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.
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: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.
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: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, Kashgar region, 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, 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.
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.
蠕形螨是人类皮肤上最常见的寄生虫,在眼部主要寄居于毛囊、睑板腺及皮脂腺,可引起眼干、眼痒、异物感明显等眼部症状。目前已证实有2种寄生于人类的蠕形螨:毛囊蠕形螨和皮脂蠕形螨,二者均可诱发各类眼表疾病,如睑缘炎、睑板腺疾病、角膜病、翼状胬肉以及眼红斑痤疮等,但是由于疾病症状相似、检查遗漏以及认知不到位等主客观因素,该病易被误诊、漏诊。蠕形螨具有高度的年龄依赖性,并且可以在无症状的成年人中发现,因此蠕形螨的致病性一直存在争议,现有研究表明,蠕形螨可以通过直接损伤、诱发超敏反应和作为载体携带细菌等方式致病。蠕形螨的感染可以通过有效的手段进行检测,确诊后可通过热敷、眼睑清洁、局部或全身使用除螨药物进行治疗。了解蠕形螨在眼部疾病中的重要性对于准确诊断和适当的管理策略至关重要,近年来对于蠕形螨的研究越来越多,有必要对蠕形螨感染相关眼表疾病的诊断及治疗技术进行更新,因此本文综述了蠕形螨的病原学、流行病学、致病机制、检出方法,探讨了蠕形螨感染与各类眼表疾病之间的联系以及治疗方法,以期为蠕形螨感染相关眼表疾病的研究提供参考。
Demodex mites are the most common parasites found on human skin. They primarily reside in hair follicles, meibomian glands, and sebaceous glands of the eyes, and can trigger eye-related symptoms such as dry eyes, itchy eyes, and a pronounced foreign-body sensation. At present, it has been established that two types of Demodex mites parasitic in humans: Demodex follicle mite and Demodex sebum mite. Both types can induce various ocular surface diseases, including blepharitis, meibomian gland dysfunction, corneal disease, pterygium and ocular rosacea. However, due to subjective and objective factors, such as similar disease symptoms, omission of examination and a lack of awareness, these diseases are easy to misdiagnosis and underdiagnosis. Demodex mites exhibit a highly degree of age-dependence and can be detectd in asymptomatic adults. Consequently, the pathogenicity of Demodex mites has been a subject of debate. Existing studies have shown that Demodex mites can cause diseases through direct injury, by inducing hypersensitivity reactions, and by acting as carriers for bacteria. Effective means are available for detecting Demodex mite infections. Treatement options include warm compresses, eyelid cleaning, and the use of topical or systemic anti-mite drugs. Understanding the significance of Demodex mites in ocular diseases is crucial for accurate diagnosis and the formulation of appropriate management strategies. In recent years, there has been a growing body of research on Demodex mite. It is necessary to update the diagnositic and therapeutic techniques for ocular surface diseases associated with Demodex mite infection. Therefore, this paper reviews the etiology, epidemiology, pathogenic mechanism, and detection methods of Demodex mite. It also discusses the relationship between Demodex mite infection and various ocular surface diseases, as well as the corresponding treatment methods, with the aim of providing a reference for the research on ocular surface diseases related to Demodex mite infections.
散光是儿童视力发育的重要威胁之一,很多情况下其发生与眼表疾病的进展密切相关。非先天性眼表疾病如睑缘炎相关性角结膜病变、春季角结膜炎、干眼、感染性角膜炎和眼外伤等可通过慢性炎症介导的眼表微环境失衡、角膜瘢痕产生、泪膜稳定性破坏及角膜生物力学结构异常重塑等途径,导致角膜表面不规则性的产生和角膜曲率的改变。先天性眼表疾病如圆锥角膜、睑内翻和眼表肿瘤等则可通过遗传或发育异常改变眼睑结构、改变角膜曲率的对称性和机械压迫角膜产生散光,例如遗传疾病圆锥角膜的进行性角膜变薄与发生春季角结膜炎时眼表微环境的炎症性改变可协同作用加剧散光进展。针对不同病因,局部糖皮质激素滴眼液、免疫抑制剂环孢素滴眼液等药物使用和手术治疗均可改善患儿本身的病情和散光情况,只是不同疾病的治疗和散光矫正方案不尽相同。现有研究虽指出了部分儿童眼表疾病与散光的关联,但对于儿童的特异性机制部分如发育过程中免疫系统的变化、角膜可塑性差异及各种因素交互作用效应尚未完全解析。
Astigmatism is a significant threat to children's visual development and is often closely linked to the progression of ocular surface diseases. Non-congenital conditions, such as blepharitis-associated keratoconjunctivitis, vernal keratoconjunctivitis, dry eye, infectious keratitis, and ocular trauma, can induce irregularities on the corneal surface and changes in corneal curvature. This occurs through mechanisms like the ocular surface microenvironment imbalance mediated by chronic inflammation, corneal scarring, tear film instability, and abnormal corneal biomechanical remodeling. Congenital disorders, including keratoconus, entropion, and ocular surface tumors, can also lead to astigmatism. These conditions do so by causing genetic or developmental abnormalities that alter the eyelid structure, disrupt corneal symmetry, or exert mechanical pressure. Notably, there can be synergistic effects between progressive corneal thinning seen in hereditary keratoconus and the inflammatory microenvironment changes associated with vernal keratoconjunctivitis. Therapeutic interventions, such as topical corticosteroids, cyclosporine eye drops, and surgical procedures, can improve both the primary conditions and the astigmatism. However, treatment strategies vary depending on the different etiologies. Current research has established associations between pediatric ocular surface diseases and astigmatism. Nevertheless, the specific developmental mechanisms, including the maturation of the immune system, differences in corneal plasticity, and the interactive effects of multiple factors, remain incompletely understood.
近视已成为全球性流行病,预计到2050年全球将有近半数人群发生近视,已成为全球性重大功能卫生问题。近视不仅影响视力,还增加黄斑病变、青光眼等致盲性疾病的风险。近视的发病机制尚未完全明确,但与环境、遗传因素及昼夜节律紊乱密切相关。昼夜节律通过调节光照、多巴胺代谢和视网膜信号传导等机制影响近视的发生和发展。光照是调节昼夜节律的关键,户外活动时的高光照强度能有效刺激多巴胺分泌,抑制眼轴增长,减少近视发生,而异常光照模式(如夜间光暴露)则会干扰此过程。其次,睡眠不足与儿童近视患病率呈负相关,眼部关键参数(如眼轴长度、玻璃体腔深度等)均呈现显著的昼夜节律性波动。多巴胺作为视网膜中的重要神经递质,受生物钟基因调控,具有抑制眼轴生长的作用。视网膜中的生物钟基因和光敏色素也参与调节眼球生长,自主神经系统则通过调节脉络膜厚度与血流灌注参与眼球生长调控。动物实验和临床研究表明,昼夜节律紊乱会导致眼轴增长和近视进展。未来研究应进一步探讨昼夜节律与近视的因果关系、多巴胺代谢的调控机制以及生物钟基因的功能,以制定有效的近视防控策略。
Myopia has become a global epidemic,with projections indicating that nearly half of the world’s population will be affected by myopia by 2050, positioning it has a significant global functional health concern.Beyond merely impairing vision, myopia also heightens the risk of blinding diseases such as macular degeneration and glaucoma. Although the pathogenesis of myopia is not yet fully elucidated, it is stongly associated with environmental factors, genetic predispositions, and circadian rhythm disruptions. The circadian rhythm plays a pivotal role in the onset and progression of myopia by goerning mechanism such as light exposure, dopamine metabolism, and retinal signaling. Light serves as a crucial regulator of the circadian rhythm. Specifically, high light intensity during outdoor activities can effectively stimulate dopamine secretion, thereby inhibiting axial elongaation and reducing the incidence of myopia. Conversely, abnormal light patterns, such as exposure to light at night, can disrupt this regulatory process. Moreover, insufficient sleep has been found to be negatively correlated with the incidence of myopia in children. Additionally, key ocular parameters, including axial length and vitreous cavity depth, exhibit pronounced diurnal rhythmic fluctuations. Dopamine, an important neurotransmitter in the retina, is regulated by circadian clock genes and functions to inhibit axial elongation. Both the circadian clock genes and photosensitive pigments within the retina are involved in regulating eye growth. Meanwhile, the autonomic nervous system contributes to this regulation by modulating choroidal thickness and blood flow perfusion. Animal experiments and clinical studies have consistently demonstrated that disrupted circadian rhythms can lead to axial elongation and the progression of myopia. Future research should delve deeper into the causal relationship between circadian rhythm and myopia, the regulatory mechanisms underlying dopamine metabolism, and the functions of circadian clock genes. Such investigation will pave the way for the development of effective strategies for myopia prevention and control.
角膜基质透镜是带有一定屈光度的角膜组织,为利用激光或板层刀等在角膜基质层内雕刻出一个精确对焦点的光学透镜。随着角膜屈光手术的不断发展,术中产生了大量的角膜基质透镜, 越来越多的学者也将目光聚焦于此。我国角膜供体来源匮乏与手术量需求严重不匹配, 眼库严重缺乏供体角膜,而对角膜组织的需求却越来越大。角膜穿孔作为角膜疾病的终末阶段,严重威胁患者的视力,甚至要面临摘除眼球的风险, 是对患者身体与心理的双重打击。绝大多数的角膜穿孔需要紧急手术处理, 对于一些常规治疗无效或角膜病变更严重的,角膜移植术可能是唯一有效的手段。对原本废弃的透镜重新利用, 将其用于治疗角膜溃疡、修补角膜穿孔以及辅助治疗各类角膜疾病的危重阶段, 均观察到其取得了良好的效果, 这在一定程度上缓解了临床上角膜供体缺乏的现状。本文报道了2例由角膜白斑引起的角膜穿孔患者使用异体角膜基质透镜移植治疗的病例, 术后2名患者病情均得到稳定。同时探讨了角膜基质透镜移植的局限性, 本文并未观察到角膜透镜移植对于感染性、免疫性等其他原因造成的角膜穿孔的疗效, 因此在行角膜移植之前,要正确认识及处理原发病,尽量避免一些并发症和排斥反应的发生。
Corneal stromal lenses are corneal tissues with specific refractive power, created by precisely sculpting an optical lens within the corneal stromal layer using lasers or microkeratomes. With the ongoing development of corneal refractive surgery, a large amount of corneal stromal lenses are generated during procedures, drawing increasing attention from researchers. In China, there exists a severe mismatch between the scarcity of corneal donors and the high demand for surgical procedures. This has led to a critical shortage of donor corneas in eye banks, while the need for corneal tissue keeps rising. Corneal perforation, which is the end-stage of various corneal diseases, poses a significant threat to patients' vision and may even result in enucleation, causing considerable physical and psychological distress. Most cases of corneal perforation require urgent surgical intervention. For patients with severe conditions or those for whom conventional treatments are ineffective, corneal transplantation may be the only viable option. Reusing stromal lenses that were previously discarded to treat corneal ulcers, repair corneal perforations, and assist in managing critical stages of various corneal diseases has shown promising results. This, to some extent, helps alleviate the clinical shortage of donor corneas. This article presents two cases of corneal perforation caused by corneal leukoma, both of which were successfully treated with allogeneic corneal stromal lens transplantation. Both patients achieved stable conditions after the operation. Additionally, this paper discusses the limitations of corneal stromal lens transplantation. The efficacy of corneal lens transplantation for perforations caused by infectious or immunological etiologies was not observed in this study. Therefore, it is essential to accurately diagnose and manage the underlying disease before transplantation and to minimize the occurrence of complications and rejection reactions.