目的：探索采用一眼眼罩联合另一眼眼垫的改良包眼方式对斜视患者双眼矫正术后恢复期生活质量及焦虑情绪的影响。 方法：于2024年9—10月在中山大学中山眼科中心招募日间手术接受双眼斜视矫正术的患者80例，按入院时间单双周分为联合眼罩组和眼垫组，每组各40例。联合眼罩组在手术肌肉少的眼睛或主导眼佩戴多小孔塑料眼罩，另一眼用眼垫包眼；眼垫组采用双眼眼垫包眼。主要结局指标为术后1 d的视功能相关生活质量。次要结局指标包括术后1 d的睡眠评分、疼痛评分、球结膜充血水肿、切口外观及术后1周患者满意度。 结果：两组患者在性别、年龄、术前斜视情况和斜视手术肌肉条数等基线特征分布的差异无统计学意义（P>0.05）。联合眼罩组术后1 d视功能相关生活质量、睡眠和术后1周患者满意度均优于眼垫组，差异具有统计学意义（P＜0.05）。两组患者在术后1 d疼痛程度、球结膜充血、切口外观、斜视改善程度的比较，差异无统计学意义（P＞0.05）；结论：斜视双眼矫正术后采用一眼眼罩联合一眼眼垫遮盖的方式，在保证术后恢复效果的同时，能够有效改善患者术后视功能相关生活质量和睡眠质量，并提升患者满意度。
Objective:To investigate the effects of a modified eye-patching technique, which combines the use of an eye shield on one eye and an eye patch on the other, on the quality of life and anxiety levels of strabismus patients during the recovery period after binocular correction surgery. Methods: A total of 80 patients who underwent bilateral strabismus correction as day surgery at our hospital between September and October 2024 were recruited for this study. Based on whether their admission week was odd or even, they were randomly assigned to two groups: the combined patching group (n=40) and the conventional patching group (n=40). In the combined patching group, patients wore a multiple-aperture plastic eye shield on the eye with fewer operated muscles or the dominant eye, while the other eye was covered with a conventional eye patch. In the conventional patching group, patients received bilateral eye patches. The primary outcome measure was vision-related quality of life on the first postoperative day. Secondary outcomes included the sleep quality score, pain score, conjunctival hyperemia and edema, incision appearance on the first postoperative day, and patient satisfaction one week after surgery. Results: There were no statistically significant differences in baseline characteristics, such as gender, age, preoperative strabismus status, or the number of operated muscles, between the two groups. Compared to the conventional patching group showed significantly better vision-related quality of life and sleep quality on the first postoperative day, as well as higher patient satisfaction one week after surgery (P< 0.05). On the first postoperative day, there were no significant differences between the two groups in pain level, conjunctival hyperemia, incision appearance, or degree of strabismus improvement (P > 0.05). Conclusions: The application of a modified eye-covering method, which combines an eye shield on one eye and an eye patch on the other, after bilateral strabismus correction surgery, can effectively enhance postoperative vision-related quality of life and sleep quality. Moreover, it can maintain recovery outcomes and increase patient satisfaction. This approach holds clinical value and is worthy of wider promotion.
全眼球移植（Whole eye transplantation, WET）是治疗因外伤、肿瘤等导致眼球不可逆损伤及永久性失明的潜在终极手段。其核心不仅在于实现眼球解剖结构的完整移植，更关键的是实现功能性视觉恢复，关键挑战包括优化手术策略重建眼球血液循环，实现供体视神经与受体视觉中枢的神经连接，建立精准有效的免疫调控策略以平衡移植耐受与感染风险。本文系统梳理了WET领域的研究进展与发展挑战。早期研究以变温动物模型为主，这些模型在一定程度上证实了视觉通路在眼球移植后仍具有一定的可塑性，但由于其眼球结构与人类存在显著解剖差异，且实验设计中未涉及精细的血管与神经吻合，因而临床转化价值有限。随着显微血管技术的发展，哺乳动物模型及人眼球移植的初步探索在显微外科血管吻合技术方面取得重要突破，实现了移植眼球视网膜血液灌注的短期重建，但仍面临视神经再生障碍和功能维持难题。当前的研究瓶颈主要集中在三个方面：血液循环重建技术优化、神经轴突精准再生及免疫微环境调控。建立与人类接近的标准化非人灵长类动物模型，并开展系统性的实验研究，将为克服现有技术障碍、推动WET走向临床提供至关重要的实验依据和新思路。
Whole eye transplantation (WET) is a potential definitive treatment for irreversible ocular damage and permanent blindness caused by conditions like trauma or tumors. The success of WET depends not only on the complete anatomical restoration of the transplanted eye but, more critically, on the recovery of functional vision. Key challenges in this field include optimizing surgical strategies to re-establish ocular blood circulation, achieving functional neural integration between the donor optic nerve and the recipient's visual centers, and developing precise and effective immunomodulation strategies to strike a balance transplant tolerance and infection risk. This review provides a systematic review of the research progress and developmental challenges in the field of WET. Early studies primarily utilized poikilothermic animal models, which demonstrated a certain degree of plasticity in the visual pathway following transplantation. However, due to significant anatomical differences compared to humans and the lack of sophisticated vascular and neural anastomosis in experimental designs, their clinical translatability of these studies remained constrained. With the progress in microvascular techniques, preliminary explorations in mammalian models and human eye transplantation have achieved significant breakthroughs in microsurgical vascular anastomosis, enabling the short-term reestablishment of retinal blood perfusion in transplanted eyes. Nonetheless, perisitent obstacles include inadequate optic nerve regeneration and poor long-term functional maintenance. Currently, research bottlenecks mainly focus on three aspects: optimizing surgical techniques for blood circulation reconstruction, precisely regenerating nerve axons, and regulating the immune microenvironment. Establishing standardized non-human primate models that closely mimic humans and conducting systematic experimental studies will furnish crucial evidence and novel insights to overcome existing technical hurdles and propel WET toward clinical application.
目的：评估显微射频消融术治疗异位睫毛的临床疗效和安全性。方法：回顾性分析接受显微射频消融术治疗的18例异位睫毛患者资料，均采用美国Ellman公司Surgitron射频刀进行治疗，术后随访至少3个月。观察指标包括异位睫毛清除率、达到治愈所需治疗次数、并发症、患者满意度。采用Spearman等级相关分析评估患者基线特征与治疗次数的相关性。结果：共纳入18例患者30眼。显微射频消融术的术后即刻异位睫毛清除率达100%。5眼（16.7%）经单次治疗后达到治愈，11眼（36.7%）需要2次治疗达到治愈，13眼（43.3%）需要3次治疗达到治愈，1眼（3.3%）需要3次以上治疗达到治愈。主要并发症包括干眼13眼（43.3%）、睑缘炎症1眼（3.3%），未发现睑缘畸形、瘢痕等严重并发症。患者满意度调查显示非常满意16例（88.9%），基本满意2例（11.1%），总体满意度（非常满意+基本满意）达100%。相关性分析提示倒睫数量与达到治愈的治疗次数呈显著正相关（rs=0.672, P=0.002）。结论：显微射频消融术治疗异位睫毛具有精确定位、有效破坏毛囊、治疗时间短、创伤小、恢复快、安全性高等优点，患者满意度高，是治疗异位睫毛的有效方法。
Objective: To evaluate the clinical efficacy and safety of microscopic radiofrequency ablation in treating of distichiasis and aberrant lashes. Methods: We performed a retrospective analysis on 18 patients with trichiasis (distichiasis and aberrant lashes) who underwent microscopic radiofrequency ablation treatment. All patients were followed up for a minimum of 3 months after the operation. The outcome measures included trichiasis clearance rate, the number of treatment sessions needed to achieve success, complications, and patient satisfaction. Spearman rank correlation analysis was used to evaluate the correlation between the baseline characteristics of patients and the number of treatment sessions. Results: The study included 18 patients with a total of 30 eyes. Immediately after the operation, the trichiasis clearance rate achieved through microscopic radiofrequency ablation was 100%. Among the eyes, 5 eyes (16.7%) were successful treatment after just one session, 11 eyes (36.7%) required 2 treatment sessions, 13 eyes (43.3%) needed 3 treatment sessions, and 1 eye (3.3%) required more than 3 treatment sessions to achieve success. The major complications included dry eye in 13 cases (43.3%) and eyelid margin inflammation in 1 case (3.3%). Notably, no severe complications such as eyelid deformity or scarring were observed. According to the patient satisfaction survey, 16 cases (88.9%) reported being very satisfied, and 2 cases (11.1%) were basically satisfied, resulting in an overall satisfaction rate of 100%. The correlation analysis indicated that the number of trichiatic eyelashes was significantly positively correlated with the number of treatment sessions (rs=0.672, P=0.002). Conclusions: Microscopic radiofrequency ablation for distichiasis and aberrant lashes treatment boasts serveral advantages, including precise localization, effective destruction of hair follicle, short treatment duration, minimal trauma, rapid recovery, and high safety. With a high level of patient satisfaction, it serves as an effective treatment method for distichiasis and aberrant lashes.
目的：调查新疆喀什地区英吉沙县芒辛镇60岁及以上老年人群眼底疾病患病率及其分布特征，分析该地区眼底疾病流行病学现状，为西部高海拔地区眼底疾病防控策略制定和基层眼健康服务体系建设提供科学依据和数据支撑。方法：采用横断面研究设计，于2024年5—6月对芒辛镇60岁及以上常住人口进行调查。纳入标准为年龄≥60岁、在当地连续居住≥6个月、自愿参与并签署知情同意书者。=采用标准化眼科检查包括视力测定、眼压、裂隙灯显微镜检查、眼底照相等，同时进行结构化问卷调查收集基本信息、生命体征测量和实验室检查。眼底疾病诊断严格按照国内外相关诊断标准执行，采用SPSS24.0软件进行统计分析，计算各类眼底疾病患病率及其95%置信区间。结果：共调查1 310名老年人，响应率为76.76%。研究对象中男性669人（51.1%），女性641人（48.9%），平均年龄68.4±6.6岁。眼底疾病总患病率为16.1%（95% CI：14.2~18.0）。各类眼底疾病患病率依次为：年龄相关性黄斑变性5.9%（77例），视神经萎缩2.8%（36例），黄斑前膜2.3%（30例），糖尿病性视网膜病变1.8%（23例），其他黄斑病变1.07%（14例）、高血压性视网膜病变0.99%（13例）。其他眼底疾病包括高度近视眼底改变、视网膜色素变性、黄斑裂孔、血管炎、视网膜出血等，患病率均低于0.38%。在糖尿病患者中，糖尿病性视网膜病变患病率为20.8%，与国内外相关研究结果基本一致。结论：新疆芒辛镇老年人群眼底疾病患病率较高，年龄相关性黄斑变性是最主要的眼底疾病类型。研究结果填补了西部高海拔地区眼底疾病流行病学数据空白，提示应建立针对性的分层筛查和防控体系，重点关注老年人的眼底健康管理，推广便携式眼底照相结合远程医疗的筛查模式，提升基层眼健康服务的可及性与质量。
Objective: To investigate the prevalence and distribution characteristics of fundus diseases among the elderly population aged 60 and above in Mangxin Town, Yengisar County, Kashgar Prefecture, Xinjiang, and to analyze the epidemiological status of fundus diseases in this region, thereby providing a scientific basis and data support for the development of fundus disease prevention and control strategies and the construction of a primary eye health service system in high-altitude areas of Western China. Methods: A cross-sectional study was conducted from May to June 2024 among the permanent residents aged 60 and above in Mangxin Town. Inclusion criteria were age ≥ 60 years, local residence for ≥ 6 months, and voluntary participation with signed informed consent. Data were collected through standardized ophthalmological examinations (including visual acuity testing, intraocular pressure measurement, slit-lamp microscopy, and fundus photography), structured questionnaire surveys, vital sign measurements, and laboratory tests. Diagnoses of fundus diseases were strictly based on domestic and international diagnostic criteria. Statistical analysis was performed using SPSS 24.0 to calculate the prevalence rates of various fundus diseases and their 95% confidence intervals. Results: A total of 1,310 elderly individuals were included, with a response rate of 76.76%. Among them, 669 (51.1%) were male and 641 (48.9%) were female, with a mean age of 68.4 ± 6.6 years. The overall prevalence of fundus diseases was 16.1% (95% CI: 14.2–18.0). The prevalence rates of specific fundus diseases were as follows: age-related macular degeneration, 5.9% (77 cases); optic atrophy, 2.8% (36 cases); epiretinal membrane, 2.3% (30 cases); diabetic retinopathy, 1.8% (23 cases); other macular diseases, 1.07% (14 cases); and hypertensive retinopathy, 0.99% (13 cases). Other fundus diseases, including high myopia-related fundus changes, retinitis pigmentosa, macular hole, vasculitis, and retinal hemorrhage, each had a prevalence of less than 0.38%. Among diabetic patients, the prevalence of diabetic retinopathy was 20.8%, which is consistent with previous domestic and international studies. Conclusions: The prevalence of fundus diseases among the elderly in Mangxin Town, Xinjiang, is relatively high, with age-related macular degeneration being the most common type. This study fills a gap in the epidemiological data on fundus diseases in high-altitude regions of Western China. The findings highlight the need to establish a targeted stratified screening and prevention system, strengthen fundus health management in the elderly, and promote a screening model combining portable fundus photography with telemedicine to improve the accessibility and quality of primary eye health services.
脂质运载蛋白2（LCN2/NGAL）是一种多效性分泌糖蛋白，通过调控铁代谢、炎症反应及细胞死亡（铁死亡、凋亡）等机制，广泛参与眼科疾病的病理进程。生理状态下，LCN2在角膜上皮、视网膜神经节细胞层等部位低表达；病理条件下，其表达显著上调且功能呈现高度背景依赖性。在各类眼科疾病（如干眼症、角膜疾病、葡萄膜炎、青光眼、视网膜疾病等）中，既可表现为促炎促凋亡的致病因子，亦能发挥抗炎保护作用。靶向调控LCN2表达或其下游通路可能为眼科疾病治疗提供新策略。
Lipocalin-2 (LCN2/NGAL) is a multifunctional secretory glycoprotein that plays a critical role in the pathogenesis of ophthalmic diseases by regulating iron metabolism, inflammatory responses, and cell death pathways (ferroptosis, apoptosis). Under physiological conditions, LCN2 is expressed at low levels in tissues such as the corneal epithelium and retinal ganglion cell layer. However, its expression is significantly upregulated under pathological conditions, exhibiting highly context-dependent functionality. In major ophthalmic diseases—including dry eye disease, corneal disorders, uveitis, glaucoma, and retinal diseases—LCN2 can act either as a pro-inflammatory and pro-apoptotic pathogenic factor or as an anti-inflammatory protective agent. Targeted modulation of LCN2 expression or its downstream pathways may offer novel therapeutic strategies for ocular diseases.
本文应用接触式和非接触式角膜内皮照相机对 4 例虹膜角膜内皮综合征（包括 2 例 Chandler's 综合征、1 例 Cogan-Reese 综合征和 1 例进行性实质性虹膜萎缩）作角膜内皮细胞观察照相研究。可见病眼角膜内皮细胞均有相同的病理性形态学改变，结合临床表现和病理学检查所见，提示这几种不同表现的病变有可能是具有相同发病学基础的同一种疾病，亦支待这一类病变的基本病因是角膜内皮细胞的异常增殖所致，而且健眼角膜内皮细胞亦可见有改变，说明双眼可受影响。本文对内皮细胞密度的变化、角膜内皮细胞异常增殖和神经嵴细胞分化学说作了讨论。
Clinical contact and non-contact specular microscopic examination in 4 patients with iridocorneal endothelial syndrome (including 2 cases of Chandler's syndrome, 1 case of Cogan-Reese syndrome and l case of essential iris atrophy) showed that the affected eyes had the same morphological changes. From the clinical and pathologic examinations, it is shown that this spectrum of syndrome may be the different manifestations of the same pathogenic disease and the basic pathogenic event is abnormal proliferation of the corneal endothelium that could also be seen in the contralateral eye.
本文介绍用韩氏二重 15 色相测试的 Farn-sworth 色相配列法应用于色觉检查，此法比其他临床常用的色觉检查具有色觉障碍分型和定量分析的优点， 同时方法简便易懂。本文报告应用此法于先天性色盲和继发性色盲患者，其红色盲、绿色盲、红绿色盲、蓝色 盲、全色盲等及不同色觉异常程度的变异的实例。
The application of Farnsworth dichotomous test for color blindness using Hahn Double 15-Hue is introduced. The advantages of this method compared with other clinical color tests are that it is simple and can classify the types of color defect and analyse the defect quantitatively. This method applied to the patients with congenital and acquired color blindness, such as prota-, deutera-and tritanopia, protano-, deuteranomalopia, achromatopia and abnormal extent of color defect is reported.
帕金森病（Parkinson’s disease, PD）作为仅次于阿尔茨海默病的第二大神经退行性疾病，其眼部表现近年来逐渐成为跨学科研究热点。以往医生多关注运动迟缓、静止性震颤和肌强直等PD典型症状，但大量临床研究表明，眼睑异常、眼球运动障碍、视觉功能异常等眼部表现不仅普遍存在于PD患者中，更可能在典型运动症状出现前就已显现。长期以来，这些眼部症状因其他症状的掩盖往往被忽视，进一步降低了患者的生活质量。本综述系统梳理PD患者眼部表现的三大方面：首先，眼睑异常方面，PD患者瞬目频率降低，61.1%患者出现干眼症状，导致PD患者的生活质量进一步下降。其次，眼球运动障碍表现为特征性的阶梯式方波急跳、集合功能减退以及反向扫视错误率增加，其中反向扫视潜伏期延长对步态冻结的发生具有预测价值。最后，视觉功能障碍方面，PD患者可出现视敏度下降、色觉异常、对比敏感度受损和视幻觉。影像学检查观察到视网膜神经节细胞层变薄，伴随视网膜微血管密度降低，这些结构性改变与PD患者的视觉功能障碍有关，作为生物标志物具有独特潜力。神经内科-眼科联合诊疗模式不仅有助于PD的早期诊断和预后评估，更有助于临床医生全面理解PD的疾病机制和表现，为未来诊疗策略的优化提供客观依据。
Parkinson’s disease (PD), the second most common neurodegenerative disorder after Alzheimer’s disease, has increasingly garnered interdisciplinary research attention due to its ocular manifestations. While the classical triad of motor symptoms—bradykinesia, resting tremor, and rigidity—remains the diagnostic hallmark, accumulating clinical evidence indicates that ocular abnormalities, including eyelid dysfunction, oculomotor disturbances, and visual impairments, are not only prevalent in PD patients but may also precede the onset of typical motor symptoms. Historically overlooked due to masking by other clinical features, these ocular manifestations contribute to the deterioration of patients' quality of life. This review systematically examines PD-related ocular abnormalities across three key domains: First, eyelid dysfunction manifests as reduced blink frequency, with 61.1% of PD patients reporting dry eye symptoms, further exacerbating their life quality impairment. Second, oculomotor disturbances are characterized by staircase-pattern square-wave jerks, convergence insufficiency, and increased error rates in antisaccade tasks, with prolonged antisaccade latency serving as a predictive marker for freezing of gait. Third, visual dysfunction encompasses diminished visual acuity, dyschromatopsia, impaired contrast sensitivity, and visual hallucinations. Imaging studies reveal structural alterations such as retinal ganglion cell layer thinning and reduced retinal microvascular density, which correlate with visual deficits and hold promise as potential biomarkers. The establishment of a neuro-ophthalmological collaborative framework not only facilitates early PD diagnosis and prognostic assessment but also enhances clinicians' comprehensive understanding of disease mechanisms. Such an approach provides an objective foundation for optimizing future therapeutic strategies.
目的：探讨蛋白A免疫吸附联合糖皮质激素治疗对MOG抗体相关视神经炎（MOG antibody-associated optic neuritis， MOG-ON）患者的临床疗效及安全性。方法：回顾性分析2022年6月—2024年12月在广东三九脑科医院神经内科确诊并接受蛋白A免疫吸附联合糖皮质激素治疗的7例MOG-ON患者。所有患者均接受蛋白A免疫吸附治疗（隔天1次，共5次为1个疗程）并同期联合糖皮质激素治疗。评估治疗前及治疗后3个月、6个月的视力变化、扩展伤残状态量表（expanded disability status scale，EDSS）评分变化及MOG抗体滴度变化，并记录不良反应。结果：治疗后6个月，6/7患者视力较治疗前改善，其中4/7视力改善显著。左眼LogMAR视力值从治疗前的0.20(0.14，0.70)改善至0.10(0.10，0.42)，右眼LogMAR视力值从0.30(0.19，0.47)改善至0.18(0.10，0.21)，EDSS视力评分从2.86±1.68降至1.43±1.51（P < 0.05）。治疗前血清MOG抗体滴度几何平均数为1:52.0（几何标准差GSD = 3.7），治疗后3个月降至1:8.8（GSD = 1.9）（P = 0.027），治疗后6个月降至1:13.0（GSD = 4.1）（P = 0.027）。7例患者共接受35次免疫吸附治疗，未观察到严重不良反应，仅有轻微可控的不良事件。结论：蛋白A免疫吸附联合糖皮质激素治疗能够有效降低血液中MOG抗体水平，改善MOG-ON患者的视力。
Objective: To investigate the clinical efficacy and safety of protein A immunoadsorption combined with glucocorticoid therapy in patients with myelin oligodendrocyte glycoprotein antibody-associated optic neuritis（MOG-ON）. Methods: A retrospective analysis was conducted on 7 patients with MOG-ON who were diagnosed and treated with protein A immunoadsorption combined with glucocorticoid therapy at the Department of Neurology，Guangdong Sanjiu Brain Hospital from June 2022 to December 2024. All patients underwent protein A immunoadsorption therapy （once every other day, with 5 sessions constituting one course） in conjunction with concurrent steroid therapy. Visual acuity changes, EDSS score changes, and MOG antibody titer changes were assessed before treatment, as well as at 3 and 6 months after treatment. Additionally, adverse events were meticulously recorded. Results: At the 6 months post-treatment mark, 6 patients （85.7%） demonstrated an improvement in visual acuity compared to their baseline levels, with 4 patients （57.1%） achieving a significant improvement. The median LogMAR visual acuity values in the left eye improved from 0.20(0.14,0.70) to 0.10(0.10,0.42), and in the right eye, they improved from 0.30(0.19,0.47) to 0.18(0.10,0.21). MeanWhile, the EDSS visual score decreased from 2.86±1.68 to 1.43±1.51（P < 0.05）. The geometric mean serum MOG antibody titer declined from 1:52.0（GSD = 3.7） before treatment to 1:8.8（GSD = 1.9） at 3 months after treatment（P = 0.027）, and further decreased to 1:13.0（GSD = 4.1） at 6 months after treatment（P = 0.027）. A total of 35 immunoadsorption sessions were administered to the 7 patients, and no serious adverse reactions were observed; only minor and manageable adverse events occurred. Conclusion: Protein A immunoadsorption combined with glucocorticoid therapy can effectively lower serum MOG antibody levels and enhance visual outcomes in patients with MOG-ON.
