目的：开发细胞级高分辨率、结构与功能一体化的双模态全视场光学相干层析系统(full-field optical coherence tomography,FFOCT)，实现角膜缘组织的双模态FFOCT成像。方法：基于Linnik干涉成像原理，利用高数值孔径显微物镜(NA=0.8)及高速平面互补金属氧化物半导体(complementary metal oxide semiconductor,CMOS)相机，设计搭建高分辨率的组织静态结构和内源动态功能成像一体化双模态FFOCT系统；构建基于四相位调制结构影像提取及时域干涉信号动态频谱分析的功能影像重建算法；对人供体角膜缘组织开展各深度层的双模式FFOCT成像有效性验证。结果：搭建的双模态FFOCT成像系统可实现横向分辨率0.5 μ m，轴向分辨率1.7 μ m，成像视野320 μ m×320 μ m，相机采集速度100 Hz。系统实现角膜缘组织无外源标记情况下的细胞级分辨率三维结构和内源功能成像，FFOCT静态结构影像清晰显示角膜缘上皮、Vogt栅栏、隐窝、基质、血管及淋巴管等结构，FFOCT动态功能影像突出显示了代谢活跃细胞(角膜缘上皮细胞、免疫细胞等)。结论：双模态FFOCT高分辨率成像系统可提供角膜缘微观结构和活细胞无标记内源功能可视化信息，将为角膜缘疾病的研究及临床诊疗提供全新的成像分析技术。

Objective: To develop a cellular-level, high-resolution, integrated dual-modal full-field optical coherence tomography (FFOCT) system capable of simultaneously imaging the structure and function of limbus tissue. Methods: Utilizing the Linnik interference imaging principle, a high-resolution dual-modal FFOCT system was designed and constructed using a high numerical aperture (NA=0.8) microscope objective and a high-speed flat CMOS camera. A functional imaging reconstruction algorithm based on four-phase modulation structure image extraction and dynamic frequency spectrum analysis of temporal interference signals was developed. The effectiveness of dual-mode FFOCT imaging at various depth layers of human corneal limbal tissue was validated. Results: The constructed dual-modal FFOCT imaging system achieved lateral resolution of 0.5 μ m, axial resolution of 1.7 μ m, imaging field of view of 320 μ m × 320 μ m, and camera acquisition speed of 100 Hz. The system enabled cellular-level resolution three-dimensional structural and intrinsic functional imaging of corneal limbal tissue without exogenous labeling. Static structural FFOCT images clearly displayed limbal epithelium, palisades of Vogt, crypts, stroma, blood vessels, and lymphatic vessels, while dynamic functional FFOCT images highlighted metabolically active cells (limbal epithelial cells, immune cells, etc.). Conclusion: The dual-modal FFOCT high-resolution imaging system provides visualization of corneal limbal microstructural and live cell intrinsic functional information without labeling, offering a novel imaging analysis technique for research and clinical diagnosis and treatment of limbal diseases.

目的: 比较新鲜羊膜和保存羊膜治疗睑球粘连的疗效差异, 分析影响疗效的因素。

方法: 共 51 例 55 只眼因陈旧性化学伤、热烧伤或 Stevens-Johnson 综合征而发生睑球粘连的临床连续病例接受睑球粘连分离联合新鲜羊膜移植(22 只眼) 或保存羊膜移植(33 只眼) 。其中男 30 例 32 只眼, 女 21 例 23 只眼。年龄 4～51 岁, 平均(34.2 ± 4.3) 岁。其中 11 只眼在烧伤后5～11个月, 平均(7.4 ± 1.6) 个月时接受手术, 40 只眼在烧伤后 1～8 年, 平均(2.0 ± 0.7) 年进行手术。

结果: 术后随访 12～32 个月, 平均(19.3 ± 4.1) 个月 。所有移植在结膜眼表面的羊膜(包括新鲜羊膜) 植片在术后早期均未见溃烂和溶解, 周边对合良好。31/55(56.4%) 只眼形成了足够深的穹窿部且恢复了眼球运动功能。9/55(16.4%) 只眼发生部分睑球粘连, 眼球运动轻度受限,但其面积远较术前为小。15 /55(27.3%) 眼术后发生中度以上的睑球粘连。新鲜羊膜和保存羊膜重建眼结膜表面的效果相似( X ² = 0.466, P = 0.797) ; 不同程度睑球粘连的患者其羊膜移植术后的效果不同(新鲜羊膜, X²=27.995, P=0.000; 保存羊膜, X²=33.610, P=0.000) ; 在眼表烧伤后1年内手术比 1 年以上进行羊膜移植的效果也不同(X ²= 4.243, P = 0.039) 。

结论: 新鲜羊膜和保存羊膜一样可以有效地用于重建睑球粘连解除后的结膜眼表。患眼术前睑球粘连程度以及烧伤后其眼表炎症是否处于安静状态等因素都会直接影响羊膜移植重建眼结膜表面的远期疗效。

Purpose: To compare the effect of fresh versus preserved amniotic membrane transplant-ation for conjunctival surface reconstruction after symblepharon lysis and analyze the associated factors.

Methods: Fifty-one consecutive cases (55 eyes) with symblepharon at different degree due to eye burns or Stevens-Johnson syndrome were accepted lysis of symblepharon and amniotic membrane transplantation. Twenty-two eyes of them were performed with fresh amnion grafts, the others (33 eyes) with preserved human amniotic membrane. Eleven eyes were performed within 1 year and forty eyes in 1 to 8 years (mean value, 2.0 ± 0.7 years) after eye burns.

Results: The follow-up time varied from 12 to 32 months (mean value, 19.3 ± 4.1 months) . Fifty-six point four percent (31/55) eyes got enough deep conjunctival fornix and resolution of eye movement restrict. Sixteen percent of them (9/55) recurred less symblepharon and remained slightly eye movement restrict. Fifteen- five eyes of them (27.3%) recurred moderate symblepharon. The effects of surgery were similar between fresh and preserved AMT (X ² = 0.466, P = 0.797) . The effects of AMT for those patients with symblepharon at different degree had significant difference statistically (fresh amnions, X ²= 27.995, P = 0.000; preserved amnions, X ² =33.610, P = 0.000) . The same results were observed between those patients who were performed in different time periods after eye burns ( X ² = 4.243, P = 0.039) .

Conclusion: Fresh amnion has the same effect as preserved one for conjunctival surface reconstruction. The degree of symblepharon and the surgical environment of the ocular surface in the affected eye before surgery will influence the results of amniotic membrane transplantation for conjunctival surface reconstruction.

角膜缘的细胞，特别是角膜缘干细胞，对于维持角膜的透明和健康至关重要。基于影像技术对角膜缘进行高精度可视化评价是相关疾病诊疗的重要手段。眼科临床使用的裂隙灯显微镜、共聚焦显微镜、眼前节光学相干断层扫描仪(optical coherence tomography,OCT)等成像技术，因低分辨、低对比度、侵入性等原因，限制了其在角膜缘细胞结构及功能影像评估中的应用。本团队创新研发新型双模态全视场光学相干断层扫描仪(full-field OCT，FFOCT)，成功实现了无标记的角膜缘细胞级分辨率结构及功能成像。FFOCT基于空间非相干光平面干涉原理提取组织内部散射光，获得微米级分辨率三维结构成像；通过FFOCT原始相干信号的高时空分辨率采集及动态特征解析，实现源于活细胞新陈代谢运动的无标记细胞功能影像可视化。双模态FFOCT创新性地整合了高分辨率、无标记的结构及功能成像模态，不仅清晰获取角膜缘组织的高精结构特征如Vogt栅栏、角膜缘隐窝、血管壁等，同时还能捕捉不同角膜缘细胞内的代谢活性动态变化，无需使用外源荧光染料或标记剂，为角膜缘生物学及疾病机制研究提供全新细胞水平结构及功能成像方法，具有广泛应用前景。

角膜缘的细胞，特别是角膜缘干细胞，对于维持角膜的透明和健康至关重要。基于影像技术对角膜缘进行高精度可视化评价是相关疾病诊疗的重要手段。眼科临床使用的裂隙灯显微镜、共聚焦显微镜、眼前节光学相干断层扫描仪(optical coherence tomography,OCT)等成像技术，因低分辨、低对比度、侵入性等原因，限制了其在角膜缘细胞结构及功能影像评估中的应用。本团队创新研发新型双模态全视场光学相干断层扫描仪(full-field OCT，FFOCT)，成功实现了无标记的角膜缘细胞级分辨率结构及功能成像。FFOCT基于空间非相干光平面干涉原理提取组织内部散射光，获得微米级分辨率三维结构成像；通过FFOCT原始相干信号的高时空分辨率采集及动态特征解析，实现源于活细胞新陈代谢运动的无标记细胞功能影像可视化。双模态FFOCT创新性地整合了高分辨率、无标记的结构及功能成像模态，不仅清晰获取角膜缘组织的高精结构特征如Vogt栅栏、角膜缘隐窝、血管壁等，同时还能捕捉不同角膜缘细胞内的代谢活性动态变化，无需使用外源荧光染料或标记剂，为角膜缘生物学及疾病机制研究提供全新细胞水平结构及功能成像方法，具有广泛应用前景。

目的：获取眼表图像的综合信息，建立眼表疾病综合诊断和评估。方法：将超高分辨率光学相干断层成像仪(ultra-high resolution optical coherence tomography，UHR-OCT)与基于裂隙灯生物显微镜的微血管成像系统相结合，开发了一种多模态、非接触式的眼科光学成像平台。结果：UHR-OCT模块在组织中实现轴向分辨率约为2 μm 。眼表微血管成像模块在最大放大倍率下横向分辨率约为3.5 μm。通过集成在裂隙灯显微镜成像光学路径的不同模块，多模态成像平台能够执行实时前段OCT结构成像、结膜微血管成像和传统裂隙灯成像功能。利用自主开发的软件，进一步分析结膜血管网络图像和血流图像，获取血管分形维数、血流速度、血管直径等定量形态学和血流动力学参数。结论：通过在健康受试者和角膜炎患者的在体成像测试，表明多模态眼前段成像设备可为眼科临床应用及人工智能提供结构和功能信息数据。

Objective: To obtain the comprehensive information of the anterior eye image, establish complementary information for the diagnosis and evaluation of ocular diseases. Methods: We developed a multi-modal, non-invasive optical imaging platform by combining ultra-high resolution optical coherence tomography (UHR-OCT) with a microvascular imaging system based on slit-lamp biomicroscopy. Results: The uHR-OCT module achieved an axial resolution of approximately 2 μm in tissues. The lateral resolution of the ocular surface microvascular imaging module under maximum magnification was approximately 3.5 μm. By combining the imaging optical paths of different modules, the customized multi-modal eye imaging platform was capable of performing real-time cross-sectional UHR-OCT imaging of the anterior eye, conjunctival vessel network imaging, high-resolution conjunctival blood flow videography, and traditional slit-lamp imaging on a single device. With self-developed software, a conjunctival vessel network image and blood flow videography were further analyzed to acquire quantitative morphological and hemodynamics parameters, including vessel fractal dimensions, blood flow velocity and vessel diameters. Conclusion: The ability of the multi-modal anterior eye imager to provide both structural and functional information for ophthalmic clinical applications can be demonstrated in a healthy human subject and a keratitis patient.

目的：分析人眼的睑板腺形态学特征，探索睑板腺分析系统在眼表疾病的应用研究。方法：中山眼科中心入组正常受试者24例(42眼)，进行睑板腺红外摄影。选取受试者中的10例(20眼)在同型号的设备上由二名操作员分别进行睑板腺红外摄影。图像通过自行设计的分析软件对上睑结膜中央5条腺体形态学参数进行定量分析，对数据进行重复性测试。结果：测量的生物参数腺体直径为(0.48±0.09) mm，腺体长度为(5.25±0.68) mm，腺体面积为(2.12±0.53) mm，腺体形变系数为10.01±3.85，显影值为6.32±1.23，中央五条腺体占中央区域面积百分比为(10.94±2.20)%，腺体占上睑结膜面积百分比为(58.07±8.13)%。各指标两次测量值差异无统计学意义(P>0.05)。重复性分析结果显示：腺体各项生物参数的变异系数(coefficients of variation，CV)均小于5%，组内变异系数(intraclass correlation coefficient，ICC)均大于0.95。结论：睑板腺综合分析系统对腺体的形态学分析有良好的可靠性和一致性，有望为临床上对睑板腺腺体功能评估提供新的非侵入性参考指标。

Objective: To analyze the morphological characteristics of meibomian glands in human eyes and to explore the application research of meibomian glands analysis system in ocular surface diseases. Methods: A total of 24 healthy subjects were recruited by Zhongshan Ophthalmic Center to infrared photography of meibomian glands. Ten of healthy subjects were selected by the two operators for infrared photography of meibomian glands on the same model of equipment. The images were repeatedly measured and analyzed by the self-designed analysis software on the morphological measurements of the five glands in the center of the upper eyelid. Results: The measured biological parameters are shown below: the average gland diameter was (0.48±0.09) mm, the average gland length was (5.25±0.68) mm, the average gland area was (2.12±0.53) mm, the gland deformation coefficient was 10.01±3.85, the development value was 6.32±1.23, the percentage of the five central glands in the central area was (10.94±2.20)%, and the glands accounted for (58.07±8.13)% of the upper conjunctiva area. There was no statistical difference between the two measurements of each index (P>0.05). Repeatability analysis results showed that coefficients of variation (CV) of all biological parameters of glands were less than 5% and the intraclass correlation coefficient (ICC) in both groups were greater than 0.95. Conclusion: The Meibomian Gland Bioimage Analyzer provides good reliability and consistency for morphological measurements of the meibomian gland, and it is expected to provide new non-invasive indicators for clinical assessment of the meibomian glands function.

目的：针对活体共聚焦显微镜(in vivo confocal microscopy，IVCM)和传统光学相干层析技术(optical coherence tomography，OCT)在人眼角膜成像各自存在成像视野小或无法细胞成像的限制，开发具有高分辨率的非接触全视场光学相干层析系统(full-field optical coherence tomography，FFOCT)，实现活体人眼角膜细胞结构FFOCT成像。方法：FFOCT系统采用高数值孔径干燥显微物镜及高速面阵相机，使用双相位调制图像处理方法，实现系统高速高分辨率非接触成像。利用系统对健康人眼进行角膜各深度层的活体FFOCT成像验证其可行性。结果：本研究团队研发了FFOCT的新型活体人眼角膜高分辨率成像系统，实现理论平面成像分辨率1.7 μm，成像视野1.26 mm×1.26 mm，成像速率达275帧/s。利用该系统对正常活体人眼角膜成像实验，在非接触情况下获取了角膜各主要结构层的高分辨率结构影像。结论：FFOCT高分辨率活体人眼角膜成像系统兼具了传统OCT的非接触、大成像视野及IVCM的细胞级别平面分辨率的优势，将为角膜疾病的研究及临床诊疗提供全新的成像分析技术。

Objective: Due to the limitations of small imaging field of view of in vivo confocal microscopy (IVCM) or the incapability of cellular imaging of traditional optical coherence tomography (OCT) in human corneal imaging, this study was designed to develop a novel high-resolution in vivo human corneal imaging system based on full-field OCT (FFOCT). Methods: The FFOCT system utilized a high numerical aperture air immersion microscope objective and a high-speed area array CMOS camera with two-phase modulation image processing algorithm to achieve high-speed high-resolution non-contact imaging of human cornea. To verify its feasibility, in vivo cornea imaging at different depth was performed on a healthy human subject. Results: The FFOCT system achieved a theoretical lateral imaging resolution of 1.7 μm, an imaging field of view of 1.26 mm×1.26 mm, and an imaging rate of 275 Hz/s. High-resolution FFOCT images of the main structural layers of cornea were achieved by imaging a healthy human cornea in vivo with this system in a non-contact way. Conclusion: The FFOCT human corneal imaging system combines the advantages of the non-contractness and the large imaging field of view of traditional OCT with the cellular lateral resolution of IVCM, potentially providing a new imaging system for the research and clinical diagnosis and treatment of corneal diseases.

目的：对视网膜光学相干断层扫描图像中不同层和积液区域的分割。方法：提出一种基于深度学习的轻量级的神经网络，参考DRUNet体系、膨胀卷积和残差网络的架构，通过连接不同深度网络处得到的上采样输出，进行多尺度特征融合，使网络能够更好地识别出图像中的边界信息。结果：改进型DRUNet显著提升了视网膜分层的效果，准确率较U-Net提高了1.25%，同时能提前1~2次迭代达到传统U-Net的准确度。结论：本文采用的网络结构提高了对视网膜光学相干断层扫描图像的分割性能，同时降低了网络参数，具有强大的应用潜力。

Objective: To achieve the segmentation of different layers and fluid areas on the optical coherence tomography (OCT) image of the retina. Methods: A lightweight neural network based on deep learning was proposed. The network structure adopted in this study was designed based on the architecture of dilated-residual U-Net. By connecting the upsampling output obtained at different depth networks, multi-scale feature fusion was performed to enable the system to accurately identify the boundaries on the OCT image. Results: Compared with U-Net, this algorithm could achieve the same accuracy with 1–2 epochs less, and the accuracy was also improved by 1.25%. Conclusion: The proposed network improves the segmentation performance of retinal OCT images, and reduces the number of parameters, which demonstrates the network has great application potential.