目的：探讨中国西北地区60岁以上人群晶状体厚度（lens thickness, LT）和晶状体相对位置（relative lens position,RLP）的影响因素以及与眼前房角结构的相关性，为探索晶状体在原发性闭角型青光眼疾病中的作用机制提供依据。方法：横断面研究，纳入2024年4—6月在新疆喀什地区英吉沙县社区人群中检查的60岁以上正常受检者，采用眼前节相干光断层扫描仪等，测量双眼眼球生物学参数。将患者右眼纳入研究范围，通过相关性分析和线性回归模型分析晶状体参数变化与房角结构的相关性。结果：性别、腰围和眼轴长度（axial length, AL）为RLP的独立预测因子。年龄越大，晶状体越厚，70岁前LT与AL呈正相关，眼轴、LT和RLP是眼前房角巩膜突前500 μm开放距离（AOD500）的独立预测因子，其多元线性回归方程为：AOD500=-2.501 4+0.083 3AL-0.115 7LT+7.0211RLP-0.0026Sex-0.0010身高。 结论：新疆喀什地区60岁以上人群中，女性、腰围大和眼轴短提示晶状体相对位置靠前，而晶状体厚度、相对位置以及眼轴显著影响眼前房角开放距离，成为闭角型青光眼发病的潜在危险因素。

Objective: To explore the influencing factors of lens thickness (LT) and relative lens position (RLP) in individuals aged 60 and above in Northwestern China, as well as their correlation with anterior chamber angle structure. The aim is to provide evidence for exploring the role of the lens in the pathogenesis of primary angle - closure glaucoma. Methods: A cross - sectional study was conducted. Normal subjects aged 60 and above were enrolled from community - based examinations in Yingjisha County, Kashi, Xinjiang, between April and June 2024. An anterior segment optical coherence tomography was used to measure ocular biological parameters of both eyes. Only the right eyes of the subjects were included in the analysis. The correlation between changes in lens parameter and angle structure was examined through correlation analysis and linear regression models. Results: Gender, waist circumference and axial length emerged as independent predictors of the relative lens position. As age increased, the lens became thicker. Before the age of 70, lens thickness was positively correlated with axial length. Axial length, LT and RLP were identified as independent predictors of the anterior chamber angle scleral spur anterior 500 - μ m - opening distance (AOD500). The multiple linear regression equation is as follows: AOD500 (mm) = -2.5014 + 0.0833AL (mm) - 0.1157LT (mm) + 7.0211RLP - 0.0026Sex - 0.0010Height (cm). Conclusions: Among individuals aged 60 and above in Northwest China, being female, having a large waist circumference, and a short axial length are indicative of a relatively anterior lens position Furthermore, lens thickness, its relative position, and axial length significantly affect the anterior chamber angle opening distance, potentially contributing to the pathogenesis of angle-closure glaucoma.

目的：调查新疆喀什地区英吉沙县芒辛镇60岁及以上老年人群眼底疾病患病率及其分布特征，分析该地区眼底疾病流行病学现状，为西部高海拔地区眼底疾病防控策略制定和基层眼健康服务体系建设提供科学依据和数据支撑。方法：采用横断面研究设计，于2024年5—6月对芒辛镇60岁及以上常住人口进行调查。纳入标准为年龄≥60岁、在当地连续居住≥6个月、自愿参与并签署知情同意书者。=采用标准化眼科检查包括视力测定、眼压、裂隙灯显微镜检查、眼底照相等，同时进行结构化问卷调查收集基本信息、生命体征测量和实验室检查。眼底疾病诊断严格按照国内外相关诊断标准执行，采用SPSS24.0软件进行统计分析，计算各类眼底疾病患病率及其95%置信区间。结果：共调查1 310名老年人，响应率为76.76%。研究对象中男性669人（51.1%），女性641人（48.9%），平均年龄68.4±6.6岁。眼底疾病总患病率为16.1%（95% CI：14.2~18.0）。各类眼底疾病患病率依次为：年龄相关性黄斑变性5.9%（77例），视神经萎缩2.8%（36例），黄斑前膜2.3%（30例），糖尿病性视网膜病变1.8%（23例），其他黄斑病变1.07%（14例）、高血压性视网膜病变0.99%（13例）。其他眼底疾病包括高度近视眼底改变、视网膜色素变性、黄斑裂孔、血管炎、视网膜出血等，患病率均低于0.38%。在糖尿病患者中，糖尿病性视网膜病变患病率为20.8%，与国内外相关研究结果基本一致。结论：新疆芒辛镇老年人群眼底疾病患病率较高，年龄相关性黄斑变性是最主要的眼底疾病类型。研究结果填补了西部高海拔地区眼底疾病流行病学数据空白，提示应建立针对性的分层筛查和防控体系，重点关注老年人的眼底健康管理，推广便携式眼底照相结合远程医疗的筛查模式，提升基层眼健康服务的可及性与质量。

Objective: To investigate the prevalence and distribution characteristics of fundus diseases among the elderly population aged 60 and above in Mangxin Town, Yingjisha County, Kashi, Xinjiang, and to analyze the epidemiological status of fundus diseases in this region, thereby providing a scientific basis and data support for the development of fundus disease prevention and control strategies and the construction of a primary eye health service system in high-altitude areas of Western China. Methods: A cross-sectional study was conducted from May to June 2024 among the permanent residents aged 60 and above in Mangxin Town. Inclusion criteria were age ≥ 60 years, local residence for ≥ 6 months, and voluntary participation with signed informed consent. Data were collected through standardized ophthalmological examinations (including visual acuity testing, intraocular pressure measurement, slit-lamp microscopy, and fundus photography), structured questionnaire surveys, vital sign measurements, and laboratory tests. Diagnoses of fundus diseases were strictly based on domestic and international diagnostic criteria. Statistical analysis was performed using SPSS 24.0 to calculate the prevalence rates of various fundus diseases and their 95% confidence intervals. Results: A total of 1,310 elderly individuals were included, with a response rate of 76.76%. Among them, 669 (51.1%) were male and 641 (48.9%) were female, with a mean age of 68.4 ± 6.6 years. The overall prevalence of fundus diseases was 16.1% (95% CI: 14.2–18.0). The prevalence rates of specific fundus diseases were as follows: age-related macular degeneration, 5.9% (77 cases); optic atrophy, 2.8% (36 cases); epiretinal membrane, 2.3% (30 cases); diabetic retinopathy, 1.8% (23 cases); other macular diseases, 1.07% (14 cases); and hypertensive retinopathy, 0.99% (13 cases). Other fundus diseases, including high myopia-related fundus changes, retinitis pigmentosa, macular hole, vasculitis, and retinal hemorrhage, each had a prevalence of less than 0.38%. Among diabetic patients, the prevalence of diabetic retinopathy was 20.8%, which is consistent with previous domestic and international studies. Conclusions: The prevalence of fundus diseases among the elderly in Mangxin Town, Xinjiang, is relatively high, with age-related macular degeneration being the most common type. This study fills a gap in the epidemiological data on fundus diseases in high-altitude regions of Western China. The findings highlight the need to establish a targeted stratified screening and prevention system, strengthen fundus health management in the elderly, and promote a screening model combining portable fundus photography with telemedicine to improve the accessibility and quality of primary eye health services.