数字眼科技术的蓬勃发展已经渗透于眼科各领域,并为眼科前沿技术研究带来了重大变革。文章对眼科前沿技术研究和发展进行综述,重点关注各项技术的突破和成果,聚焦国内的同时也放眼全球,阐明近年来全球数字眼科前沿技术现状和成果。如人工智能可运用于诸多疾病的精准监测、高发疾病的高效评估、远程医疗的技术支持等,提高了筛查、诊断、治疗等各环节的精确度和效率,减轻了医生的负担,展现了极大的应用潜能。其余各类技术方面,如数字成像技术也取得了飞跃式进展,在手术导航和影像诊断方面实现突破;3D建模技术和机器学习技术在手术设计和提高手术成功率方面立下汗马功劳,为世界各地的眼科疾病患者提供了更为高效、便捷的服务。此外,数字眼科技术还呈现出多元化发展的态势,与多学科协同交流,交叉运用。虽然诸多眼科前沿技术还处在发展初期,距离全覆盖实施仍有一定距离,在算法的准确性和可解释性、医疗伦理、民众接受度、医疗纠纷、临床技术挑战等问题上还存在很多不确定性。但毫无疑问的是,随着医学水平的日益提升,上述技术必会得到不断完善和普及。
The rapid evolution of digital ophthalmology technology has profoundly transformed various fields within ophthalmology. This article provides a comprehensive overview of the research and advancements in cutting-edge ophthalmology technologies, emphasizing both domestic and global breakthroughs and achievements. For instance, artificial intelligence has demonstrated remarkable potential in precise monitoring of various diseases, efficient assessment of high-prevalence conditions, and the technological support for telemedicine, thereby enhancing the accuracy and efficiency of screening, diagnosis, treatment processes, while alleviating the workload of medical professionals. Additionally, digital imaging technology has made significant strides in surgical navigation and diagnostic imaging, while 3D modeling and novel machine learning techniques have contributed to surgical planning and enhanced surgical success rates, ultimately delivering more efficient and convenient services to patients with eye diseases worldwide. Despite the diversified development trends and interdisciplinary collaborations that digital ophthalmology technology exhibits, many of these cutting-edge technology are still in their infancy, facing challenges in achieving high coverage, algorithm accuracy and interpretability, medical ethics, public acceptance, medical disputes, and clinical technical hurdles. Nonetheless, while the continuous advancement of medical standards, it is anticipated that these technologies will undergo further refinement and widespread adoption.
目的:研究调节抑制对不同单色光中豚鼠眼屈光发育的作用。方法:根据光照不同将豚鼠分成蓝光组(430 nm)、绿光组(530 nm)和白光组(色温5 000 K),每组各8只。各组豚鼠右眼均点1%阿托品滴眼液,每天1次,持续6周。实验前后各测一次屈光度、角膜曲率半径以及眼轴各参数。结果:实验前各组豚鼠双侧眼间及组间同侧眼屈光度差异无统计学意义(约4.25 D,P >0.05)。但实验结束时蓝光组和绿光组双侧眼间屈光度差异显著(P=0.0003和P=0.028),而白光组双侧眼间无显著差异(P=0.7486)。实验结束时各组左眼(P<0.05)、绿光组和白光组右眼(P=0.001)以及蓝光组和绿光组右眼(P <0.001)屈光差异有统计学意义。蓝光组和白光组右眼屈光差异无统计学意义( P =0.072)。实验开始时各组双侧眼间及各组间同侧眼玻璃体腔长度差异无统计学意义(约3.2 mm,P>0.05)。实验结束时,蓝光组和绿光组双侧眼间玻璃体腔长度差异有统计学意义(P=0.0017和P=0.0113),但白光组双侧眼间差异无统计学意义(P=0.9371)。同时,各组间同侧眼玻璃体腔长度差异有统计学意义(P<0.01)。此外,实验前后各组双侧眼间及组间同侧眼角膜曲率半径、前节长度、晶状体厚度差异无统计学意义(P>0.05)。结论:1%阿托品加强530 nm单色光促进豚鼠眼玻璃体腔延长和近视形成的作用,但减弱430 nm单色光抑制豚鼠眼玻璃体腔延长和远视形成的作用。眼调节反应可能参与了单色光中豚鼠眼的屈光发育机制。阿托品影响单色光中豚鼠眼屈光发育的作用可能是通过抑制眼调节反应实现的。
Objective: To investigate the effect of inhibiting accommodation on ocular refractive development of guinea pigs in different monochromatic lights. Methods: Twenty-four pigmented guinea pigs were randomly divided into three groups with 8 animals per group: short-wavelength light (SL, 430 nm) group, middle-wavelength light (ML,530 nm) group and broad-band light (BL, 5 000 K color temperature) group. The right eyes of all animals were treated by 1% Atropine solution once a day for 6 weeks. Measurements of ocular refraction, corneal curvature, and axial length were performed at the start and the end of the study. Results: There was no significant difference in bilateral ocular refraction for all groups at the beginning of the experiment (about 4.25 D, P>0.05) and in ipsilateral ocular refraction among groups at the start of the experiment (P>0.05). But at the end of the experiment,significant differences were detected between binocular refraction of the ML group (P=0.028) and the SL group (P=0.0003), however, there was no significant difference between bilateral refraction in the BL group (P=0.7486).There were significant differences in refraction between the left eyes of any two groups (P<0.05), between the right eyes of the ML and BL group (P=0.001), and between the right eyes of the ML and SL (P<0.001) at 6 weeks.No significant refractive difference was detected between the right eyes of the SL and BL groups (P=0.072). The vitreous length was about 3.2 mm in bilateral eyes of all groups at the onset of the experiment (all inner- or inter-group P>0.05). After the experiment, the bilateral difference in vitreous length was significant in the ML group(P=0.0113) and the SL group (P=0.0017), but not significant in the BL group (P=0.9371). There were significant vitreous differences in right or left eyes among the groups at the end of the experiment (P<0.01). There were no significant inter-group (ipsilateral) or inner-group (bilateral) differences at any time in any of corneal radius of curvature, anterior segment length and lens thickness (P>0.05 for all comparisons). Conclusion: 1% atropine can strengthen the effect of vitreous elongation and myopic formation on guinea pig eyes in 530 nm monochromatic light. Moreover, atropine can weaken the effect of vitreous shortening and hyperopic formation on guinea pig eyes in 430 nm monochromatic light. Ocular accommodation response should involve in the mechanism of refractive development of guinea pig in monochromatic light. Atropine can influence the refractive development of guinea pig in monochromatic light possibly by inhibiting accommodation response.