眼底老化是年龄相关性黄斑变性(age-related macular degeneration, AMD)发生和进展的关键因素及病理基础，在组织病理学上主要表现为脉络膜毛细血管萎缩、布鲁赫膜(Bruch's membrane, BrM)增厚以及视网膜色素上皮(retinal pigment epithelium, RPE)异常。BrM增厚可由多种眼底老化沉积物聚集引起，在AMD的病理机制中具有重要作用。其中，基底薄层沉积物(basal laminar deposit, BLamD)代表了RPE基底膜的弥漫性增厚，通常作为一种正常眼底老化改变。而以酯化和未酯化胆固醇等中性脂质为主的RPE基底膜下沉积物，即基底线性沉积物(basal linear deposits, BLinD)和软性玻璃膜疣，均可参与破坏脉络膜与外层视网膜间物质交换稳态，造成外层视网膜缺血、缺氧及氧化应激，是AMD早期重要病理改变。硬性玻璃膜疣主要分布于周边视网膜，多见于正常老化眼底；表皮玻璃膜疣是RPE基底膜局灶性结节状增厚的结果，眼底表现与硬性玻璃膜疣相似，但其主要分布于后极部，数量更多且密度更高。近年来逐渐加深了对视网膜下玻璃膜疣样沉积物(subretinal drusenoid deposit, SDD)的认识和研究，其是位于RPE上方的沉积物，在AMD发病机制中亦具有深刻意义。文章就几种眼底老化相关沉积物(包括硬性玻璃膜及表皮玻璃膜疣)的病理特征和多模态影像学表现进行综述，旨在帮助认识和理解这些沉积物的眼底表现、病理特征和形成机制，以及在AMD发生及进展中的临床意义。

Fundus aging is a key factor and pathological basis for the development and progression of age-related macular degeneration (AMD), which is histopathologically characterized by choroidal capillary atrophy, Bruch’s membrane (BrM) thickening, and abnormalities of retinal pigment epithelium (RPE). BrM thickening can be induced by the aggregation of age-related fundus deposits and plays an essential role in the pathogenesis of AMD. Basal laminar deposits (BLamD) represent diffuse thickening of the basement membrane of RPE, usually considered to be a normal fundus aging. Basal linear deposits (BLinD) and soft drusen, mainly composed of neutral lipids such as esterified and unesterified cholesterol, can disrupt the homeostasis of material exchange between the choroid and the outer retina, resulting in ischemia, hypoxia, and oxidative stress in the outer retina, which are important pathological changes in the early AMD. Hard drusen is mainly distributed in the peripheral retina and is very common in aging fundus; Cuticular drusen are resulted from focal nodular thickening of the basement membrane of RPE, with similar appearance as hard drusen, but mainly distributed in the posterior pole and more numerous and denser. Recently, our understanding of subretinal drusenoid deposits (SDD), deposits above the RPE, has been gradually deepened and it also has profound significance in the pathogenesis of AMD. In this review, we presented the pathologic features and multimodal imaging of age-related fundus deposits (including hard drusen and cuticular drusen), aiming to help recognize and understand the manifestations, pathologic features, and formation mechanisms of these deposits, as well as their clinical significance in the development and progression of AMD.

目的：探讨出血型视网膜大动脉瘤及合并症的红外光反射成像（infrared light reflection, IR）和眼底荧光血管造影（fundus fluorescein angiography, FFA）的影像特征。方法：采用回顾性病例系列研究。收集2010年2月—2024年6月在河南省立眼科医院确诊的出血型视网膜大动脉瘤患者35例35眼，所有眼均行IR联合FFA检查，其中10眼行吲哚菁绿血管造影（indocyanine green angiography, ICGA）检查，分析视网膜大动脉瘤及其合并症的眼底影像学特点。结果：IR检查显示34眼视网膜大动脉瘤体呈囊状反射光。FFA检查显示27眼视网膜大动脉瘤呈囊样强荧光，此外，FFA检查还发现5眼伴视网膜分支静脉阻塞，1眼伴视网膜分支动脉阻塞。FFA组在视网膜大动脉瘤检出率低于IR组(P <0.05)。在10眼出血型视网膜大动脉瘤中，IR组和ICGA组在视网膜大动脉瘤检出率方面比较差异无统计学意义(P >0.05)。结论：IR检查对于出血型视网膜动脉瘤的检测可等效于ICGA检查，IR联合FFA检查适合于出血型视网膜大动脉瘤及合并症的个体化诊断。

Objective: To evaluate the imaging characteristics of infrared light reflection (IR) and fundus fluorescein angiography (FFA) in hemorrhagic retinal artery aneurysm and its complications. Methods: Retrospective case series study was used. The clinic data of 35 patients (35 eyes) were diagnosed in Henan Eye Hosptial from February 2010 to June 2024. All eyes were examinated by IR and FFA, and 10 eyes examinated by indocyanine green angiography (ICGA). The fundus imaging characteristics of hemorrhagic retinal artery aneurysm and its complications was analyzed. Results: The images of IR presented 34 eyes with cystic strong reflex light. FFA showed 27 eyes with cystic strong fluorescence, in addition, FFA revealed 5 eyes with retinal branch vein occlusion and 1 eye with retinal branch artery occlusion. The detection rate of hemorrhagic retinal artery aneurysm in the FFA group was lower than that in the IR group (P =0.038<0.05). There was no significant difference in the detection rate of hemorrhagic retinal artery aneurysm between the IR group and the ICGA group in 10 eyes with hemorrhagic retinal artery aneurysm (P =1.000>0.05). Conclusion: IR examination could be equivalent to ICGA examination for detecting hemorrhagic retinal artery aneurysm, and IR combined with FFA examination is suitable for individualized diagnosis of hemorrhagic retinal artery aneurysm and its complications.

荧光素眼底血管造影（fundus fluorescein angiography, FFA）是眼底疾病诊疗不可或缺的检查技术。虽然开展已有半个世纪，但临床工作者在FFA操作的规范性、科学性、安全性和结果同质性仍有不少顾虑和问题，同时缺乏相关指南和共识可供参考。中国微循环学会眼微循环专业委员会眼影像学组专家就FFA操作规范达成本共识，就开展FFA的条件和配置、适应证和禁忌证、检查前准备、检查操作程序、不良反应及处理、造影后患者告知和处理、造影报告等方面为FFA临床操作工作者提供建议和指导，以期在临床实践中获取良好眼底影像、减少不良反应、提高检查质量效率。

Fundus fluorescein angiography (FFA) is an indispensable examination for the diagnosis and treatment of ocular fundus diseases. Although FFA has been carried out for half a century, clinicians still have many concerns and problems in the standardization, scientificity, safety and result homogeneity of FFA practice, and there is a lack of relevant guidelines and consensus for reference. The experts of the Ophthalmic Imaging Group of the Ocular Microcirculation Division of the Chinese Society of Microcirculation reached a consensus on the standardized practice of FFA, providing suggestions and guidance for FFA operators about the clinical conditions and configurations, indications and contraindications, pre-examination preparation, examination procedures, adverse reactions and treatment, patient notification, and angiography reports, in order to obtain good fundus images, reduce adverse reactions, and improve the quality and efficiency of FFA examinations in clinical practice.

“六要素，三个一”是眼底影像基础阅片工作中进行眼底疾病临床创新性研究的模式要点，即在眼底阅片过程中捕捉到1个异常的病例后，通过积累病例、提炼特征、文献检索、寻同查异，进而扩展到1组病例，最后通过思辨创新，提出或完善1种新的疾病或疾病表征。近二十年来，在此模式的指导下，团队在眼底疾病研究工作中取得了一些原创性的成果：比如息肉状脉络膜血管病变的认识及其在国人新生血管性年龄相关性黄斑变性中发病比例第一，提出点状内层脉络膜病变病灶国际分期和命名新亚型，年龄相关的吲哚菁绿血管造影晚期散在弱荧光点揭示潴留性视网膜色素上皮脱离的发病机制，发现急性黄斑神经视网膜病变是登革热患者视力下降的主要原因，在全球最大的持续性鳞状黄斑病变的病例系列中明确病灶层次等创新性成果。“六要素”框架规范眼底影像研究流程，强调研究过程的严谨性与渐进性，且多次循环后衍生发散出更多研究线索和思路，极大拓展研究深度和广度。“三个一”路径体现了研究的层次性，从个体现象(点)到群体规律(线)，最终构建疾病认知的立体网络(面)；指导眼底异常影像征象、罕见病、新病种研究，加速疾病谱系完善。以“六要素”为纲，以“三个一”为略，将继续推动眼底疾病临床研究的创新与突破。

The "6 Elements, 3 Ones" constitutes a methodological framework for conducting innovative clinical research of ocular fundus diseases in foundational fundus imaging interpretation. This model emphasizes: 1) identifying a single abnormal case during routine fundus evaluation; 2) systematically expanding this observation into a case series through case accumulation, feature extraction, literature review, and comparative analysis; and 3) ultimately proposing or refining novel disease entities or manifestations through critical thinking and innovation. Over the past two decades, guided by this paradigm, our research team has achieved several original breakthroughs in fundus imaging studies, including: establishing polypoidal choroidal vasculopathy as the predominant subtype of neovascular age-related macular degeneration in Chinese populations; proposing an international staging system and novel subtypes for punctate inner choroidopathy; elucidating the pathogenesis of retentional retinal pigment epithelial detachment through the sign of age-related scattered hypofluorescent spots on late-phase indocyanine green angiography; identifying acute macular neuroretinopathy as the primary cause of vision loss in dengue fever patients; and precisely localizing lesion in the world's largest case series of persistent placoid maculopathy. The "6 Elements" framework standardizes fundus disease research protocols, emphasizing methodological rigor and progressive investigation while generating multiple research trajectories through iterative cycles, thereby expanding both the depth and breadth of scientific inquiry. The "3 Ones" pathway embodies hierarchical research progression - transitioning from individual phenomena (point observations) to population-level patterns (linear correlations), ultimately constructing a multidimensional disease cognition network (planar integration). This approach guides investigations ranging from signs of common disease to rare disorders and novel disease entities, accelerating the refinement of disease taxonomies. By adhering to the "6 Elements" as the structural framework and implementing the "3 Ones" as the strategic pathway, we will continue to advance innovation and achieve breakthroughs in clinical fundus disease researches.

目的：自行设计并应用眼科表格式护理记录单，探讨眼科日间病房精细化护理管理工作的方法。方法：于中山大学中山眼科中心眼底病中心，根据日间手术流程，设计和运用眼底病中心24 h出入院护理记录单、眼底病中心日间病房交班记录单和眼底病中心日间病房手术记录单，书写方法基本以打勾、数字或简单文字记录为主。结果：新的表格式护理记录单大大节省护理记录和交班时间，提高护理工作效率，得到临床护理人员的广泛认可，提高医护对护理工作的满意度。结论：突出专科特色的表格式护理记录单能统一规范临床护理工作，提高护理工作效率和护理质量，保障护患安全，落实精细化护理管理。

Objective: To explore ffne management method of day ward in ocular department, through applying self-designed table format of eye nursing records. Methods: According to the day surgery process, the tables of 24-h nursing records and shifting records and surgery records were designed and applied to day ward of the ophthalmic fundus center. The basic writing methods included ticking, number and filling in the blanks. Results: The new nursing records tables decreased the time consumed in recording and shifting, improving the work efficiency, accepted widely by clinical staffs. Conclusion: The new table format with highlight of special features of the nursing records can unify and standard the clinical nursing work, improve the nursing work efficiency and nursing quality, ensure patients’ safety, and implement fine management. 

目的：探讨医护一体化管理模式在眼底病中心日间病房中的应用与成效。方法：2015年6月至2016年6月于眼底病中心实行医护一体化管理模式，通过问卷调查比较实施前后医生和患者对护理工作的满意度。结果：医护一体化管理模式实行后，医生满意度显著提高，差异有统计学意义(t=?4.412，P<0.01)，患者满意度有所提高，差异有统计学意义(t=2.592，P=0.01)。结论：采用医护一体化管理模式对眼底病日间手术住院患者进行管理，加强医护沟通，可有效提高护理质量，保障患者医疗、护理的安全性。

Objective: To explore the effect of the medical integration mode applying in the day ward of ophthalmic clinical key specialty. Methods: The ophthalmic fundus center started to carry out the medical integration mode from June 2015 to June 2016. Doctors’ and patients’ satisfaction towards nurses were surveyed before and after the implementation. Results: The doctors’ satisfaction towards nurses was statistically higher than before (t=?4.412, P<0.01). TTe patients’ satisfaction also improved, and the difference was statistically signiffcant (t=2.592, P=0.01). Conclusion: The medical integration mode strengthens the communication with doctors and patients, improves the nursing quality, and ensures the medical safety.

目的：探讨口服25%葡萄糖减轻早产极低出生体重儿在第一次早产儿视网膜病眼底检查时的疼痛 的效果。方法：选取2014年9月至2015年8月在广东省妇幼保健院NICU住院的早产极低出生体重儿，随机分为观察组和对照组，观察组在进行第一次早产儿视网膜病眼底检查前2 min，给予25% 葡萄糖溶液1mL口服；对照组未用任何安慰剂。两组患儿眼底检查后分别进行新生儿疼痛量表的 评估。结果：观察组患儿眼底检查后疼痛评分低于对照组(P<0.001)。结论：眼底检查前2 min口服25%葡萄糖溶液1 mL是缓解早产儿视网膜病检查引起的疼痛的有效措施。

Objective: To explore the analgesic effect of oral glucose 25% on preterm and very low birth weight infants for the first time of fundus examination for retinopathy screening. Methods: Cases of preterm and very low birth weight infants in Guangdong Women and Children’s Hospital NICU from February 2014 to January 2015 were randomly divided into observation group and control group. The observation group was given 1 mL of 25% glucose solution by oral 2 min before the first time of retinopathy screening. The control group was given nothing. Pain was evaluated using the Neonatal Infant Pain Scale immediately after the fundus examination in both groups. Results: The NIPS of the observation group was lower than that of the control group (P<0.001). Conclusion: 1 mL of 25% glucose solution given 2 min before fundus examination for retinopathy of prematurity by oral was an effective measure for pain relief.

目的: 观察老年性黄斑变性(Age-related macular degeneration, AMD) 和息肉状脉络膜视网膜病变(Polypoidal choroidal vasculopathy, PCV) 患者眼底陈旧性出血在吲哚青绿血管造影(Indocyanine green angiography, ICGA) 中的自发荧光表现。

方法: 对伴有眼底陈旧性出血的AMD和PCV患者共36例(36只眼)行ICGA检查。受试者在进行ICGA检查前, 均经过详细的眼底镜检查、眼底彩色照相及荧光素眼底血管造影(Fundus fluorescein angiography, FFA) 检查。

结果: 眼底陈旧性出血灶 ICGA 均表现出相应的自发荧光。陈旧性出血灶呈浅灰黄色, 其自发荧光的形态大小与眼底彩色图像所示的陈旧性出血灶相一致, 边界清晰; 造影后期陈旧性出血灶的自发荧光强度最强，与 AMD 的斑状及焦点状脉络膜新生血管 (Choroidal neovasculari-zation, CNV) 及 PCV 的息肉状脉络膜血管扩张灶的荧光表现不同。陈旧性眼底出血的自发荧光多与 CNV 或息肉状病灶重叠或位于其边缘(27只眼, 75%) 。

结论: ICGA 中陈旧性眼底出血所致的自发荧光易与 CNV 及息肉状病灶性强荧光相混淆, 将眼底彩色图像与 ICGA 图像对比分析及掌握其与CNV及息肉状血管扩张灶的不同荧光特性有助于鉴别诊断。

Objective: To investigate the autofluorescence of stale fundus haemorrhage in age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV) with indocyanine green angiography (ICGA) .

Methods: The color photographs and ICGA were performed in 36 eyes of 36 cases of exudative AMD or PCV with stale fundus haemorrhage. All of the cases were examined by funduscopy and fundus fluorescein angiography (FFA) .

Results: Autofluorescence could be observed in all of the stale haemorrhage cases. Stale haemorrhage showed grayish color and the shapes and sizes of autofluoresence in ICGA were in accordance with those of the stale haemorrhage in the color photographs. The boundaries of autofluorescence were clear and the intensities were strong. The percentage of choroidal neovascularization (CNV) or PCV in or beside stale haemorrh-age was significantly higher than that outside the stale haemorrhage (27 eyes, 75%) . 

Conclusions: Autofluorescence of stale haemorrhage in ICGA can be mixed up with the high fluorescence of CNV and grapes-like polypoidal dilatation. It is helpful to compare the color photographs with ICGA and recognize the different ICGA characteristics in the assessment of ICGA results in these circumstances.

目的：评价欧堡Daytona 200度超广角激光扫描检眼镜检查近视患者眼底周边部视网膜病变的应用价值。方法：本研究为前瞻性病例研究，收集爱尔眼科医院要求行屈光手术的近视患者1 000例(2 000只眼)，分别进行小瞳下欧堡Daytona 200度超广角激光扫描检眼镜眼底检查和散瞳后三面镜检查，记录检查结果并进行比较分析。结果：通过欧堡Daytona 200度超广角激光扫描检眼镜检查发现有周边视网膜病变共230例(310只眼)，检出阳性率为15.50%；三面镜检查发现周边部视网膜病变共242例(322只眼)，检出阳性率为16.10%。两种检查方法对近视患者周边部视网膜病变检出阳性率具有很好的一致性(Kappa值0.8~1.0)。结论：欧堡Daytona 200度超广角成像系统为检查周边部视网膜病变提供了更省时高效的方法，在屈光手术前筛查视网膜周边部病变，具有广阔的临床应用前景。

Objectives: To evaluate the clinical value of peripheral retinal diseases in myopic patients examined by 200-degree ultra-wide field laser ophthalmoscope (Daytona). Methods: This was a prospective case-control study. We collected 1 000 myopic patients (2 000 eyes) who were scheduled to undergo refractive surgery in Aier Eye Hospital. They were examined by 200-degree ultra-wide field laser ophthalmoscope (Daytona) with non-mydriasis and three-mirror contact lens with mydriasis. The examination results were recorded and statistically analyzed. Results: A total of 230 cases (310 eyes) with peripheral retinopathy were found by 200-degree ultra-wide field laser ophthalmoscope (Daytona). The positive rate was 15.50%; 242 cases (322 eyes) with peripheral retinopathy were found by three- mirror contact lens, and the positive rate was 16.10%. The two methods were consistent in the detection of peripheral Retinopathy in myopic patients (the Kappa value is between 0.8 and 1.0). Conclusion: 200-degree ultra-wide field laser ophthalmoscope (Daytona) is an effective and rapid method for detecting peripheral retinopathy. It provides a broad clinical application prospects for peripheral retinopathy screening before refractive surgery.

剥脱综合征(exfoliation syndrome,XFS)以眼内异常纤维样物质沉积为特征，临床典型表现为裂隙灯下瞳孔缘和(或)晶状体前囊膜存在灰白色粉末状的剥脱物(exfoliation material,XFM)。XFM可阻塞小梁网引起剥脱性青光眼(exfoliaiton glaucoma,XFG)，并可通过房水循环进入血液，引起血管性损害。眼底病变视力损伤通常不可逆，XFM可进入眼底微血管及毛细血管，引起眼底结构和血管异常。基于光学相干断层成像技术的光学相干断层扫描(optical coherence tomography,OCT)及光学相干断层扫描血管成像(optical coherence tomography angiography,OCTA)以实时、非侵入性、高分辨率等优势，已广泛应用于眼底组织结构及血管病变检查。文章对XFS眼底病变在OCT和OCTA上的表现进行综述。

Exfoliation syndrome (XFS) was characterized by the abnormal deposition of the fber-like material intraocularly, and manifested as white or gray, powdery exfoliation material (XFM) on the pupillary border and (or) anterior lens capsule under slit lamp microscopy. XFM could obstruct the trabecular meshwork and cause exfoliation glaucoma (XFG). In addition, XFM that entered aqueous humor circulation could enter bloodstream and result in vascular damage. XFM could enter ocular fundus microvascular and capillary vessels, causing abnormalities of fundus structures and vessels. Optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA), which were based on optical coherence tomography technology, had the advantages of real-time, non-intrusive and high resolution, et al. OCT and OCTA were widely used in detection of fundus structural and vascular abnormalities. Tis study was to review the fundus lesion of XFS on OCT and OCTA.