眉的对称和完整对外貌有重要影响，眼外伤常会造成眉毛皮肤缺损，较大缺损会形成皮肤疤痕和畸形，影响患者外貌。烟台市莱阳中心医院门诊急诊收住 1 例眉弓外 1/3 皮肤缺损，采用耳后游离皮片移植缺损处，皮片成活，对患者外貌无明显影响。

Eyebrow symmetry and integrity have important influence on appearance. Eye injury often causes eyebrow skin defect, and large defect can form skin scar and deformity, and affect the appearance of the patient. In the outpatient department of our hospital, one patient was admitted to the emergency department for one third of the skin defect. The graft defect of the free skin graft after ear was used, and the skin graft was not significantly affected by the appearance of the patients.

目的：评估逆行剥离法用于翼状胬肉切除联合球结膜瓣移植术的临床效果并总结手术经验。方法：回顾性收集 2013 年 11 月至 2017 年 10 月于中国人民解放军第 474 医院眼科中心手术的翼状胬肉切除患者 416 例（481只眼），均接受逆行剥离法翼状胬肉切除联合球结膜瓣移植术，观察胬肉剥离的连续性和评估角膜创面。结果：胬肉剥离一次性完成的有 438 只眼（91.06%），分次完成的有 43 只眼（8.94%）；角膜创面光滑的有 466 只眼（96.88%），胬肉残留的有 15 只眼（3.12%），无一例角膜基质层剥离损伤。结论：逆行剥离法翼状胬肉切除术是安全有效、简便易行的翼状胬肉手术，可替代顺行剥离法在翼状胬肉手术中的应用。

Objective: To evaluate the clinical efficacy of retrograde excision in the pterygium resection combined with conjunctival transplantation and summarize operation techniques. Methods: This study retrospectively analyzed 416 patients (481 eyes) with pterygium admitted to No. 474 Hospital of Chinese People’s Liberation Army from November 2013 to October 2017, who were treated by the retrograde pterygium resection combined with conjunctival transplantation. The degree of corneal injury and the success rate of pterygium disposable stripping were observed. Results: The success rate of pterygium disposable stripping was 91.06% (n=438), the corneal wound was smooth in 466 eyes (96.88%), residual pterygium were observed in 15 eyes (3.12%), and no severe corneal stromal inury was seen. Conclusion: The retrograde excision is better than the anterograde excision in pterygium resection combined with conjunctival transplantation. It is a safe, efficient and simple operation.

目的：探讨 miR-145-5p 调控视网膜 β-catenin 表达对小鼠眼轴的影响。方法：取 18 只雄性 3 周龄 C57BL/6 小鼠按照随机数字表法随机分成对照组，miR-145-5p mimics 组和 miR-145-5p 对照组。分组第 2 ，5 ，8 天双眼玻璃体腔注射 1 次药物，共注射 3 次 ：对照组小鼠玻璃体腔内注射 3 μL 枸橼酸盐缓冲液，miR-145-5p mimics 组小鼠玻璃体腔内注射 3 μL 含有 3 μg miR-145-5p mimics 的枸橼酸盐缓冲液，miR-145-5p 对照组采取同样方法注射 3 μg miR-145-5p 对照载体。最后一次注射完成 3 d 后 A 超测量小鼠眼轴长度，之后取小鼠视网膜组织，采用 RT-PCR 技术检测视网膜中 miR-145-5p 和 β-catenin 的表达，采用 Western 印迹法检测视网膜组织中 β-catenin 的含量。取 6 只成年雄性 C57BL/6 小鼠，构建 β-catenin mRNA 3'UTR 荧光素酶过表达载体，将 β-catenin mRNA 3'UTR 荧光素酶过表达载体与 miR-145-5p mimics 共同转染小鼠视网膜组织，3 d 后取视网膜组织，应用荧光素酶报告基因技术检测和验证 miR-145-5p 与 β-catenin 的相关性。结果：视网膜转染 miR-145-5p mimics 后，小鼠眼轴长度降低，与对照组相比有显著性差异（P<0.05），视网膜组织中 miR-145-5p 表达上升，β-catenin 在 mRNA 和蛋白水平表达均下降（P<0.05）。视网膜转染 miR-145-5p 对照后，视网膜组织中 miR-145-5p 表达以及 β-catenin 的蛋白含量未见明显变化（P>0.05）；荧光素酶报告基因结果显示转染 miR-145-5p 和 β-catenin mRNA 3'UTR 荧光素酶过表达载体后，视网膜组织中荧光活性显著降低（P<0.001）。结论：miR-145-5p 能够下调视网膜 β-catenin 的表达，进而控制眼轴增长。

Objective: To investigate the effect of miR-145-5p on mouse axial length by regulating the expression of β-catenin.Methods: Eighteen 3-week-old C57BL/6 mice were divided to the control, miR-145-5p mimics and miR-145-5p control groups according to the random number table. Both eyes received intravitreal injection once every 3 days, for 3 injections in total （2nd, 5th and 8th days）. Patients in the control group received intravitreal injection of 3 μL citrate buffer, those in the miR-145-5p mimic group received intravitreal injection of 3 μL citrate buffer with 3 μg miR-145-5p mimics, and patients in the miR-145-5p control group received 3 μg miR-145-5p control. Axial length was measured by A-scan ultrasonography 3 days after the last intravitreal injection, then the expression of miR-145-5p and β-catenin in retinas was analyzed by RT-PCR or Western blot. After the over-expressed luciferase vector of β-catenin mRNA 3'UTR was constructed, the mRNA 3'UTR and miR-145-5p mimics were transfected to the retina of 6 male adult C57BL/6 mice. Luciferase reporter gene assay was used to verify the relationship between miR-145-5p and β-catenin in the retina. Results: After the transfection of miR-145-5p mimics in the retina, the expression of miR-145-5p in the retina was significantly up-regulated （P<0.05）, but the axial length and expression of β-catenin decreased significantly compared to those in the control group （both P<0.05）. There were no significant differences in the axial length, miR-145-5p and β-catenin expression after the transfection of miR-145-5p control. The results of luciferase reporter gene assay showed that the fluorescence activities in the retina were decreased significantly after the transfection of over-expressed luciferase vectors of β-catenin mRNA 3'UTR. Conclusion: miR-145-5p may regulate the axial length growth by inhibiting the Wnt/β-catenin pathway in the mouse retina.

内源性眼内炎发病率较低、早期临床表现缺乏特异性，初次诊断易误诊、漏诊，且起病急，发展快，预后差。本文报道的1例患者为女性，66岁，因无明显原因出现急性左侧腹痛，伴尿频尿急，无肉眼血尿，恶心呕吐胃内容物（量多），稀便起病，就诊于乡卫生院，转诊县级医院肾内科、泌尿外科，先后诊断为：1）休克原因待查（感染中毒性休克、低血容量性休克）；2）左侧输尿管结石、左肾结石并感染；3）急性肾功能不全；4）右眼眶蜂窝组织炎合并内源性眼内炎。后转至眼科，因错失最佳治疗时机，行右眼眼内容物剜除术。提示临床医师应加强对该病的认识，减少误诊、漏诊率，以改善患者预后。

The incidence of endogenous endophthalmitis is relatively low, and early clinical manifestations are not specific. It is easy to misdiagnose and miss the diagnosis, and it requires timely treatment due to rapid progression and poor prognosis. A 66-year-old female patient reported acute left abdominal pain with unknown causes, urinary urgency, no gross hematuria, nausea and vomiting and loose stool. She received ineffective treatment in local public health centre and then transferred to county hospital, successively was diagnosed as: 1） unknown causes of shock （septic shock, hypovolemic shock）; 2） left ureteral calculi left-kidney calculi co-infection; 3） acute renal failure; 4） right orbital cellulitis with endogenous endophthalmitis. Subsequently, she was transferred to the department of ophthalmology and underwent enucleation surgery of the right eye due to treatment delay. It is necessary for clinicians to deepen understanding, reduce the missed diagnosis rate and improve the prognosis of patients.

糖尿病视网膜病变（diabetic retinopathy，DR）是糖尿病中最常见的微血管严重并发症之一，是具有特异性改变的眼底病变。当DR发展到增殖性糖尿病视网膜病变（proliferative diabetic retinopathy，PDR）阶段，由纤维血管膜的收缩牵拉引起的玻璃体积血及视网膜脱离是导致PDR患者视力下降甚至失明的主要因素。纤维血管膜的形成与视网膜的纤维化作用密切相关，而结缔组织生长因子（connective tissue growth factor，CTGF）是与DR纤维化密切相关的一种细胞因子，可刺激成纤维细胞和血管内皮细胞的生长、黏附，促进细胞外基质的沉积，造成毛细血管基底层增厚，是视网膜纤维化程度的预测指标。CTGF还可通过外源性调节和血管生长因子（vascular endothelial growth factor，VEGF）水平之间的平衡，有效延缓视网膜纤维化进程，但其具体机制尚不明确。

Diabetic retinopathy（DR）is one of the most serious complications of diabetic microangiopathy, which has many special fundus lesions. When it is the phase of proliferative diabetic retinopathy（PDR）, vitreous hemorrhage and the retinal detachment caused by the contraction of fibrovascular membrane become the main factors of visual decreasing and even blindness. Fibrovascular membrane formation was closely related with retinal fibrosis, and connective tissue growth factor（CTGF）is a cytokine closely related to the DR fibrosis. It can stimulate the growth and adhesion of fibroblast and vascular endothelial cell, the accumulation of extracellular matrix（ECM）, the proliferation, adhesion and migration of cell, then effectively relieve retinal fibrosis process, but its mechanism has not been yet completely clear.

目的：探讨改良的睑板腺囊肿手术的长期临床效果。方法：选择广东省中西医结合医院确诊睑板腺囊肿的手术125例患者（139眼）实施改良的手术方式，观察术后并发症、术后 1 周治愈率及术后 6 个月内的复发率。结果：125 例（139眼）患者均实施睑板腺囊肿切开及刮除术；其中 84 眼（60.4%）患者囊壁无增厚，囊腔内 0.5% 聚维酮碘棉片烧灼囊壁；55 眼（39.6%）患者囊壁增厚，联合部分囊壁剪除术。术后 14 例（10.1%）的患者发生皮下淤血，术后1周治愈率为 100%，术后 6 个月内复发率为 4.2%。复发的 5 例患者实施二次手术后治愈率为 100%，术后 6 个月再无复发。结论：实施改良的睑板腺囊肿手术，能一期有效治愈，且术后并发症较少，复发患者可行二期手术治疗，亦能达到临床治愈的效果。

Objective: To evaluate the long-term clinical efficacy of modified chalazion surgery. Methods: A total of 139 eyes from 125 patients with chalazion were included in this study. The postoperative complications, the cure rate at 1 week after operation and the recurrence rate within postoperative 6 months were observed. Results: The incision and curettage were performed in 125 cases (139 eyes); 84 eyes (60.4%) had no thickening of the cystic wall, which were cauterized with 0.5% povidone-iodine solution; 55 eyes (39.6%) had thickening of the cystic wall, and combined with partial excision of the cystic wall; 14 patients (10.1%) presented with subcutaneous congestion. At postoperative 1 week, the cure rate was 100%, and the recurrence rate was 4.2% within postoperative 6 months. Five recurrent patients underwent second chalazion surgery. The cure rate was 100% at postoperative 1 week, and no recurrence was observed within postoperative 6 months. Conclusion: The modified chalazion surgery is effective, and yields mild postoperative complications. The recurrent patients can be cure by the second surgery.

目前超过 90%的眼缺血综合征（ocular ischemic syndrome，OIS）由同侧颈动脉狭窄或闭塞引起，颅外段动脉狭窄的发生常代表着更严重的头颅动脉粥样硬化，导致远期缺血性脑卒中的发生。因此合理应用各种影像学方法检查OIS患者颈动脉系统尤为重要，可帮助眼科医师发现眼缺血症结所在，并以此为线索发现个体眼、颅乃至全身血管问题，实施积极对症处理并早期预防心脑血管危险事件的发生。

More than 90% of the ocular ischemic syndrome（OIS）are caused by ipsilateral carotid artery stenosis or occlusion. The occurrence of extracranial artery stenosis often represents more severe intracranial atherosclerosis, resulting in the occurrence of ischemic stroke. The examination of carotid artery system is important to help doctors find the origin of OIS, then to discover individual eyes, cranial and systemic vascular problems, and carry out active symptomatic treatment and early prevention of the cardiovascular risk events.

目的：探讨内窥镜下泪囊鼻腔吻合术联合泪道扩张引流管治疗复发性慢性泪囊炎的治疗效果及其应用价值。方法：选择齐齐哈尔市五官医院治疗的复发性慢性泪囊炎患者 26 例作为研究对象，随机分为观察组与对照组，对照组采用外路泪囊鼻腔吻合手术治疗，观察组采用内窥镜下泪囊鼻腔吻合术联合泪道扩张引流管治疗，记录治疗效果。结果：观察组总有效率为 92.30%；对照组总有效率为 69.23%，观察组临床治疗总有效率高于对照组，差异有统计学意义（P < 0.05）。结论：采用内窥镜下泪囊鼻腔吻合术联合泪道扩张引流管综合治疗复发性慢性泪囊炎手术成功率高，手术创伤小，术后皮肤无瘢痕，手术及住院时间短，值得在临床上推广使用。

Objective: To explore the therapeutic effect and application value of endoscopic dacryocystorhinostomy combined with dilated drainage tube for recurrent chronic dacryocystitis. Methods: A total of 26 patients with recurrent chronic dacryocystitis treated in our hospital were selected as the research subjects. The patients were randomly divided into the observation group and the control group. The control group was treated with external dacryocyst nasal anastomosis, and the observation group was treated by endoscopic dacryocystorhinostomy combined with lacrimal duct dilatation and drainage treatment. Results: The total effective rate of the observation group was 92.30%. The total effective rate of the control group was 69.23%. The total effective rate of the observation group was higher than that of the control group, and the difference was statistically significant (P<0.05). Conclusion: Endoscopic dacryocystorhinostomy combined with dilated lacrimal duct drainage tube has a high success rate in the treatment of recurrent chronic dacryocystitis, reducing the surgical wound is small and there is no scar on the skin after surgery, and the duration of the operation and hospitalization were short. It is worth popularizing in clinical practice.

目的：分析 1 个先天性晶状体脱位家系原晶状体原纤维蛋白 1（fibrillin-1，FBN1）基因突变的情况。方法：对 1 个单纯性晶状体脱位家系中的 25 位家族成员（包括 5 名患者）进行眼睛及全身临床检查。从外周静脉血抽提 DNA 进行 PCR 扩增反应，并对 FBN1 全部 65 个外显子进行测序分析。结果：在 5 位患者的核苷酸序列中均发现 FBN1 基因 c.1759 胸腺嘧啶突变为胞嘧啶。这个点突变导致 FBN1 蛋白第 587 号的半胱氨酸被精氨酸代替。结论：c.1759 胸腺嘧啶突变是导致患者晶状体脱位的 FBN1 基因突变位点，该结论进一步丰富了马凡综合征（Marfan syndrome，MFS）基因突变库，并有助于该家系中相关亲属的遗传咨询。

Objective: To identify the genetic defects of a family with inherited ectopia lentis. Methods: Among 25 family members, 5 patients underwent general physical and full ophthalmic examinations. Genomic DNA was extracted from leukocytes of venous blood of every family member. Polymerase chain reaction （PCR） amplification and Sanger’s sequencing of all exons of fibrillin-1 （FBN1） gene were analyzed. Results: A C>T mutation was identified at FBN1 nucleotide position c.1759. This mutation led to substitution of Cysteine for Arginine at condon 587. No FBN1 gene defects were found in any unaffected family member. Conclusion: We identified a mutation in FBN1. Our result expanded the mutation spectrum of FBN1 and also provided genetic counseling for the family relatives.

       患者，男，38岁，主因“右眼突然视力下降、视物变形 1 个月”就诊于河北省眼科医院。眼部检查：右眼视力 0.5，眼底黄斑区可见一个约 1/4 PD的黄白色病灶，周围可见散在出血斑，毛细血管扩张，黄斑颞下方可见黄白色渗出。荧光素眼底血管造影+吲哚青绿血管造影（f luorescein angiography + indole green angiography，FFA+ICGA）示：可动态观察到黄斑区毛细血管扩张渗漏及晚期黄斑区的囊样水肿。光学相干断层扫描成像（optical coherence tomography，OCT）示：黄斑区局部神经上皮层隆起，呈囊样水肿表现。诊断：右眼特发性黄斑中心凹旁毛细血管扩张症（macular telangiectasia，MacTel）。中医辨证治疗，早期以清热凉血、健脾除湿为主；中期采用疏肝清热、健脾渗湿法；后期以补肾健脾为原则。治疗后，患者视力恢复正常，视功能明显改善，黄斑区水肿完全消退。随诊观察 4 年，患者病情控制良好。

The patient, male, 38 years old, was treated in Hebei Eye Hospital for the main cause of “sudden visual acuity of the right eye and visual deformity for 1 month”. Eye examination: visual acuity of the right eye was 0.5. A yellow-white lesion of approximately 1/4 diameter of visual nipple was seen in the macular area at the fundus of the eye. Around the macular area, there were scattered bleeding spots, telangiectasia, and yellow-white exudation was seen below the temporal lobe of the macula. Fluorescein angiography + indole green angiography (FFA+ICGA) showed that the telangiectasia leakage in macular area and cystic edema in late macular area was observed dynamically. Optical coherence tomography (OCT) showed local neuroepidermal bulges in macular area with cystic edema. Diagnosis: right eye idiopathic macular central fovea paravicular telangiectasia. Traditional Chinese medicine offer differentiation treatment, early to clear heat and cool blood, improve the function of spleen and dispel moisture; in the middle stage, the method of soothing liver and clearing heat and strengthening spleen infiltration; in the later period to invigorate the kidney and invigorate the spleen as the principle. After treatment, the patient’s vision returned to normal, visual function improved significantly, and the edema in the macular area completely subsided. After 4 years of follow-up, the patient’s condition was well controlled.