研究成果,提出建立儿童青少年视力档案、建立五位一体弱视康复治疗布局模式、进行联合临床治疗青少年弱视的对策,以期为青少年弱视提供康复治疗手段参考和选择,促进青少年弱视康复治疗眼健康事业发展。
Eye health is an important part of national health. Visual impairment, including blindness, seriously affects people’s physical health and quality of life, increases the burden on families and society, threatens social and economic production activities, and is a major public health and social problem related to people’s livelihood. Amblyopia,as one of the main visual disorders in early childhood, is the primary factor causing low vision in adolescents, which affects their academic and mental health and increases the risk of blindness. Therefore, it is urgent to do a good job in the prevention and rehabilitation of amblyopia. By summarizing existing studies, it is found that traditional treatment methods for amblyopia at home and abroad include occlusion therapy, refractive correction, and depressive therapy, while perceptual learning, visual function training, electronic video games, acupuncture and so on are gradually emerging in recent years and widely used in recent years. There are numerous studies on the impact of age on the rehabilitation of amblyopia. By sorting out the previous research results, this paper puts forward the countermeasures of establishing visual acuity files for children and adolescents, establishing the five- in-one rehabilitation treatment layout model, and combining clinical treatment for adolescent amblyopia, in order to provide reference and choice for the rehabilitation treatment of adolescent amblyopia, and promote the development of the eye health cause of adolescent amblyopia rehabilitation.
论著

斜视性弱视伴偏中心注视患者的光学相干断层扫描血管成像技术表现

Optical coherence tomography angiography manifestation of strabismic amblyopia patients with eccentric fixation

:131-136
 
目的:探讨光学相干断层扫描血管成像技术(optical coherence tomography angiography,OCTA)在斜视性弱视伴偏中心注视患者中应用的价值。方法:收集2018年1月到2020年5月斜视性弱视伴偏中心注视的患者17人为研究组,采用OCTA系统软件工具,以μm为单位测量视网膜固视点和黄斑中心凹之间的距离,同时收集非斜视、弱视且中心注视健康者17人为对照组,并分析受试者的浅层视网膜血管丛的黄斑中心凹血流长度密度(vessel length density,VLD)、灌注密度(perfusion density,PD)、黄斑中心凹无血流信号区(foveal avascular zone,FAZ)、面积、FAZ周长及FAZ圆形度。结果:斜视组弱视眼偏心距离为(632.18±310.62) μm,黄斑中心凹浅层血管丛VLD为(5.31±3.44) mm?1,PD为0.16±0.08,黄斑中心凹无血流信号区FAZ面积(0.28±0.17) mm2,FAZ周长(2.05±0.56) mm、FAZ圆形度0.67±0.06;与研究组対侧眼和对照组相比,VLD差异有统计学意义(P<0.05),PD、FAZ面积等差异无统计学意义(P>0.05)。斜视组弱视眼偏心度与偏中心距离显著相关(r=0.834,P<0.001)。结论:OCTA可以量化偏中心距离,斜视性弱视伴偏中心注视眼的黄斑中心凹血流长度密度较対侧眼及健康眼低。
Objective: To explore the application value of optical coherence tomography angiography (OCTA) in patients with strabismic amblyopia accompanied by eccentric fixation. Methods: Seventeen strabismus amblyopia patients with eccentric fixation admitted to our hospital from January 2018 to May 2020 were enrolled as the study group. OCTA software was used to measure the distance between fixation point and macular fovea in micron units. Seventeen non-strabismus and non-amblyopia patients with centric fixation were enrolled as the control group. Vessel length density (VLD), perfusion density (PD), and foveal avascular zone (FOZ) were measured for the superficial retinal vascular cluster. Perimeter of FAZ and circularity of FAZ were analyzed. Results: The eccentric fixation distance was (632.18 ±310.6) μm, the macular fovea retinal thickness was (207.82±17.79) μm, the VLD of the superficial retinal vascular plexus was (5.31±3.44) mm?1, the PD was 0.16±0.08, the FAZ area was 0.28±0.17 mm2, the FAZ perimeter was 2.05±0.56 mm, and the FAZ circularity was 0.67±0.06. These results showed statistically significant differences in the VLD compared with the fellow eyes (P=0.043) and the control group (P=0.049), but there were no statistically significant differences in the PD, or FAZ area. In the strabismus group, the eccentricity of amblyopia was significantly correlated with the eccentric distance (r=0.834, P<0.001). Conclusion: OCTA can quantify the eccentric distance. The blood flow length density of macular fovea in strabismic amblyopia with eccentric fixation is lower than that in contralateral and healthy eyes.
论著

氦氖激光治疗喀什地区儿童弱视的随机对照研究

氦氖激光治疗喀什地区儿童弱视的随机对照研究

:2-7
 
目的:通过随机对照试验,观察氦氖激光在喀什地区弱视儿童中的治疗效果。方法:选取2016年2月至2018年11月期间就诊喀什地区第一人民医院符合纳排标准的弱视儿童,按随机数字表法,分为试验组(氦氖激光+弱视常规治疗组)与对照组(弱视常规治疗组),比较两组的弱视治疗效果。结果:本试验成功纳入弱视儿童111例(177眼),其中试验组61例(97眼),对照组50例(80眼)。与对照组相比,汉族试验组弱视儿童效果明显(P=0.023),维吾尔族试验组弱视儿童未见明显疗效(P=0.481);试验组与对照组在喀什地区不同年龄、不同弱视程度、不同弱视类型及不同弱视眼数儿童中未见明显差异(P>0.05)。结论:氦氖激光治疗喀什地区弱视儿童作用有限,为避免过度医疗,不建议在南疆地区开展。
Objective: To observe the therapeutic effect of helium-neon laser in amblyopia children in Kashgar by a randomized controlled trial. Methods: Amblyopia children who met eligibility criteria during February 2016 to November 2018 were selected and divided into two groups according to random number table: test group(helium-neon laser + conventional treatment for amblyopia) and control group (conventional treatment for amblyopia). The effects of amblyopia treatment were compared between two groups. Results: One hundred and eleven amblyopic children (177 eyes), including 61 children (97 eyes) of the test group and 50 children (80 eyes) of the control group were included in this study. The effect of helium-neon laser was significant in Han children (P=0.023), but not in Uygur children (P=0.481) in the test group compared with the control group.Conclusion: Helium-neon laser has limited effect in treating children with amblyopia in Kashgar region. To avoid over-treatment, it is not recommended to perform it in southern Xinjiang.

其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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