目的：探讨正常眼压性青光眼(normal tension glaucoma，NTG)患者睡眠体位与其双眼不对称损害的关系。方法：纳入2014年1月至2018年9月在温州青光眼进展研究(Wenzhou Glaucoma Progression Study，WGPS)项目中的NTG患者。眼部主要检查有视野和光学相干断层扫描(optical coherence tomography，OCT)。睡眠体位数据通过基线睡眠体位问卷获得。根据侧卧位睡眠偏好，将NTG患者眼部参数分为卧位高侧眼和卧位低侧眼进行讨论；根据双眼不对称损害，将患者眼部参数分为较好眼和较差眼讨论。双眼不对称损害定义为双眼视野平均偏差(mean deviation，MD)差值>6 dB或杯盘比差值>0.2。结果：共纳入158例NTG患者，最长随访时间为48个月，其中122例(77.22%)患者存在睡眠偏好；存在睡眠偏好的患者中，83例(68.03%)患者存在侧卧位偏好；存在侧卧位偏好的患者中，大多数患者偏好右侧卧位[右vs左：59 (71.1%) vs 24 (28.9%)，P<0.001]。对存在侧卧位偏好的患者进行分析，发现卧位高侧眼与卧位低侧眼眼部参数之间，差异无统计学意义(P>0.05)；卧位低侧眼的视野进展速率[视野指数(visual field index，VFI)、MD]慢于卧位高侧眼(0.48%±1.66%/年 vs ?0.45%±3.07%/年；0.54±0.96 dB/年 vs 0.2±1.15 dB/年)，差异无统计学意义(P=0.086，P=0.308)。对同时存在侧卧位偏好及双眼不对称损害的患者进行分析，发现卧位高侧眼与卧位低侧眼的眼部参数之间，差异无统计学意义(P>0.05)；卧位低侧较好眼的个数及占比高于卧位低侧较坏眼[23 (57.5%) vs 17(42.5%)]，但差异无统计学意义(P=0.132)；卧位低侧眼的视野进展速率(VFI、MD)也慢于卧位高侧眼(1.19%±1.65%/年 vs ?0.86%±3.65%/年；0.71±1.13 dB/年 vs0.13 dB/年)，但差异无统计学意义(P=0.064，P=0.419)。结论：存在睡眠体位偏好的NTG患者中，约68%存在侧卧位偏好；存在侧卧位偏好的患者中，约70%偏好右侧卧位。但本研究并未发现睡眠体位与青光眼患者双眼不对称损害及其疾病进展存在相关性。

Objective: To investigate the association between lateral decubitus position (LDP) and asymmetric loss in normal tension glaucoma (NTG) patients. Methods: NTG patients were enrolled from Wenzhou Glaucoma Progression Study (WGPS) in Jan. 2014 to Sep. 2018. The main eye examinations included visual field test and optical coherence tomography (OCT). A questionnaire to determine the preferred sleeping position was administered to each patient in the baseline. According to the LDP, the eye parameters were divided into non-dependent eyes(higher lateral eyes) and dependent eyes (lower lateral position eyes) for discussion. According to the asymmetric damage, the ocular parameters of the patients were divided into the better eyes and the worse eyes for analysis.Asymmetric loss was defined as a difference in mean deviation (MD) between the 2 eyes of at least 6 dB or disc/cup >0.2. Results: One hundred and twenty-two patients (77.22%) had sleep preferences among the 158 NTG patients who was finally recruited and the longest follow up time was 48 months. Among the patients with sleep preference, 83 patients (68.03%) preferred the lateral decubitus position. Patients who had the lateral decubitus position mostly preferred the right lateral position [59 (71.1%) vs 24 (28.9%), P<0.001]. For patients who had the lateral decubitus position, the ocular parameters between the dependent eyes and the non-dependent eyes had no statistical difference(P>0.05); the rate of visual field progression in the dependent eyes was slower than that in non-dependent eyes, but there was no statistical difference between the two groups (0.48%±1.66%/year vs ?0.45%±3.07%/year; 0.54±0.96 dB/year vs 0.2±1.15 dB/year; P=0.086, P=0.308, respectively). For patients who had the lateral decubitus position and asymmetric damage, the ocular parameters between the dependent eyes and the non-dependent eyes had also no statistical difference (P>0.05); the number and ratio of the dependent-better eye and the dependent-worse eye were 48 and 41, respectively [23 (57.5%) vs 17 (42.5%), P=0.132]; the rate of visual field progression in the dependent eyes was also lower than that in non-dependent eyes, but there was no statistical difference between the two groups (1.19%±1.65%/year vs ?0.86%±3.65%/year; 0.71±1.13 dB/year vs 0.13 dB/year; P=0.064, P=0.419 respectively). Conclusion: About 68% of NTG patients with sleep preferences preferred the lateral decubitus position; and about 70% of patients with the lateral decubitus position preferred the right side sleeping. However, this study did not find a correlation between lateral decubitus position and asymmetric visual field loss.

目的：应用彩色多普勒超声造影检查测定不同类型原发性青光眼患者的视神经血液供应情况，探讨血流变化与青光眼的关系。方法：选取2012年1 2月至2014年3月在哈尔滨医科大学附属第二医院眼科经临床确诊的原发性闭角型青光眼(primary angle closure glaucoma，PACG)患者16例(20只眼)和原发性开角型青光眼(primary open angle glaucoma，POAG)患者8例(10只眼)，分别设为PACG组和POAG组；同时，选取1 0例1 0只正常眼设为对照组。所有受试者分别行彩色多普勒及超声造影检查，观察眼动脉(ophthalmic artery，OA)、视网膜中央动脉(central retinal artery，CRA)、睫后短动脉(short posterior ciliary artery，SPCA)的血流动力学指标，包括收缩期最大血流速度(peak systolic velocity，PSV)、舒张末期血流峰值速度(diastolic peak velocity,EDV)、血流阻力指数(resistance index，RI)、造影剂到达时间(arrival time，AT)及消退时间(departure time，DT)等指标，并对结果进行统计学分析。结果：超声造影测定POAG组的眼动脉造影剂AT较正常对照组延长(P=0.035)，PACG组及POAG组的眼动脉造影剂DT均较正常对照组延长(P=0.010)；彩色多普勒测定PACG组及POAG组的OA和SPCA，以及POAG组的CRA的PSV、EDV均较正常对照组减低(P=0.003)；同时，PACG组及POAG组的OA以及POAG组的CRA的RI较正常对照组增高(P<0.001)。结论：彩色多普勒及超声造影可以检测青光眼患者的眼部血供明显低于正常人群，为临床诊治青光眼及评价眼部疾病患者的眼部血供状态提供了一种新的技术手段。

Objective: This study used Doppler imaging and contrast-enhanced ultrasound to measure ocular haemodynamic of patients with primary angle-closure glaucoma (PACG) and primary open-angle glaucoma (POAG), to investigate the association between the blood flow changes and glaucoma. Methods: Doppler imaging and contrast-enhanced ultrasound were performed on 16 PACG patients (20 eyes, PACG group), 8 POAG patients(10 eyes, POAG group) who were diagnosed in the Department of Ophthalmology, the Second Affiliated Hospital of Harbin Medical University from Dec. 2012 to Mar. 2014. The normal eyes from 10 persons were selected as control group. The flow velocity of ophthalmic artery, central retinal artery, and posterior ciliary artery were observed, including the peak systolic velocity, diastolic peak velocity, resistance index, and the arrival time and departure time of the ultrasound microbubbles (SonoVue). Results: Compared to control group, the arrival timeof the ultrasound microbubbles (SonoVue) of ophthalmic artery of patients with POAG increased (P=0.035),and the departure time of ophthalmic artery of patients with PACG and POAG increased (P=0.010). Both peak systolic velocity and diastolic peak velocity of the ophthalmic artery and short posterior ciliary artery of patients with PACG and POAG and the central retinal artery of patients with POAG decreased (P=0.003). Meanwhile, the resistance index of ophthalmic artery of patients with PACG and POAG and the central retinal artery of patients with POAG were higher than those in the control group (P<0.001). Conclusion: The flow velocity of ocular vascular was worse than that of normal group respectively. This study provides a new technology for the diagnosis of glaucoma and the evaluation of the flow velocity of ocular vascular.

视神经炎(optic neuritis,ON)是指视神经的炎性脱髓鞘病变，是引起中青年人视力下降的主要原因。近年来，髓鞘少突胶质细胞糖蛋白抗体阳性视神经炎(myelin oligodendrocyte glycoprotein antibody-positive ON,MOG-ON)成为神经眼科领域的研究热点，国内外报道不断增加。2021年3月，中华医学会眼科学分会神经眼科学组制定了《中国脱髓鞘性视神经炎诊断和治疗循证指南(2021年)》，将MOG-ON作为新的视神经炎亚型纳入脱髓鞘性视神经炎的诊疗体系，给广大眼科医生提供了新的参考依据。因此，临床医生需要充分认识MOG抗体相关疾病和MOG-ON的临床特征和治疗进展，努力提高其诊断和治疗水平，使此类患者能够得到更多的获益，造福于更多的视神经疾病患者。

Optic neuritis(ON)is an inflammatory demyelinating disease of the optic nerve, which is the main cause of vision loss in young and middle-aged people. In recent years, myelin oligodendrocyte glycoprotein antibody-positive ON(MOG-ON)has become a research hotspot in the field of neuro-ophthalmology, and reports at home and abroad are increasing.In March 2021, the Neuro-ophthalmology Group of Ophthalmology Branch of Chinese Medical Association formulated the Evidence-Based Guidelines for the Diagnosis and Treatment of Demyelinating Optic Neuritis in China(2021) , and included MOG-ON as a new optic neuritis subtype in the diagnosis and treatment system of myelinating optic neuritis providing a new reference for the majority of ophthalmologists. Therefore, clinicians need to fully understand the clinical features and treatment progress of MOG antibody-related diseases and MOG-ON, and strive to improve the level of diagnosis and treatment, so that such patients can get more benefits and benefit more patients with optic nerve diseases.

非器质性视力下降也称为心因性或功能性视力下降，除视力下降外，还可伴有视野缺损，多由于精神心理疾患导致的转换障碍引起，部分患者为诈病以获取利益。本文报道1例6岁的女性患者，主诉双眼反复视力下降1年余，早期被误诊为儿童视神经炎，给予糖皮质激素冲击治疗，治疗后稍有好转。通过本例患者误诊的教训，提醒我们在遇到儿童出现不明原因的视力下降时，在没有明确器质性疾病证据时要想到非器质性视力下降的可能，掌握识别非器质性视力下降的检查方法，不能忽略相对性传入性瞳孔障碍等基础的神经眼科检查。

Non-organic vision loss is also known as psychogenic or functional vision loss. In addition to vision loss, it can also be accompanied by visual field defect. It is mostly caused by conversion obstacles caused by mental and psychological diseases. Some patients cheat to obtain benefits. This paper reports a 6-year-old female patient who complained of repeated visual acuity decline for more than one year. She was misdiagnosed as pediatric optic neuritis in the early stage and was treated with glucocorticoid shock therapy, which her condition improved slightly after treatment. The misdiagnosis of this patient teaches us that when children have unexplained visual acuity decline, we should think of the possibility of non-organic visual acuity decline when there is no clear evidence of organic diseases, master the examination methods to identify non-organic visual acuity decline, and cannot ignore the basic neuro-ophthalmic examination such as relative afferent pupillary defect (RAPD).

视神经脊髓炎相关性视神经炎(neuromyelitis optica spectrum disorder optic neuritis，NMO-ON)是一种常见的视神经炎(optic neuritis，ON)类型。女性非白种人占优势，损伤严重，双侧受累较多，视力预后差。我国有很大部分特发性ON最终诊断为NMO-ON。在相关实验室、光学相干断层扫描(optical coherence tomography，OCT)、磁共振(magnetic resonance imaging，MRI)等技术支持下，目前对NMO-ON的认识有了很大的进步，治疗方式除了皮质类固醇外还有免疫球蛋白、血浆置换及免疫抑制剂等。但提高NMO-ON的诊疗水平还有很长的路，更好地认识NMO-ON有助于更快速的诊断、更规范的治疗、更良好的预后。我们可以联合神经科开展多中心大样本量前瞻性的临床对照研究。

Neuromyelitis optica spectrum disorder- optic neuritis (NMO-ON) is a common type of optic neuritis (ON). This affliction is predominant in female non-Caucasians, with severe injury, more bilateral involvement, and poor visual prognosis. In China, a large proportion of idiopathic ON is ultimately diagnosed as NMO-ON. Our understanding of NMO-ON has made great progress under the technical support, such as the relevant laboratory, optical coherence tomography (OCT), magnetic resonance imaging (MRI). In addition to corticosteroids, immunoglobulin, plasmapheresis and immunosuppressive agents are also available for treatment. However, there is still a long way to improve the diagnosis and treatment level of NMO-ON. A better understanding of NMO-ON contributes to faster diagnosis, more standardized treatment, and better prognosis. We should cooperate with the neurology department to conduct a multi-center, large sample size prospective clinical control study.

目的：探讨外伤性视神经病变(traumatic optic neuropathy，TON)患者内镜下经蝶筛径路视神经管减压术(endoscopic trans-ethmosphenoid optic canal decompression，ETOCD)的整体护理。方法：选取中山大学中山眼科中心2020年1月至2021年3月收治的80例TON患者，回顾总结患者 ETOCD期间的护理措施及手术疗效。结果：所有患者经过综合护理后均顺利完成手术，未发生感染，出血、疼痛情况经治疗和护理后均改善，68.8%患者术后视力有提高。结论：针对TON患者ETOCD的特点，采取个体化的整体护理具有重要意义，有利于帮助患者顺利完成手术，降低并发症的发生率，促进患者康复。

Objective: To investigate the holistic nursing care of patients with traumatic optic neuropathy undergoing endoscopic trans-ethmosphenoid optic canal decompression (ETOCD). Methods: A total of 80 patients with traumatic optic neuropathy admitted to Zhongshan Ophthalmology Center of Sun Yat-sen University from Jan 2020 to Mar 2021 were selected as the subjects, and the nursing measures and surgical effect during ETOCD were reviewed and summarized. Results: All 80 surgical patients successfully completed the operation after comprehensive nursing without infection. The bleeding and pain were improved after treatment and nursing, and 68.8% patients presented with vision improvement. Conclusion: According to the characteristics of ETOCD in patients with traumatic optic neuropathy, it is of great significance to take individualized overall care, which is beneficial to help patients successfully complete the operation, reduce the incidence of complications, and promote the recovery of the patient’s healthy.

视神经脊髓炎谱系疾病(neuromyelitis optica spectrum disorders，NMOSD)是一种中枢神经系统炎性脱髓鞘性疾病，以视神经、脊髓和大脑受累为主要特征，该疾病易复发且致盲、致残率高，严重威胁人类视力和健康。目前NMOSD病因尚不明确，现有治疗方案也无法彻底治愈NMOSD，而动物模型是探索其发病机制与病理生理特点的重要工具。NMOSD动物模型主要建立在抗水通道蛋白4抗体(anti-aquaporin 4 immunoglobulin G，AQP4-IgG)致病基础上，主要包括破坏或绕过血脑屏障(blood brain barrier，BBB)被动转移AQP4-IgG或AQP4特异性T细胞等，目前还没有一种动物模型可以完整模拟人类NMOSD的临床和病理特征，因此在研究中选择合适的动物模型对相关研究至关重要。

Neuromyelitis optica spectrum disorders (NMOSD) is an inflammatory demyelinating disease of the central nervous system. It is mainly characterized by the involvement of the optic nerve, spinal cord and brain. The disease is prone to relapse and has a high rate of blindness and disability, which seriously threatens human vision and health. At present, the etiology of NMSOD is not clear, and the existing treatment schemes can’t completely cure NMOSD. Animal models are important tools to explore its pathogenesis and pathophysiological characteristics. NMOSD animals were mainly established on the basis of anti-aquaporin 4 immunoglobulin G (AQP4-IgG), including destroying or bypassing the blood-brain barrier and passively transferring AQP4-IgG or AQP4 specific T cells. At present, no animal model can completely simulate the clinical and pathological characteristics of human NMOSD. Therefore, it is important to select appropriate animal models for the study. This article reviews various animal models of NMOSD in recent years, and discusses the advantages and disadvantages of various models, in order to provide references for the study of the progress and treatment of NMOSD.