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:探讨青光眼日间手术患者的自我管理行为现状及影响因素分析。方法:采用便利抽样法选取2021年9月—2022年5月于广州市某三级甲等眼科专科医院就诊的223例青光眼日间手术患者。采用一般资料调查表、青光眼自我管理行为量表、慢性疾病自我效能量表和青光眼知识学习问卷进行问卷调查。结果:青光眼日间手术患者的自我管理行为得分为(54.03±6.95)分,其中生活调整维度得分最低。慢性病自我效能与自我管理行为呈正相关(r=0.368, P<0.001)。疾病知识与自我管理行为无显著相关性(r=0.077, P=0.252)。多因素线性回归分析结果显示,患者的文化程度(P<0.001)和自我效能(P=0.028)是自我管理行为的影响因素,可解释自我管理行为总变异的12.4%。结论:青光眼日间手术患者具有良好的自我管理行为,较低的自我效能和文化程度是自我管理行为的危险因素,因此应优先提高患者的自我效能,并提供个性化教育。
Objective: To determine self-management and its association with self-efficacy and knowledge among glaucoma patients undergoing day surgery. Methods: A total of 223 glaucoma patients were recruited from September 2021 to May 2022and they were investigated with the Glaucoma Self Management Questionnaire (GSMQ), The Self- Efficacy in Chronic Disease Scale (SECD-6), and the glaucoma knowledge questionnaire. Results: Of the 223 study participants, the study population had a total GSMQ score of 54.03±6.95 with the lowest score found in the life adjustment dimension. The total SECD-6 score was showing a significantly positive correlation with the total GSMQ score(r =0.368, P <0.001). The total score of disease knowledge was without significant correlation with the total GSMQ score (r =0.077, P =0.252). Multivariate linear regression analysis showed that self-efficacy (P <0.001) and education level was independently associated with self-management(P =0.028). Conclusions: Glaucoma patients undergoing daytime surgery demonstrated good overall self-management, yet further improvement was required in terms of life adjustment. Low self-efficacy and educational level were identified as risk factors for self-management. Therefore, self-management programs should prioritize enhancing patients' self-efficacy and delivering individualized education.
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.
息肉状脉络膜血管病变(polypoidal choroidal vasculopathy,PCV)是亚洲人群中常见的致盲性眼病,发生大出血并发症后严重危害视力且预后差。PCV大出血包括视网膜下出血(subretinal hemorrhage,SRH)和玻璃体积血(vitreous hemorrhage,VH)。SRH的危险因素包括较长病程、簇型PCV、息肉状病灶不消退、合并视网膜色素上皮脱离;其治疗方式包括抗血管内皮生长因子药物、光动力疗法、激光、玻璃体腔注气、眼内注射组织纤溶酶原激活剂、玻璃体切割术或联合治疗等方式,其中,黄斑中心凹是否受累和出血时间是影响治疗方式选择的主要因素。发病年龄较大、白细胞计数较高、天门氨酸转移酶和丙氨酸转氨酶的比值较高、活化部分凝血活酶时间较长、曾行光动力疗法、有玻璃体腔注药治疗史、SRH面积大、出现视网膜色素上皮脱离的PCV患者发生VH的风险高。浓厚的VH通常需行玻璃体切割术,其手术时机和手术方式的选择是临床关注的焦点。鉴于目前PCV大出血的危险因素尚不完全明确、治疗方面也尚未形成共识,需要开展相关临床研究,提供更多依据。
Polypoidal choroidal vasculopathy (PCV) is a common blinding disease in Asian populations. Massive hemorrhage complications secondary to PCV include subretinal hemorrhage (SRH) and vitreous hemorrhage (VH). The risk factors for SRH include a long duration, clustered PCV, non-regression of polyp lesions and presented with retinal pigment epithelial detachment. The treatments for SRH include anti-vascular endothelial growth factor drugs, photodynamic therapy, laser, vitreous pneumatic displacement, intravenously injected tissue plasminogen activator, vitrectomy and combination therapy. Whether macular fovea is involved and the time since bleeding onset are the main factors afecting the choice of treatment for SRH. Older age of onset, higher white blood cell count, higher aspartate amino transferase and alanine amino transferase ratio, longer activated partial thromboplastin time retinal pigment epithelium detachment, photodynamic therapy history, intravitreal injection history larger SRH area and presented with retinal pigment epithelial detachment were associated with higher risk of VH. PCV patients with massive VH should be treated with vitrectomy, while the timing and technique of operation should be paid atention to. At present, the risk factors of PCV massive bleeding are not completely clear, and its treatment methods are diverse, which requires a large number of studies to prove its effectiveness and establish expert diagnosis and treatment consensus.
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.
糖尿病性黄斑水肿(diabetic macular edema, DME)是糖尿病最常见和最严重的并发症之一,也是中青年劳动人群常见的致盲原因。DME病理生理机制复杂,是多种因素相互作用的结果,控制这些危险因素是降低发病率的关键。DME是全身病相关性眼病,其发生与发展受众多危险因素的影响,但此前文献对其总结不足,本文从全身因素及眼部因素两个方面就DME的危险因素进行综述。全身危险因素主要包括血糖控制欠佳、糖尿病病程长、高血压、血脂代谢紊乱、肥胖、肾功能异常、妊娠状态、降糖药物使用、贫血、阻塞性睡眠呼吸暂停低通气综合征、遗传因素、吸烟、饮酒、高血钙、低血镁等;而其眼部危险因素主要包括白内障、青光眼及玻璃体切割术、全视网膜激光光凝术、合并视网膜静脉阻塞和相关细胞因子等。深入认识和理解这些危险因素,有助于更好地预防和早期治疗DME,同时为治疗糖尿病视网膜病变过程中控制DME进展提供指引和参考。但是,其中一部分因素还存在一定争议,更多的DME危险因素仍有待进一步探索,期望在不久的将来,更多基础和前瞻性临床研究为DME危险因素及治疗提供高质量的证据。
Diabetic macular edema (DME) is one of the most common and severe complications of diabetes, and it is a leading cause of blindness in the working-age population. The pathophysiology of DME is complex, resulting from the interplay of various factors. Controlling these risk factors is crucial in reducing the incidence of DME. As a systemic diseaserelated ocular condition, the onset and progression of DME are influenced by numerous risk factors. However, previous literature has provided insufficient summaries of these factors. This review aims to summarize the risk factors for DME from both systemic and ocular perspectives. The systemic risk factors primarily include poor glycemic control, prolonged duration of diabetes, hypertension, dyslipidemia, obesity, renal dysfunction, pregnancy, the use of hypoglycemic medications, anemia, obstructive sleep apnea-hypopnea syndrome, genetic factors, smoking, alcohol consumption, hypercalcemia, and hypomagnesemia. On the other hand, ocular risk factors include cataracts, glaucoma and vitrectomy, panretinal photocoagulation, coexisting retinal vein occlusion, and related cytokines. A deeper understanding of these risk factors will aid in the better prevention and early treatment of DME, while also providing guidance and reference for controlling the progression of DME during the treatment of diabetic retinopathy. However, some of these factors remain controversial, and additional DME risk factors still need to be explored. It is hoped that, in the near future, morefoundational and prospective clinical studies will provide high-quality evidence on DME risk factors and treatments.
目的:探讨白内障人群角膜屈光力(corneal refractive power,CRP)的分布特点及与眼生物学参数的相关因素分析。方法:回顾性横断面研究福州眼科医院2019年3月至2022年7月就诊的40岁以上白内障人群共23035眼,使用OA-2000测量其眼轴(axial length,AL)、CRP、前房深度(anterior chamber depth,ACD)、晶状体厚度(lens thickness,LT)、角膜水平直径即白到白(white-to-white,WTW)、中央角膜厚度(central corneal thickness,CCT)。绘制各眼生物学参数及年龄Spearman相关性热力图,绘制CRP与AL、CRP与WTW散点拟合图。将CRP与上述参数及年龄进行Spearman相关性分析,分段数据的线性关系使用Pearson分析及线性回归分析。结果:白内障人群CRP为(44.36±1.52)D,在总体数据中CRP与AL为非线性相关;但在分段数据中存在线性相关:当AL≤25.06 mm,CRP与AL负线性相关(R2 =0.397,P<0.001);当AL>25.06 mm,CRP与AL正线性相关(R2 =0.045,P<0.001);无论AL长短,CRP与WTW、CCT均呈负相关。在总体数据中,CRP与WTW也存在非线性关系;但在分段数据中存在线性相关:当10.52 mm≤WTW≤12.46 mm,CRP与WTW负线性相关(R2 =0.149,P<0.001),并与AL、ACD、CCT呈负相关。结论:CRP与AL、WTW呈非线性相关,使用CRP优化计算人工晶状体(intraocular lens,IOL)屈光力时需适当考虑AL、WTW与CRP的相关性。
Objective: To investigate the distribution characteristics of corneal refractive power (CRP), and analyze the correlation between corneal refractive power and ocular biometric parameters in cataract patients. Methods: A retrospective cross-sectional study was conducted on 2,3035 eyes of cataract patients over 40 years old, who visited Fuzhou Eye Hospital during the period between March 2019 and July 2022. The subjects' examination results of axial length (AL), corneal refractive power (CRP), anterior chamber depth (ACD), lens thickness (LT), horizontal corneal diameter (WTW), central corneal thickness (CCT) were measured by OA-2000. Spearman correlation thermograms of bilological parameters and age for each eyes were worked out. The plot scatter fitting plots of CRP and AL, CRP and WTW were made. Spearman correlation analysis was made among CRP, above-mentioned parameters and age. Linear relationships of the segmented data were analyzed with Pearson and linear regression analysis. Results: In the cataract patients, CRP was (44.36 ± 1.52) D. There was a non-linear correlation between CRP and AL in the total data. However, there was a linear relationship in the segmented data. When AL ≤ 25.06 mm, CRP was negatively linearly correlated with AL (R2 =0.397, P<0.001). When AL>25.06 mm, CRP was weakly positively correlated with AL (R2 =0.045, P<0.001). Regardless of the length of AL, CRP was negatively correlated with WTW and CCT. There was also a nonlinear relationship between CRP and WTW in the total data. But there was a linear correlation in the segmented data.When 10.52 mm ≤ WTW ≤ 12.46 mm, the negative linear correlation was found between CRP and WTW (R2 =0.149, P<0.001), while there was negative correlation among CRP, AL, ACD, and CCT. Conclusion: There is a non-linear correlation among CRP, AL and WTW. To optimize the calculation of intraocular lens (IOL) refractive power with CRP, it is necessary to consider the correlation between AL, WTW, and CRP.
玻璃体切割术是目前临床上常见的眼科手术之一,其应用广泛,且具有良好的治疗效果,但术后仍会出现各种并发症,眼压升高便是其中常见的一种。玻璃体切割术后眼压升高的病因复杂多样,术前原发病的不同、术中处理方式的差异以及术后并发症均可引起眼压升高,根据不同的病因可以选用更合适的治疗方法。早期的眼压升高较易控制,主要采用药物及激光治疗,晚期眼压升高导致继发性青光眼则相对复杂,以手术治疗为主。该文主要对玻璃体切割术后高眼压的原因分析及治疗进展进行综述。
Pars plana vitrectomy is one of the common ophthalmic surgeries in clinic practice currently, which is widely used with good therapeutic effect. However, various complications may still occur after operation. Elevated intraocular pressure is one of common complications. The causes of postoperative ocular hypertension are complex and diverse. Elevated intraocular pressure could be caused by different preoperative primary diseases, intraoperative management methods,and postoperative complication. More appropriate treatment methods can be selected based on different causes. Early elevated intraocular pressure iseasier to control and is mainly treated with medicine and laser. Late elevated intraocular pressure leads to secondary glaucoma, which is relatively complex and mainly treated with surgery. This review mainly states causes and treatment progress of high intraocular pressure after vitrectomy.
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.
儿童白内障是全球范围内可治疗儿童盲症的主要原因之一。对于这些患儿而言,手术是恢复或保护视力的主要方法。然而,手术后的并发症,特别是青光眼相关不良事件(glaucoma-related adverse events, GRAEs),常常成为导致儿童二次致盲的主要原因,这引起了眼科医疗领域的广泛关注。文章综述了儿童Ⅱ期人工晶状体植入术后GRAEs的影响因素,包括手术设计、眼部解剖特征、其他眼部发育异常和全身疾病等。手术设计中是否植入人工晶状体(intraocular lens,IOL)以及植入的时机和位置都对GRAEs的发生有显著影响。此外,眼部解剖特征如角膜直径、眼轴长度、前房深度、中央角膜厚度和术前晶状体厚度等,也是影响GRAEs发生的重要因素。同时,其他眼部发育异常和全身疾病,如先天性无虹膜、先天性风疹综合征等,也会增加儿童白内障术后青光眼的发生率。文章还总结了预测GRAEs的方法,并推荐使用Cox回归模型建立预测模型。这种模型可以有效地预测儿童Ⅱ期IOL植入术后在特定时间段内发展为GRAEs的概率,从而为早期识别GRAEs高危儿童提供了重要的借鉴。通过对GRAEs影响因素的深入分析和预测模型的建立,文章旨在帮助眼科医生更好地理解GRAEs的发生机制,并在手术前对患儿进行风险评估,从而选择最佳的手术方案和预防措施。这对于改善患儿的术后恢复、减少并发症、保护视功能具有重要的临床意义。
Pediatric cataract is one of the leading causes of treatable childhood blindness worldwide. For these children, surgery is the primary method to restore or preserve vision. However, postoperative complications, particularly glaucoma-related adverse events (GRAEs), often become the main reason for secondary blindness in children, attracting widespread concern in the field of ophthalmology. This study reviews the impact factors of glaucoma-related adverse events after secondary intraocular lens (IOL) implantation in children, including surgical design, ocular anatomical characteristics, other ocular developmental abnormalities, and systemic diseases. Whether to implant an IOL in the surgical design and the timing and positioning of the implantation have a significant impact on the occurrence of GRAEs. In addition, ocular anatomical characteristics, such as corneal diameter, axial length, anterior chamber depth, central corneal thickness, and preoperative lens thickness, are also important factors affecting the occurrence of GRAEs. At the same time, other ocular developmental abnormalities and systemic diseases, such as congenital aniridia and congenital rubella syndrome, also increase the incidence of glaucoma after pediatric cataract surgery. The article also summarizes methods for predicting GRAEs and recommends using the Cox regression model to establish a predictive model. This model can effectively predict the probability of children developing GRAEs after secondary IOL implantation within a specific time period, providing an important reference for the early identification of high-risk children for GRAEs. Through in-depth analysis of the impact factors of GRAEs and the establishment of predictive models, the article aims to help ophthalmologists better understand the mechanisms of GRAEs and assess the risks of children before surgery, thereby selecting the best surgical plan and preventive measures. This is of great clinical significance for improving postoperative recovery in children, reducing complications, and protecting visual function.