综述

数字智能技术在斜视诊疗中的应用

The application of digital intelligent technologies in the diagnosis and treatment of strabismus

:839-847
 
斜视作为眼科的常见疾病之一,多发生于儿童群体。传统的诊疗手段高度依赖医生的个人经验,效率欠佳,患者依从性差,极易延误病情,严重影响患儿视功能及身心发育。近年来,人工智能(artificial intelligence, AI)与虚拟现实(virtual reality, VR)技术作为数字智能技术中的前沿科技手段,已广泛应用于眼科疾病的筛查、诊断和治疗环节,并正推动斜视诊疗体系向智能化转型。AI技术凭借强大的图像识别与分析能力可自动检测斜视类型和角度,更全面地评估病情。同时,通过分析大量数据预测手术参数,辅助制定个性化的手术方案,并且评估手术效果,大幅提升了斜视诊疗的精准度和效率;而VR技术则通过眼动追踪和动态场景模拟,实现更全面的眼位测量和动态分析。在手术中为医生提供清晰全面的眼部视图,借助模拟试验提升操作精准度,降低手术风险。借助沉浸式的视觉训练有效优化了斜视的康复效果。本文系统地回顾了数字智能技术在斜视诊疗方面的创新应用实例,深入探讨了AI和VR在斜视诊疗中独特的技术优势以及显著的临床价值。AI与VR技术的协同创新,为斜视诊疗模式带来了智能化的变革,在未来,有望为眼科医疗领域的发展注入新的动力,推动整个行业迈向新的高度。
Strabismusis a prevalent ophthalmic disorder predominantly affects children. For a long time, its diagnosis and treatment have heavily relied on traditional methods, which are highly dependent on clinical expertise. This reliance often leads to inefficiency, poor patient compliance, and delayed treatment. These issues can severely impair visual function and hinder psychosocial development. Recently, there have been significant advancements in artificial intelligence (AI) and virtual reality (VR), both of which are cutting-edge digital technologies. These innovations have brought about a revolution in the screening, diagnosis, and treatment of ophthalmic diseases, driving the intelligent transformation of strabismus management. AI demonstrates remarkable capabilities in the automated detection of strabismus types and deviation angles. It achieves this through robust image recognition and analysis techniques, enabling a comprehensive evaluation of the disease. By analyzing vast amounts of data, AI can predict surgical parameters, assists in personalized surgical planning, and objectively assesses postoperative outcomes. This significantly enhances diagnostic accuracy and therapeutic efficiency. At the same time, VR technology enables holistic ocular alignment measurements and dynamic analysis via eye-tracking and simulated dynamic environments. During surgical procedures, VR offers surgeons an enhanced visualization of ocular structures and improves operational accuracy through simulated trials. As a result, it helps reduce surgical risks. After surgery, immersive VR-based visual training programs can optimize rehabilitation outcomes. This review systematically examines innovative applications of AI and VR in strabismus care, highlighting their unique technical advantages and clinical value. The synergistic integration of AI and VR has catalyzed an intelligent paradigm shift in strabismus management. This shift promises to inject new momentum into ophthalmic medicine and propel the field towards unprecedented advancements.
论著

新疆各地州学龄儿童青少年屈光参差患病率及其影响因素

Prevalence of anisometropia and its influencing factors among school-aged children and adolescents in various prefectures of Xinjiang

:787-796
 
目的:评估分析新疆地区14个地州6~18岁学龄儿童青少年屈光参差的患病率、空间分布特征和影响因素,为制定区域性眼健康干预策略提供科学依据。方法:采用横断面研究设计,纳入新疆地区14个地州的小学、初中及高中学生共64 277名,收集其人口学特征、屈光状态及地域分布数据。通过等效球镜度(spherical equivalent,SE)评估屈光状态,近视为SE ≤ -0.50 D,屈光参差为眼间SE差异≥1.0 D,采用Moran's I分析屈光参差患病率的空间分布,采用单因素及多因素回归分析探讨屈光参差的危险因素。结果:屈光参差的总体患病率为17.9%(95% CI:17.6%~18.2%),女性屈光参差患病率(18.8%)高于男性(16.9%),汉族(23.9%)高于维吾尔族(11.7%)和其他民族(18.4%)(P<0.001)。屈光参差患病率呈空间聚集分布(Moran's I = 0.450,P = 0.043,Z = 2.026),并且存在地域差异,昌吉最高(24.1%),克孜勒苏柯尔克孜自治州最低(7.9%),城市(19.0%)高于农村(15.6%),北疆(19.9%)高于南疆(13.5%)(P<0.001)。屈光参差的患病率与年龄呈正相关,6岁为9.8%,18岁达22.4%。多因素回归分析显示,女性、北疆地区、近视和较高年龄是屈光参差的独立危险因素(P<0.05)。结论:新疆地区学龄儿童青少年屈光参差患病率较高,在空间上呈聚集分布,且存在显著的人口学及地域差异,女性、北疆地区、近视和较高年龄是屈光参差的独立危险因素,建议加强对高危人群的视力筛查及早期干预。  
Objective: To evaluate and analyze the prevalence, spatial distribution characteristics, and influencing factors of anisometropia among school-aged children and adolescents aged 6-18 across 14 prefectures in Xinjiang, thereby providing a scientific foundation for formulation of regional eye health intervention strategies. Methods: A cross-sectional study design was employed, including 64,277 students from primary, middle, and high schools in 14 prefectures of Xinjiang. Data on demographic characteristics, refractive status, and geographical distribution were collected. Refractive status was assessed using spherical equivalent (SE). Myopia was defined as SE ≤ -0.50 D, and anisometropia was defined as an interocular SE difference ≥ 1.0 D. Moran's I analysis was used to evaluate the spatial distribution of anisometropia prevalence. Additionally, univariate and multivariate regression analyses were conducted to identify risk factors for anisometropia. Results: The overall prevalence of anisometropia was 17.9% (95% CI: 17.6%-18.2%). The prevalence was higher among females (18.8%) compared to males (16.9%), and higher among Han Chinese (23.9%) than among Uyghurs (11.7%) and other ethnic groups (18.4%) (P<0.001). The prevalence of anisometropia showed a spatially clustered distribution (Moran's I = 0.450, P= 0.043, Z-score = 2.026) , with notable regional variations. Changji had the highest prevalence (24.1%), while Kizilsu Kirghiz Autonomous Prefecture had the lowest (7.9%). Urban areas (19.0%) had a higher prevalence than rural areas (15.6%), and northern Xinjiang (19.9%) had a higher prevalence than southern Xinjiang (13.5%) (P<0.001). The prevalence of anisometropia was positively correlated with age, increasing from 9.8% at age 6 to 22.4% at age 18. Multivariate regression analysis showed that female gender, residing in northern Xinjiang, myopia, and older age were independent risk factors for anisometropia. Conclusions: The prevalence of anisometropia among school-aged children and adolescents in Xinjiang is relatively high, showing a spatially clustered distribution with significant demographic and regional disparities. Female gender, residing in northern Xinjiang, myopia, and older age are independent risk factors for anisometropia. It is recommended to enhance vision screening and implement early intervention for high-risk populations.
论著

新疆眼科资源配置现状调查研究

An investigation and research into the current status of ophthalmology resource allocation in Xinjiang

:769-776
 
目的:分析新疆眼科资源配置现状,为优化地区资源配置提供依据。方法:采用问卷调查收集新疆眼科医疗机构数、床位数、医师数及护士数资料,运用洛伦兹曲线和基尼系数评估其在人口和地域面积的配置公平性。结果:2024年新疆每10万人口有眼科医疗机构0.68个、眼科床位13.90张、眼科医师7.68人、眼科护士5.88人。按人口配置:眼科医疗机构数、眼科床位数、眼科医师数、眼科护士数的基尼系数分别为0.22、0.23、0.26、0.29(相对公平);按地域面积配置:眼科医疗机构数、眼科床位数、眼科医师数、眼科护士数的基尼系数分别为0.40、0.60、0.59、0.60(高度不公平)。结论:新疆眼科资源总量显著提升,但地域配置公平性极差(基尼系数普遍大于0.4),护士配置明显不足。亟须优化资源配置策略,重点提升地域(尤其是偏远广阔地区)可及性并加强护士队伍建设。
Objective: To analyze the equity of ophthalmic resource allocation in Xinjiang and provide evidence for optimizing distribution. Methods: Data on the number of ophthalmic medical institutions,beds, physicians, and nurses in Xinjiang were collected through questionnaires. The Lorenz curve and Gini coefficient were used to evaluate allocation equity in terms of population and geographic area. Results: In 2024,Xinjiang had 0.68 ophthalmic medical institutions,13.90 ophthalmic beds, 7.68 ophthalmic physicians,and 5.88 ophthalmic nurses per 100,000 population. Population-based allocation showed Gini coefficients of 0.22, 0.23, 0.26,and 0.29 for ophthalmic institutions,beds, physicians,and nurses respectively (relatively equitable). Geographic area-based allocation yielded Gini coefficients of 0.40, 0.60, 0.59, and 0.60 for the same categories (highly inequitable). Conclusions: While the total ophthalmic resources in Xinjiang have significantly increased, geographic allocation remains extremely inequitable (Gini coefficients generally >0.4), with particularly insufficient nurse staffing. Urgent optimization of resource allocation strategies is needed, focusing on improving accessibility in remote areas and strengthening the nursing workforce.
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
    浏览