目的：干眼已成为影响儿童和青少年眼健康的重要问题，但其流行病学特征及相关因素尚未在中国西部地区儿童和青少年群体中得到充分研究。本研究旨在调查新疆喀什地区英吉沙县学龄儿童和青少年的干眼患病率，并分析其相关因素，为儿童和青少年干眼的防治提供流行病学依据。方法：本研究为横断面研究，于2024年5—6月在英吉沙县第三中学和芒辛镇中心小学开展，共纳入3 305名在校儿童和青少年进行问卷调查，并随机抽取557名儿童和青少年进行眼表检查。采用眼表综合分析仪测量泪河高度和非接触泪膜破裂时间。干眼诊断基于世界泪膜与眼表学会发布的第二版干眼专家共识（2017）。采用多因素logistic回归分析干眼的相关因素。结果：在557名参与儿童和青少年中，干眼患病率为16.88%（94/557）。不同性别间干眼患病率比较差异无统计学意义（P=0.81）。干眼患病率随年龄增长而增加，具有显著的线性趋势。任一眼有屈光不正的儿童和青少年干眼患病率更高（29.05% vs. 12.47%，P<0.001）。多因素Logistic回归分析显示年龄（OR=1.21）和屈光不正（OR=2.72）是干眼的危险因素，性别、身体质量指数、右眼眼轴长度及父母近视情况无关。结论：新疆喀什地区英吉沙县学龄儿童和青少年的干眼患病率与全国均值相近且偏低，年龄增长和屈光不正显著增加干眼患病风险，应关注儿童和青少年屈光状态对眼表健康的影响，并采取相应的预防措施。

Objective: Dry eye (DED) has emerged as an important ocular health concern among children and adolescents. However, in pediatric populations in western China, its epidemiological characteristics and associated risk factors have not been thoroughly investigated. This study aimed to investigate the prevalence of DED and analyze its risk factors among school-age children and adolescents in Yingjisha County, Kashgar Prefecture, Xinjiang, so as to provide a solid evidence base for formulating prevention and control strategies. Methods: This cross-sectional study was conducted from May to June 2024 at Yingjisha County No. 3 Middle School and Mangxin Central Primary School. A total of 3,305 school children and adolescents completed the questionnaire, and 557 of them were randomly selected for ocular surface examinations. The Keratograph 5M was used to measure tear meniscus height (TMH) and non-invasive tear break-up time (NIBUT). DED diagnosis adhered to the Dry Eye WorkShop II 2017 (DEWS II) criteria published by Tear Film & Ocular Surface Society (TFOS). Multivariate logistic regression was applied to evaluate the associated risk factors. Results: Among the 557 children and adolescents who underwent examinations, the prevalence of DED was 16.88% (94/557). No statistically significant difference was observed between genders (P = 0.81). The prevalence of DED increased with age, showing a significant linear trend. Participants with refractive errors in either eye had a significantly higher prevalence of DED (29.05% vs. 12.47%, P< 0.001). Logistic regression analysis identified age (OR = 1.21) and refractive error (OR = 2.72) as risk factors. No significant associations were found for gender, Body Mass Index (BMI), axial length of the right eye, or parental myopia. Conclusions: The prevalence of DED among school-age children and adolescents in Yingjisha County is either comparable to or slightly lower than, the national average. Age and refractive error substantially increase the risk of DED. Greater attention should be directed towards children’s refractive status to protect ocular surface health and implement early preventive measures.

目的：调查新疆英吉沙县7~16岁儿童和青少年近视前期 ( 屈光度≤+0.75 D且>-0.50 D)患病率及其相关因素,为该地区近视防控提供依据。方法：在2024年5—6月采用简单抽样法选取新疆喀什地区英吉沙县一所中学和芒辛镇一所小学的学生进行问卷调查、视力、散瞳验光、眼轴、眼前段、眼底检查等横断面评估，分析纳入等效球镜(spherical equivalent，SE)度数较高眼的数据，采用单因素和多因素逻辑回归分析人口学特征、家族史、用眼行为、生活习惯等潜在相关因素与近视前期的关系。结果：共纳入3 247名参与者，男性占50.14%，女性占49.86%。近视前期1 652人(50.88%)，近视621人(19.12%)，非近视974人(30.00%)。近视前期患病率为50.88%(95%CI:49.16%~52.60%)，近视患病率为19.12%(95%CI:17.81%~20.51%)。多因素回归分析显示，女性(OR=2.56, 95%CI:2.09~3.13, P<0.001)、较大年龄(OR=1.19, 95%CI:1.13~1.24 , P<0.001)和较长眼轴(OR=2.68, 95%CI: 2.31~3.11 , P<0.001)是近视前期的相关因素。结论：在新疆喀什地区英吉沙县7~16岁儿童和青少年中，半数处于近视前期，其相关因素包括年龄偏大、女性及眼轴偏长。

Objective: To investigate the prevalence of pre-myopia (defined as spherical equivalent ≤+0.75 D and >−0.50 D) and its related factors among children and adolescents aged 6–16 years in Yengisar County, Xinjiang, China, providing evidence for regional myopia prevention. Methods: In May and June 2024, a comprehensive assessment was carried out on students selected through simple sampling from a middle school in Yingjisha County, Kashgar Prefecture, Xinjiang, and a primary school in Mangxin Town, Yingjisha County. ,The assessment included a questionnaire survey, visual acuity test, dilated eye refraction measurement, axial length measurement, anterior segment examination, and fundus examination. The data included eyes with high spherical equivalent (SE) power. Single-factor and multiple-factor logistic regression analyses were used to investigate the relationship between demographic characteristics, family history, eye-use behavior, lifestyle habits, and other potential related factors with pre myopia. Results: A total of 3,247 participants were included in the study, with 50.14% being male and 49.86% female. Among them, 1,652 (50.88%) individuals had preclinical myopia, 621 (19.12%) had myopia, and 974 (30.00%) had non myopia. The preclinical prevalence of myopia was 50.88% (95% CI: 49.16-52.60), and the prevalence of myopia was 19.12% (95% CI: 17.81-20.51). Multivariate regression analysis showed that female (OR=2.56, 95% CI: 2.09-3.13, P<0.001), older age (OR=1.19, 95% CI: 1.13-1.24, P<0.001), and longer axial length (OR=2.68, 95% CI: 2.31-3.11, P<0.001) were related factors in the preclinical stage of myopia. Conclusions: Among children and adolescents aged 7-16 in Yingjisha County, Kashgar Prefecture, Xinjiang, Half were in the preclinical stage of myopia. The related factors include older age, female gender, and axial length.

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.

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, Yengisar County, Kashgar Prefecture, 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.

眼底老化是年龄相关性黄斑变性(age-related macular degeneration, AMD)发生和进展的关键因素及病理基础，在组织病理学上主要表现为脉络膜毛细血管萎缩、布鲁赫膜(Bruch's membrane, BrM)增厚以及视网膜色素上皮(retinal pigment epithelium, RPE)异常。BrM增厚可由多种眼底老化沉积物聚集引起，在AMD的病理机制中具有重要作用。其中，基底薄层沉积物(basal laminar deposit, BLamD)代表了RPE基底膜的弥漫性增厚，通常作为一种正常眼底老化改变。而以酯化和未酯化胆固醇等中性脂质为主的RPE基底膜下沉积物，即基底线性沉积物(basal linear deposits, BLinD)和软性玻璃膜疣，均可参与破坏脉络膜与外层视网膜间物质交换稳态，造成外层视网膜缺血、缺氧及氧化应激，是AMD早期重要病理改变。硬性玻璃膜疣主要分布于周边视网膜，多见于正常老化眼底；表皮玻璃膜疣是RPE基底膜局灶性结节状增厚的结果，眼底表现与硬性玻璃膜疣相似，但其主要分布于后极部，数量更多且密度更高。近年来逐渐加深了对视网膜下玻璃膜疣样沉积物(subretinal drusenoid deposit, SDD)的认识和研究，其是位于RPE上方的沉积物，在AMD发病机制中亦具有深刻意义。文章就几种眼底老化相关沉积物(包括硬性玻璃膜及表皮玻璃膜疣)的病理特征和多模态影像学表现进行综述，旨在帮助认识和理解这些沉积物的眼底表现、病理特征和形成机制，以及在AMD发生及进展中的临床意义。

Fundus aging is a key factor and pathological basis for the development and progression of age-related macular degeneration (AMD), which is histopathologically characterized by choroidal capillary atrophy, Bruch’s membrane (BrM) thickening, and abnormalities of retinal pigment epithelium (RPE). BrM thickening can be induced by the aggregation of age-related fundus deposits and plays an essential role in the pathogenesis of AMD. Basal laminar deposits (BLamD) represent diffuse thickening of the basement membrane of RPE, usually considered to be a normal fundus aging. Basal linear deposits (BLinD) and soft drusen, mainly composed of neutral lipids such as esterified and unesterified cholesterol, can disrupt the homeostasis of material exchange between the choroid and the outer retina, resulting in ischemia, hypoxia, and oxidative stress in the outer retina, which are important pathological changes in the early AMD. Hard drusen is mainly distributed in the peripheral retina and is very common in aging fundus; Cuticular drusen are resulted from focal nodular thickening of the basement membrane of RPE, with similar appearance as hard drusen, but mainly distributed in the posterior pole and more numerous and denser. Recently, our understanding of subretinal drusenoid deposits (SDD), deposits above the RPE, has been gradually deepened and it also has profound significance in the pathogenesis of AMD. In this review, we presented the pathologic features and multimodal imaging of age-related fundus deposits (including hard drusen and cuticular drusen), aiming to help recognize and understand the manifestations, pathologic features, and formation mechanisms of these deposits, as well as their clinical significance in the development and progression of AMD.