玻璃体腔注药是年龄相关性黄斑变性、糖尿病视网膜病变、视网膜静脉阻塞等常见慢性眼底病的主要治疗方式，凭借其治疗量大、操作流程化、实施简便，已成为眼科临床常规诊疗项目。基于《“十四五”全国眼健康规划(2021－2025年)》要求，秉承以患者为中心的服务理念，在确保医疗安全的基础上，优化治疗流程，提升患者接受玻璃体腔注药治疗的就诊体验和治疗效果。同时，广东省将有望承接越来越多港澳的眼病患者，需要建立融合粤港澳大湾区的广东省注药标准。因此，在广东省医学会的领导下，由中山大学中山眼科中心联合广东省内其他21所医疗机构共同起草，通过函审、专家论证会等形式，共邀广东省内35名权威专家进行多轮会审，在参考国内外玻璃体腔注药标准的基础上，结合粤港澳大湾区眼科现状，共同讨论最终确定了本标准。本团体标准系统地描述了玻璃体腔注药的基本要求、适应证与禁忌证，制定了全新的玻璃体腔注药标准操作流程及其质量控制标准，并且介绍了并发症或不适的预防及处理，为广东省各级具有资质的医疗机构所开展的玻璃体腔注药的临床应用以及质量评估提供指导。

Intravitreal injection represents the primary method of drug administration for a range of common chronic endophthalmic diseases, including age-related macular degeneration, diabetic retinopathy and retinal vein occlusion. Recognized for its high clinical efficacy, procedural standardization, and operational accessibility, this has become a routine clinical practice in ophthalmology. In alignment with the "National Eye Health Plan during the 14th Five-Year Plan period (2021–2025)" and the patient-centered service philosophy, this approach optimizes treatment processes and enhances patient experience and therapeutic outcomes while ensuring medical safety. Furthermore, Guangdong Province is poised to become a pivotal hub for ophthalmic care within the Guangdong-Hong Kong-Macao Greater Bay Area, anticipating a growing influx of patients from Hong Kong and Macao. This necessitates the development of a unified intravitreal injection standard tailored to regional healthcare integration. Under the auspices of the Guangdong Medical Association, a consortium led by Zhongshan Ophthalmic Center, Sun Yat-sen University, and 21 collaborating medical institutions across Guangdong, formulated this standard. Through iterative reviews involving correspondencebased evaluations and multidisciplinary expert consultations, 35 distinguished specialists refined the standard, synthesizing global best practices with insights into the Greater Bay Area’s unique ophthalmological landscape. This group standard systematically outlines the basic requirements, indications and contraindications of intravitreal injection, establishes a new standard operating procedure for intravitreal injection and quality control standards for this procedure. In addition, we have introduced guidance for the clinical application of this technique and quality assessment, as well as for the prevention and management of complications or adverse reactions.

睑板腺功能障碍(meibomian gland dysfunction, MGD)是一种慢性弥漫性睑板腺疾病，可引起眼红、眼干、异物感等眼部不适，影响患者的眼健康及生活质量。强脉冲光(intense pulsed light, IPL)作为一种新兴有效的物理治疗方法，目前已广泛应用于治疗MGD及其他常见的眼表疾病，如蠕形螨性睑缘炎、睑缘炎相关角结膜病变、复发性睑板腺囊肿等。在IPL临床应用中，规范的操作是保障治疗有效性与安全性的关键。为更好指导和规范临床眼科医护人员的IPL治疗操作，由中山大学中山眼科中心牵头，联合全国19所医疗机构，经过多次修订，于2023年12月17日在全国团体标准信息平台发布了《强脉冲光治疗睑板腺功能障碍操作流程》的团体标准。文章旨在对该团体标准进行深度解读，详细阐述操作中的重点、难点与操作细节，以更好地指导临床工作。

Meibomian gland dysfunction is a chronic diffuse meibomian gland disease that can cause eye discomfort such as redness, dryness, and foreign body sensation in patients, and influence their eye health and quality of life. Intense pulsed light (IPL), as an effective physical therapy for meibomian gland dysfunction, is being used to treat meibomian gland dysfunction and related diseases widely, such as demodex blepharitis, keratoconjunctivitis, recurrent meibomian gland cysts and so on.. In the clinical application of IPL, standardized procedures are key to ensuring the effectiveness and safety of treatment. In order to better guide and standardize the IPL treatment operation of clinical ophthalmic medical workers, led by the Zhongshan Ophthalmic Center, Sun Yat-sen University, and joined with 19 medical institutions across the country, after multiple revisions, the group standard " Operation Procedure of Intense Pulsed Light for Meibomian Gland Dysfunction" was released on the National Group Standard Information Platform on December 17, 2023. This article aims to provide an in-depth interpretation of the group's standards, detailing the key points, difficulties, and operational details of specific operations, in order to better guide clinical work.

睑板腺功能障碍可导致眼表微环境失衡，眼部不适及视功能障碍，深刻影响着患者的视觉生活质量。睑板腺按摩作为一种通过机械挤压睑板腺疏通睑板腺开口，排出异常睑酯的治疗手段，目前已被广泛应用于临床干眼患者，成为睑板腺功能障碍最常见的物理治疗方法。但由于睑板腺按摩的操作手法多样，不同医疗机构所积累的操作经验也不尽相同，导致在治疗过程中存在较多潜在风险，若操作不当，可造成眼部感染、眼睑红肿、结膜水肿出血，甚至角膜损伤。因此，制定标准化的操作流程，规范睑板腺按摩治疗非常重要。然而，目前尚缺乏全面、系统化且规范化的睑板腺按摩操作的临床实践指导。鉴于此，中山大学中山眼科中心联合全国19所医疗机构进行反复修订，于2023年12月17日在全国团体标准信息平台发布《睑板腺按摩操作流程》的团体标准。文章对该团体标准进行深度解读，以更好指导临床工作。

Meibomian gland dysfunction (MGD) can lead to an imbalance in the ocular surface microenvironment, eye discomfortable, and visual impairment, thereby profoundly affecting the visual quality of life of patients. Meibomian gland massage is now widely used in clinical patients, serving as the most prevalent physical therapy for MGD. The mechanism of meibomian gland massage is to open the meibomian gland opening by squeezing the meibomian gland and expel abnormal eyelid esters. However, due to the diverse techniques used in meibomian gland massage and the varying levels of operational experience accumulated by different medical institutions, there are many potential risks in treatment process. If medical staff operate improperly, it can cause eye infections, eyelid redness and swelling, conjunctival edema and bleeding, and even corneal damage. Therefore, it is crucial to establish the standardized procedure of meibomian gland massage therapy. Yet, there is currently lack of comprehensive, systematic, and standardized clinical practice guidance. Thus, the Zhongshan Ophthalmic Center, Sun Yat-sen University, in collaboration with 19 medical institutions across the country, has released the group standard for Operation Procedure of Meibomian Gland Massage on the National Group Standard Information Platform on December 17, 2023. This article aims to provide an in-depth interpretation of the group standard to guide clinical work better.

目的：评估炎非感染性葡萄膜炎继发炎性脉络膜新生血管(inflammatory choroidal neovascularization, iCNV)的临床特征及眼底多模式影像表现。方法：采用回顾性观察性研究，采用眼底荧光素血管造影(fundus fluorescein angiography, FFA)、吲哚菁绿血管造影(Indocyanine green angiography, ICGA)、谱域相干光断层扫描(spectral domain optical coherence tomography, SD-OCT)联合光学相干断层扫描血管成像(optical coherence tomography angiography, OCTA)等多种眼底影像学方法，对纳入患者的眼底进行检查，分析非感染性iCNV的面积、分型、位置及形态等影像学特征与临床特征的关系。结果：研究共纳入39例患者，对48只患眼中的51处iCNV病灶进行了评估。纳入患者年龄为(35.28±13.62)岁。其中3例患眼出现多灶性CNV。SD-OCT显示92.16%(47/51)的iCNV为2型CNV，17.65%(9/51)的iCNV出现海绵征，13.72%(7/51)的iCNV伴有局灶脉络膜凹陷。ICGA造影期间，74.50%的iCNV病灶(38/51)伴有弱荧光病灶，25.49%的病例(13/51)显示脉络膜高通透性表现。OCTA enface图像显示iCNV形态多样，包括焦点状(15例，29.41%)、盘状/海扇状(16例，31.37%)、枯树状(9例，17.65%)、星状(9例，17.65%)及弥漫网状(2例，3.92%)。其中，枯树状及星状iCNV提示iCNV为非活动性(P＜0.01)。结论：非感染性iCNV与炎性病灶关系密切，在SD-OCT，ICGA上皆具特征性的影像表现。OCTA能直观地观察到iCNV的形态。这些多模式影像特征为临床医生提供了对于非感染性iCNV重要的鉴别诊断依据，有助于制定有效的诊疗方案。

Objective: To evaluate the clinical characteristics and multimodal imaging features of non-infectious inflammatory choroidal neovascularization (iCNV). Methods: In this study retrospective, observational study, multimodal imaging examinations, including fluorescein angiography (FFA), indocyanine green angiography (ICGA), spectral-domain optical coherence tomography (SD-OCT), and optical coherence tomography angiography (OCTA), were used to observe the morphology of non-infectious iCNV in patients diagnosed with uveitis. The area of iCNV, CNV types, CNV morphology and other imaging characteristics were further analyzed. Results: A total of 39 patients were included, with 48 affected eyes and 51 iCNV were identified. The average age of the included patients was 35.28±13.62 years. Among the affected eyes, 3 presented with multifocal CNV, and 92.16% of iCNV were classified as type 2 CNV. iCNV exhibited diverse morphologies, including focal-like pattern (15 cases, 29.41%),sea-fan pattern(16 cases, 31.37%), dead-tree pattern CNV(9 cases, 17.65%), stellar pattern (9 cases, 17.65%), and diffuse reticular (2 cases, 3.92%). Notably, tree-like and stellar pattern iCNV showed a significant correlation with non-active CNV (P < 0.01). Conclusions: Non-infectious iCNV is closely related to inflammatory lesions, exhibiting characteristic imaging features on SD-OCT and ICGA. OCTA allows for direct observation of the morphology of iCNV. These multimodal imaging characteristics provide important diagnostic criteria for clinicians, aiding in the formulation of effective treatment plans.

目的：探讨一站式玻璃体腔注药中心成立前后不同管理模式下的成效，分析其对患者就医时间和就医体验的影响。方法：采用回顾性临床研究。选择2023年1月—2024年3月在汕头大学·香港中文大学联 合汕头国际眼科中心接受玻璃体腔注药的2955例患者纳入研究。将2023年1月—2023年8月玻璃体腔注 药中心成立前接受玻璃体腔注药的1399例患者作为对照组；2023年9月—2024年3月玻璃体腔注药中心成立后接受玻璃体腔注药的1556例患者作为观察组。对照组采用常规日间手术流程，观察组成立一 站式玻璃体腔注药中心，优化诊疗和护理服务流程。通过使用问卷调查比较两组患者就医期间从预约手术、手术当天到术后复查各节点的等待时间、健康教育知晓率、患者满意度及不良事件发生率的差异。结果：问卷调查结果显示，对照组、观察组患者间预约等待手术时间分别为(3.93±2.98) d、 (1.34±2.38) d，手术时间分别为(2.53±2.11) min、(1.93±1.82) min，在院时间分别为(313.62±184.96) min、(85.43±34.14) min，术后复查耗时分别为(45.92±48.44) min、(25.82±16.21) min，差异均有统计学意义(P＜0.001)；患者的总体健康教育知晓率成立前后分别为(95.50%、98.70%)，差异有统计学意义 (χ2 =16.09，P＜0.001)；患者满意度调查结果显示，各项就医体验选项“非常满意”的占比成立后比 成立前明显提高。结论:一站式玻璃体腔注药中心护理模式简化了就医流程，极大地减少了患者就医期 间从预约手术、手术当天到术后复查各节点的等待时间、可显著提升工作效率，明显改善患者整体就 医体验。

To explore the application effects of different nursing models before and after the establishment of a one-stop intravitreal injection center, and to analyze their impact on patient's medical time and experience. Methods: A retrospective clinical study was conducted. From January 2023 to March 2024, 2955 patients who received anti-VEGF drug treatment at the Shantou International Eye Center, a joint initiative of Shantou University and the Chinese University of Hong Kong, were included in the study. The 1399 patients who received anti-VEGF drug treatment before the establishment of the intravitreal injection center from January 2023 to August 2023 were set as the control group; the 1556 patients who received anti-VEGF drug treatment after the establishment of the intravitreal injection center from September 2023 to March 2024 were set as the observation group. The control group followed the routine day surgery process, while the observation group established a one-stop intravitreal injection center to optimize the diagnosis, treatment, and nursing service process. A questionnaire survey was used to compare the differences in waiting time at various points from appointment to surgery, on the day of surgery, and postoperative review, health education awareness rate, patient satisfaction, and adverse event rate between the two groups. Results: The questionnaire survey showed that the waiting time for surgery between the control group and the observation group was (3.93±2.98) d, (1.34±2.38) d, respectively, the surgery time was (2.53±2.11) min, (1.93±1.82) mi, the in-hospital time was (313.62±184.96 min, 85.43±34.14) min, and the postoperative review time was (45.92±48.44) min, (25.82±16.21) min, with all differences being statistically significant (P <0.001); the overall health education awareness rate before and after the establishment was (95.50%, 98.70%), with a significant difference (P <0.001, χ²=16.09); the patient satisfaction survey showed that the proportion of "very satisfied" in various medical experience options was significantly higher after the establishment than before. Conclusions: The one-stop intravitreal injection center nursing model has simplified the medical process, greatly reducing the waiting time at various points from appointment to surgery, on the day of surgery, and postoperative review, significantly improving work efficiency, and significantly improving the overall medical experience of patients.

慢性中心性浆液性脉络膜视网膜病变(cCSC)以广泛的脉络膜视网膜异常为特征，包括脉络膜血管扩张及其引发的弥漫性视网膜色素上皮病变和浆液性视网膜脱离，常累及黄斑区，引起视功能损害。传统观点认为其可能由急性CSC演变而来，但近期研究显示两者在临床上存在明显差异。其病情反复、迁延，预后较差。随着光学相干断层扫描血管造影(OCTA)、超广角成像和en face重建成像等新多模式影像(MMI)技术的出现和人工智能及机器学习的发展，更多有意义的cCSC影像学特征不断出现。文章详细介绍了cCSC在眼底成像、眼底自发荧光(FAF)、光学相干断层扫描(OCT)、眼底荧光素血管造影(FFA)、吲哚菁绿血管造影和OCTA等影像技术中的表现，并探讨了人工智能在识别CSC分类及其OCT 生物标志物等方面的应用。不同影像技术在cCSC的诊断和研究中各有优势，如FAF可能是评估疾病进展及变化的有效手段，OCT可更直观地观察视网膜结构的改变，FFA是识别渗漏点的重要检查手段，而OCTA可能是评估脉络膜微循环的的最佳手段等。这些MMI研究进展为深入了解cCSC的病理生理机制及临床特征提供了重要线索，有助于提高诊断的准确性和效率，改善患者的预后和生活质量。

Chronic central serous chorioretinopathy (cCSC) is characterized by extensive retinochoroidal abnormalities. This includes difuse retinal pigment epitheliopathy and serous retinal detachment associated with choroidal vasodilatation, ofen involving the macula and cause visual impairment. It was originally considered that it might evolve from acute CSC, but recent studies have shown significant clinical differences between the two. It tends to recur, be prolonged, and have an unfavorable prognosis. With the advent of new multimodal imaging (MMI) techniques such as optical coherence tomography angiography (OCTA), ultra-wide-feld imaging, and en face reconstruction imaging, along with the advancement of artificial intelligence and machine learning, more significant cCSC imaging characteristics have been constantly emerging. Tis article provides a comprehensive overview of cCSC’s imaging features across various modalities, including fundus photography, fundus autofluorescence (FAF), optical coherence tomography (OCT), fuorescein angiography (FFA), indocyanine green angiography, and OCTA. It also explores the application of artifcial intelligence in identifying CSC classifications and OCT biomarkers. Different imaging techniques have their own advantages in the diagnosis and study of cCSC, such as FAF being an efective means to assess disease progression and changes, OCT providing a more intuitive observation of retinal structural changes, FFA being an important tool for identifying leakage points, and OCTA possibly being the best means to assess choroidal microcirculation. Tese MMI research advancements ofer crucial insights for clinicians, aiding in more accurate diagnosis and efective treatment, thereby potentially improving patient outcomes and quality of life.

目的：探索和实践人工智能辅助诊断的闵行区视觉健康管理模式。方法：介绍闵行区人工智能辅助诊断的视觉健康管理模式；分析对比传统视觉健康管理模式和人工智能辅助诊断视觉健康管理模式下，社区视觉健康筛查情况，眼病发现、需转诊、复诊情况等；工作人员配置、眼科门诊接诊情况、居民眼病知识率和视觉健康服务满意情况等。结果：传统视觉健康管理模式和人工智能辅助诊断模式主要眼病（糖尿病视网膜病变、青光眼、年龄相关性黄斑变性、高度近视）发现率比较差异均有统计学意义（c²=954.03，P ＜0.01），需转诊率差异有统计学意义（c²=431.07，P ＜0.01）。人工智能辅助诊断管理模式与传统视觉健康管理模式的居民在青光眼的知晓率比较差异有统计学意义（c²=4.24，P＜0.05）。传统视觉健康管理模式和人工智能辅助诊断模式居民对视觉健康服务中的服务质量和服务时间的满意度比较差异有统计学意义（Z=-2.75，Z=-2.18，P ＜0.05）。结论：人工智能辅助诊断视觉健康管理模式，糖尿病视网膜病变、青光眼等主要眼病发现率高于传统模式，需转诊率降低，居民对青光眼的知晓率提升，在服务质量和服务时间上的居民满意度较高。基于人工智能辅助诊断的视觉健康筛查与管理模式值得本区其他社区的推广和应用。

Objective To explore and practice the visual health management mode of Minhang District . Methods Introduce the visual health management mode of AI-assisted diagnosis in Minhang District; analyze and compare the traditional visual health management mode and AI-assisted visual health management mode, community visual health screening projects and completion conditions, screening files, eye disease discovery , referral, actual referral and return ; analyze and compare the visual health management mode, staff allocation, ophthalmic outpatient reception, and the satisfaction of visual health service. Results The difference in the discovery rate of major eye diseases (Diabetic Retinopathy,Glaucoma,Age-related Macular Degeneration,High Myopia) between the traditional model and artificial intelligence-assisted diagnosis mode in both communities (c²=954.03, P<0.01), the referral rate (c²=431.07, P<0.01). The awareness of AI-assisted diagnosis management improved in glaucoma in the two modes was statistically significant (c²=4.24, P<0.05). Traditional model and artificial intelligence assisted diagnosis model of visual health service quality and service time is statistically significant (Z=-2.75, Z=-2.18, P<0.05). Conclusion The visual health screening and management mode based on AI-assisted diagnosis is worthy of the promotion and application in other communities in the region.

大型语言模型（large language models, LLMs）在眼科的应用为医疗领域带来了巨大的潜力，尤其是在提升诊断效率、优化医患沟通和促进个性化医疗方面。通过自然语言处理技术，LLMs可以协助医生进行临床数据的归纳和分析，可以结合患者的病史、影像资料和症状描述，提供精准的辅助诊断，并在复杂病例中提供参考。LLMs还可以帮助医生快速撰写病历报告，改善医疗记录管理效率。在医患沟通中，LLMs能够通过生成通俗易懂的解释，帮助患者理解疾病状况及治疗方案，缩短医生与患者之间的沟通障碍。在远程医疗场景下，LLMs可通过实时分析患者上传的图像文本信息，提供初步诊断建议，助力医生远程诊疗。个性化医疗也是LLMs的重要应用方向，借助患者的遗传数据和生活习惯，可以帮助医生制定更为精准的个性化治疗方案，并预测手术后的恢复情况。此外，LLMs可以通过与临床数据的不断交互进行自我优化，提升其在眼科诊疗中的智能化程度。尽管LLMs在眼科领域的应用前景广阔，但仍面临数据隐私、模型解释性、语言理解等方面的挑战。未来LLMs将继续作为医生的辅助工具，形成“人机协同”的诊疗新模式，为患者提供更好、更精准的医疗服务。

The application of Large Language Models (LLMs) in ophthalmology presents tremendous potential for the healthcare field, particularly in enhancing diagnostic efficiency, optimizing doctor-patient communication, and promoting personalized medicine. Through natural language processing technology, LLMs can assist doctors in summarizing and analyzing clinical data. They can integrate a patient's medical history, imaging data, and symptom descriptions to provide precise diagnostic support and reference for complex cases. LLMs can also help physicians quickly draft case reports, improving the management efficiency of medical records. In doctor-patient communication, LLMs can generate easy-to-understand explanations that help patients comprehend their conditions and treatment plans, thereby reducing communication barriers between doctors and patients. In telemedicine scenarios, LLMs can provide preliminary diagnostic suggestions by real-time analyzing images and textual information uploaded by patients, aiding doctors in remote diagnosis and treatment.

Personalized medicine is another significant application direction for LLMs. By utilizing patients' genetic data and lifestyle habits, LLMs can assist physicians in formulating more precise personalized treatment plans and predicting postoperative recovery outcomes. Additionally, LLMs can self-optimize through continuous interaction with clinical data, enhancing their intelligence in ophthalmic diagnosis and treatment. Despite the broad application prospects of LLMs in the field of ophthalmology, challenges remain, including data privacy, model interpretability, and language understanding. In the future,  LLMs will continue to serve as auxiliary tools for physicians, forming a new model of "human-machine collaboration" in diagnosis and treatment, ultimately providing better and more precise medical services to patients.

玻璃体腔注药是年龄相关性黄斑变性、糖尿病视网膜病变、视网膜静脉阻塞等常见慢性眼底病的主要治疗方式，凭借其治疗量大、操作流程化、实施简便，已成为眼科临床常规诊疗项目。基于《“十四五”全国眼健康规划(2021－2025年)》要求，秉承以患者为中心的服务理念，在确保医疗安全的基础上，优化治疗流程，提升患者接受玻璃体腔注药治疗的就诊体验和治疗效果。同时，广东省将有望承接越来越多港澳的眼病患者，需要建立融合粤港澳大湾区的广东省注药标准。因此，在广东省医学会的领导下，由中山大学中山眼科中心联合广东省内其他21所医疗机构共同起草，通过函审、专家论证会等形式，共邀广东省内35名权威专家进行多轮会审，在参考国内外玻璃体腔注药标准的基础上，结合广东省粤港澳大湾区眼科现状，共同讨论最终确定了本标准。本团体标准系统地描述了玻璃体腔注药的基本要求、适应证与禁忌证，制定了全新的玻璃体腔注药标准操作流程及其质量控制标准，并且介绍了并发症或不适的预防及处理，为广东省各级具有资质的医疗机构所开展的玻璃体腔注药的临床应用以及质量评估提供指导。

玻璃体腔注药是年龄相关性黄斑变性、糖尿病视网膜病变、视网膜静脉阻塞等常见慢性眼底病的主要治疗方式，凭借其治疗量大、操作流程化、实施简便，已成为眼科临床常规诊疗项目。基于《“十四五”全国眼健康规划(2021－2025年)》要求，秉承以患者为中心的服务理念，在确保医疗安全的基础上，优化治疗流程，提升患者接受玻璃体腔注药治疗的就诊体验和治疗效果。同时，广东省将有望承接越来越多港澳的眼病患者，需要建立融合粤港澳大湾区的广东省注药标准。因此，在广东省医学会的领导下，由中山大学中山眼科中心联合广东省内其他21所医疗机构共同起草，通过函审、专家论证会等形式，共邀广东省内35名权威专家进行多轮会审，在参考国内外玻璃体腔注药标准的基础上，结合广东省粤港澳大湾区眼科现状，共同讨论最终确定了本标准。本团体标准系统地描述了玻璃体腔注药的基本要求、适应证与禁忌证，制定了全新的玻璃体腔注药标准操作流程及其质量控制标准，并且介绍了并发症或不适的预防及处理，为广东省各级具有资质的医疗机构所开展的玻璃体腔注药的临床应用以及质量评估提供指导。