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:分析单中心神经眼科疾病谱及流行病学特点,为指导神经眼科疾病诊断和治疗提供基础。方法:纳入2010年1月1日—2021年12月31日中国人民解放军总医院神经眼科病区收治的神经眼科疾病患者,从电子病例系统检索和记录所有纳入病例的年龄、性别、地区分布及病种亚型分析。结果:共计7245例神经眼科患者纳入统计,其中男性3331例(46.0%)、女性3914例(54.0%),男女比例1∶1.2;年龄(38.2±17.5)岁。83.25%(6031/7245)为传入神经系统疾病,9.92%(719/7245)为传出神经系统疾病和眼眶疾病,6.83%(495/7245)未归类。病种分析显示,占比最高的是脱髓鞘性视神经炎(demyelinating optic neuritis,DON),为40.17%(2910/7245);占比第二的是非动脉炎性前部缺血性视神经病变(nonarteritic anterior ischemic optic neuropathy,NAION),为11.37%(824/7245);占比第三的是外伤性视神经病变5.15%(373/7245),其中7.85%(569/7245)表现为不明原因视神经萎缩。从年龄分布来看,DON和外伤性视神经病变患者中18~40岁者占比最高(分别为48.63%和44.24%),NAION患者中41~60岁者占比最高(66.14%),小于18岁的未成年患者在遗传性视神经病变中占比最高,比例为48.58%。在2226例DON患者中,视神经脊髓炎(neuromyelitis optica,NMO)/视神经脊髓炎谱系疾病(neuromyelitis optica spectrum disorder,NMOSD)比例最高,为60.02%;髓鞘少突胶质细胞糖蛋白抗体(myelinoligodendrocyte glycoprotein antibody,MOG-IgG)阳性视神经炎比例为11.68%;多发性硬化(multiple sclerosis,MS)和MS相关性视神经炎和慢性复发性炎性视神经病变(chronic recurrent inflammatory optic neuropathy,CRION)占比较低,分别是1.8%和2.25%。DON整体患者中,男女比例为1∶3.08;在NMO/NMOSD患者中男女比例为1∶8;MOG阳性视神经炎患者中,男女比例为4∶5;在非典型视神经炎患者中,男性比例高于女性,为1.28∶1;DON患者中,81.79%患者为中青年,MOG阳性视神经炎未成年患者可达41.15%。结论:DON和NAION是神经眼科传入系统疾病最常见两大病种。
Objective: To analyze the spectrum and epidemiological characteristics of neuro-ophthalmic diseases from single center, and to provide basis for guiding the diagnosis and treatment of neuro-ophthalmic diseases. Methods: Patients with neuro-ophthalmic diseases admitted to the neuro-ophthalmology ward of Chinese PLA General Hospital from January 1, 2010 to December 31, 2021 were enrolled. The age, gender, regional distribution and disease subtypes of all included patients were retrieved and recorded from the electronic case system. Results: A total of 7245 patients with neuro-ophthalmic diseases were enrolled, including 3331 males(46.0%)and 3914 females(54.0%), with a male to female ratio of 1:1.2. The average age was 38.2±17.5 years. 83.25%(6031/7245)were afferent nervous system diseases, 9.92% (719/7245)were efferent nervous system diseases and orbital diseases, and 6.83%(495/7245)were not classified. The ratio of demyelinating optic neuritis(DON)was the highest(40.17%,2910/7245), followed by nonarteritic anterior ischemic optic neuropathy(NAION)(11.37%,824/7245)and traumatic optic neuropathy(TON) (5.15%,373/7245). The ratio of optic nerve atrophy with unknown causes was 7.85%(569/7245). Characteristics of age distribution, the DON and TON were more common in 18-40 age group(the proportion were 48.63% and 44.24%,respectively), the NAION was common in 41-60 age group(66.14%), and the hereditary optic neuropathy was common in younger 18 age group (48.58%). In 2226 DON patients, the proportion of neuromyelitis optica(NMO)/neuromyelitis optica spectrum disorder(NMOSD)-optic neuritis(ON)was the highest(60.02%)and myelinoligodendrocyte glycoprotein antibody(MOG-IgG)ON was 11.68%, while multiple sclerosis(MS)-ON and chronic recurrent inflammatory optic neuropathy(CRION)were relatively low(1.8% and 2.25%,respectively). In DON patients, the male to female ratio was 1:3.08. In NMO/NMOSD-ON patients, the ratio of male to female was 1:8, and that of MOG-ON was 4:5. In atypical ON, the ratio of male to female was higher than that of female(1.28:1). In DON patients, 81.79% of patients were young and middle-aged, and the proportion of children with MOG-ON(less than 18 years old)was 41.15%.Conclusions: DON and NAION are the two most common diseases of neuro-ophthalmic afferent system.