息肉状脉络膜血管病变(polypoidal choroidal vasculopathy,PCV)是亚洲人群中常见的致盲性眼病，发生大出血并发症后严重危害视力且预后差。PCV大出血包括视网膜下出血(subretinal hemorrhage,SRH)和玻璃体积血(vitreous hemorrhage,VH)。SRH的危险因素包括较长病程、簇型PCV、息肉状病灶不消退、合并视网膜色素上皮脱离；其治疗方式包括抗血管内皮生长因子药物、光动力疗法、激光、玻璃体腔注气、眼内注射组织纤溶酶原激活剂、玻璃体切割术或联合治疗等方式，其中，黄斑中心凹是否受累和出血时间是影响治疗方式选择的主要因素。发病年龄较大、白细胞计数较高、天门氨酸转移酶和丙氨酸转氨酶的比值较高、活化部分凝血活酶时间较长、曾行光动力疗法、有玻璃体腔注药治疗史、SRH面积大、出现视网膜色素上皮脱离的PCV患者发生VH的风险高。浓厚的VH通常需行玻璃体切割术，其手术时机和手术方式的选择是临床关注的焦点。鉴于目前PCV大出血的危险因素尚不完全明确、治疗方面也尚未形成共识，需要开展相关临床研究，提供更多依据。

Polypoidal choroidal vasculopathy (PCV) is a common blinding disease in Asian populations. Massive hemorrhage complications secondary to PCV include subretinal hemorrhage (SRH) and vitreous hemorrhage (VH). The risk factors for SRH include a long duration, clustered PCV, non-regression of polyp lesions and presented with retinal pigment epithelial detachment. The treatments for SRH include anti-vascular endothelial growth factor drugs, photodynamic therapy, laser, vitreous pneumatic displacement, intravenously injected tissue plasminogen activator, vitrectomy and combination therapy. Whether macular fovea is involved and the time since bleeding onset are the main factors afecting the choice of treatment for SRH. Older age of onset, higher white blood cell count, higher aspartate amino transferase and alanine amino transferase ratio, longer activated partial thromboplastin time retinal pigment epithelium detachment, photodynamic therapy history, intravitreal injection history larger SRH area and presented with retinal pigment epithelial detachment were associated with higher risk of VH. PCV patients with massive VH should be treated with vitrectomy, while the timing and technique of operation should be paid atention to. At present, the risk factors of PCV massive bleeding are not completely clear, and its treatment methods are diverse, which requires a large number of studies to prove its effectiveness and establish expert diagnosis and treatment consensus.

眼睛由屈光系统和视觉神经系统两大部分构成，是人体最重要的感觉器官之一。眼部各组织的发育或功能异常都可能造成不同程度的视力损害。目前主要通过动物实验或体外细胞培养的方法探究眼病的病理生理机制和治疗手段，但上述两种方法都存在一定的局限性。体外细胞培养不能完全反映器官的形态、结构和生化特征，而动物模型的物种和遗传背景具有异质性。近年来，随着原代组织、胚胎干细胞、诱导多能干细胞衍生的体外三维结构类器官和器官微流控芯片技术的不断发展，构建出了与在体器官的结构、功能更为相似的器官克隆模型，能够提供更敏感、定量、规模化的表型分析，更好地应用于眼的发育、生理结构、疾病机制、个性化医学诊断和治疗方法等方面的研究。目前，眼科的微流控器官芯片与类器官技术在角膜、晶状体、泪腺、视网膜结构发育和疾病模型均展现出巨大的应用潜力。

The eye is composed of refractive system and visual nervous system. It is one of the most important sensory organs of the human body. The abnormal development or function of eye tissues may cause various degrees of visual impairment. At present, the pathophysiological mechanism and treatment of eye diseases are mainly explored through animal experiments and in-vitro cell culture. However, they are of certain limitations. The in-vitro cell culture cannot fully reflect the morphological, structural and biochemical characteristics of organs, whereas the animal models are heterogeneous of species and genetic background. In recent years, with the continuous development of in-vitro three-dimensional structure organoids and organ microfluidic organ-on-a-chip technology derived from primary tissues, embryonic stem cells and induced pluripotent stem cells, organ cloning models more similar to in vivo organs in terms of the structure and function have been constructed. These models can provide more sensitive, quantitative and large-scale phenotypic analysis, and can be better applied to the research of eye development, physiological structure, disease mechanism, personalized medical diagnosis and treatment. At present, microfluidic organ-on-a-chip and organoids technologies have shown great application potential in the structural development and disease models’ construction of cornea, lens, lacrimal gland and retina.

目的：探讨数字化裂隙灯显微镜作为一种定量分析的工具应用于一维尺寸测量的可靠性。

方法：3 位观察者采用单盲法，分别在 4 倍、10 倍、16 倍、25 倍、40 倍和 4 倍、10 倍、16 倍的物镜放大率下，对游标卡尺上模拟人眼的瞳孔和角膜直径的 4.00 mm 和 10.00 mm 间距，使用国产数字化裂隙灯显微镜进行图像采集和重复测量，对测量结果的正确度和精密度进行比较。

结果：3 位测量者（A、B、C）对 4.00 mm 尺寸的图像进行测量，所测结果均数位于 3.98～4.06 之间。对 10.00 mm 的图像进行测量，所测结果均数位于 10.00～10.04 之间。4.00 mm 测量结果显示，除测量者 A 4 倍、测量者 B 25 倍、测量者 C 16 倍和 25 倍外，测量值与真实值的差异具有统计学意义。10.00 mm 测量结果显示，除测量者 A 10 倍外，测量值与真实值的差异具有统计学意义。比较同一测量者对同一尺寸在不同放大倍率的测量结果，除测量者 A 对 10.00 mm 尺寸的测量无统计学差异外，其余测量结果之间在不同放大倍率下对相同尺寸测量的结果均具有统计学差异。不同测量者对相同物镜放大倍率下的同一尺寸比较，除在 4 倍放大率下对 4.00 mm 测量的结果无统计学差异外，其余测量结果之间的差异均具有统计学意义。所有测量结果的变异系数均低于 5%；随放大倍率的增加，变异系数有降低的趋势。

结论：数字化裂隙灯显微镜作为一种一维尺寸测量工具，具有良好的精密度，在利用其做定量分析前进行测量的可靠性分析有助于减少系统误差对测量结果分析的干扰。

Purpose: To study the reliability in one dimensional size measurement with digital slit lamp microscope as a tool for quantitative analysis.

Methods: Three single-blinded observers acquired and repeatedly measured the images of 4.00 mm and 10.00 mm size on the vernier caliper, which simulated the human eye pupil and cornea diameter, with home-made digital slit lamp microscope, respectively, in the objective magnification of 4 times, 10 times, 16 times, 25 times, 40 times and 4 times, 10 times, 16 times. The correctness and precision of measurement were compared.

Results: Measurements were conducted on the 4.00 mm image size by three investigators and all averages were located between 3.98 to 4.06, and for the 10.00 mm image size, between 10.00 to 10.04. Measurement results of 4.00 mm showed that, except for A4, B25, C16 and C25, the difference of the measured value and the true value was statistically significant. The measurement results of 10.00 mm showed that, except for A10, the difference of the measured value and the true value was statistically significant. Comparison of the same size, the same investigators at different magnification measurements, except for investigator A's measurements of 10.00 mm dimensions, had no significant difference; the others were all statistically significant. Compared the measurements of the same size with different magnification, except for measurements of 4.00 mm in 4-fold magnification, which had no significant difference among the investigators, the remaining different results were statistically significant. The coefficient of variation of all measurement results was less than 5%; as magnification increased, the coefficient of variation decreased.

Conclusion: The measurement of digital slit lamp microscope in one-dimensional size, with good reliability, should be used for analysis reliability before being used in quantitative analysis. 

      息肉状脉络膜血管病变(polypoidal choroidal vasculopathy,PCV)是亚洲人群中常见的致盲性眼病，发生大出血并发症后严重危害视力且预后差。PCV大出血包括视网膜下出血(subretinal hemorrhage,SRH)和玻璃体积血(vitreous hemorrhage,VH)。SRH的危险因素包括较长病程、簇型PCV、息肉状病灶不消退、合并视网膜色素上皮脱离；其治疗方式包括抗血管内皮生长因子药物、光动力疗法、激光、玻璃体腔注气、眼内注射组织纤溶酶原激活剂、玻璃体切割术或联合治疗等方式，其中，黄斑中心凹是否受累和出血时间是影响治疗方式选择的主要因素。发病年龄较大、白细胞计数较高、天门氨酸转移酶和丙氨酸转氨酶的比值较高、活化部分凝血活酶时间较长、曾行光动力疗法、有玻璃体腔注药治疗史、SRH面积大、出现视网膜色素上皮脱离的PCV患者发生VH的风险高。浓厚的VH通常需行玻璃体切割术，其手术时机和手术方式的选择是临床关注的焦点。鉴于目前PCV大出血的危险因素尚不完全明确、治疗方面也尚未达成共识，需要开展相关临床研究，提供更多依据。

      息肉状脉络膜血管病变(polypoidal choroidal vasculopathy,PCV)是亚洲人群中常见的致盲性眼病，发生大出血并发症后严重危害视力且预后差。PCV大出血包括视网膜下出血(subretinal hemorrhage,SRH)和玻璃体积血(vitreous hemorrhage,VH)。SRH的危险因素包括较长病程、簇型PCV、息肉状病灶不消退、合并视网膜色素上皮脱离；其治疗方式包括抗血管内皮生长因子药物、光动力疗法、激光、玻璃体腔注气、眼内注射组织纤溶酶原激活剂、玻璃体切割术或联合治疗等方式，其中，黄斑中心凹是否受累和出血时间是影响治疗方式选择的主要因素。发病年龄较大、白细胞计数较高、天门氨酸转移酶和丙氨酸转氨酶的比值较高、活化部分凝血活酶时间较长、曾行光动力疗法、有玻璃体腔注药治疗史、SRH面积大、出现视网膜色素上皮脱离的PCV患者发生VH的风险高。浓厚的VH通常需行玻璃体切割术，其手术时机和手术方式的选择是临床关注的焦点。鉴于目前PCV大出血的危险因素尚不完全明确、治疗方面也尚未达成共识，需要开展相关临床研究，提供更多依据。

目的：探究球面塑形镜、环曲面塑形镜在矫治近视复合散光的有效性及安全性。方法：回顾分析宜昌市第一人民医院2016年3月至2018年3月角膜塑形镜治疗青少年近视94例(178眼)，按佩戴塑形镜类型分为球面塑形镜组(48例，90眼)与环曲面塑形镜组(46例，88眼)。记录配镜前、佩戴1年后、停戴1周后的视力、角膜散光、眼轴长、球镜屈光度、眼压、泪膜破裂时间及角膜着染率。结果：戴镜1年后，2组组内相比，散光、球镜度数、眼压、泪膜破裂时间均降低，但2组组间相比，仅散光度数差异有统计学意义(P<0.01)。戴镜1年后，两组视力较戴镜前显著提高，停戴后近视度数较佩戴前增加，但组间差异无统计学意义(P>0.05)；2种塑形镜角膜着染发生率差异无统计学意义(P>0.05)。结论：2种塑形镜均能够降低近视复合散光患者度数，有效提高患者视力，但并不能完全阻止近视的进展。虽然环曲面塑形镜在矫正散光方面有优势，但总有效性与安全性并不占优势。

Objective: To observe the effectiveness and safety of orthokeratology lens and toric design othokeratology treatment for compound myopic astigmatism. Methods: From March 2016 to March 2018, 94 teenagers(178 eyes) were selected as the subjects of study. They were divided into two groups according to the type of orthokeratology: the orthokeratology lens group (48 cases, 90 eyes) and the toric design othokeratology group(46 cases, 88 eyes). Visual acuity, corneal astigmatism, axial length, spherical lens refraction, intraocular pressure,tear film rupture time and corneal staining rate were recorded before, after 1 year and after 1 week. Results: After 1 year of wearing the lens, astigmatism, spherical lens degree, intraocular pressure and tear film rupture time were all decreased in the 2 groups compared with each other, but only astigmatism degree was statistically significant between the 2 groups compared with each other (P<0.01). After wearing the glasses for 1 year, the visual acuity of the two groups was significantly improved compared with that before wearing the glasses, and the myopia degree was increased after stopping wearing the glasses compared with that before wearing the glasses, but the difference between the two groups was not statistically significant (P>0.05). There was no statistical significance in the incidence of corneal staining between the two types of shaping lenses (P>0.05). Conclusion: Both of the two shaping lenses can reduce the degree of myopic patients with complex astigmatism and effectively improve the visual acuity of patients, but they can not completely prevent the progress of myopia. Although toroidal shaping mirror has advantages in correcting astigmatism, its overall effectiveness and safety are not.

目的：了解儿童罹患青光眼的疾病类型、特点，更好地做到早期发现早期治疗。方法：收集北京同仁医院2014—2019年度834例0~18周岁住院接受抗青光眼手术的患者，回顾性分析患者的人群特点与疾病构成特点。结果：834例患者中，原发青光眼397例(47.6%)，继发青光眼429例(51.4%)。另有8例无法明确诊断青光眼类型。原发青光眼中以原发先天性青光眼最常见，继发青光眼中以白内障术后继发青光眼为主，两种类型的青光眼占总患者数的50%。结论：儿童罹患青光眼的疾病种类繁多，其中原发先天青光眼与白内障术后继发青光眼最常见，重视婴幼儿先天青光眼的筛查，监测儿童白内障术后眼压有助于早期发现青光眼，并给予治疗，延缓儿童青光眼患者视功能的损害。

Objective: To understand the types and characteristics of glaucoma in pediatric inpatients to achieve early detection and treatment. Methods: A total of 834 patients aged 0–18 years who underwent anti-glaucoma surgery in Beijing Tongren Hospital from 2014 to 2019 were collected and their population characteristics and disease composition characteristics were retrospectively analyzed. Results: In all of the 834 cases, there were 397 patients (47.6%) with primary glaucoma and 429 (51.4%) with secondary glaucoma. The type of glaucoma could not be definitively diagnosed in 8 cases. Primary infant glaucoma and secondary glaucoma following cataract surgery accounted for above 50%. Conclusion: The causes of pediatric inpatients with glaucoma are various. Screening of primary infant glaucoma should be taken seriously and monitoring intraocular pressure after cataract surgery is also important. Early detection and treatment can prevent further visual loss of pediatric patients with glaucoma.

目的：中重度甲状腺相关眼病内下壁骨性减压联合脂肪减压术的临床疗效观察。方法：回顾性分析25例(31眼)在浙江大学医学院附属第二医院眼科行内下壁骨性减压联合脂肪减压术治疗的甲状腺相关眼病患者，观察时间为2020年1月至2022年1月。术前所有患者均进行了眼眶CT检查，并对双眼视力、眼球突出、复视及双眼外观形态进行了测量。手术效果评价指标为：术后眼球突出度、视力和复视程度，并对相关数据进行统计和分析。结果：术后眼球突出度回退2~6 mm，平均回退(3.45±0.93)mm，切除眶内脂肪1.4~3.6 mL，平均切除(2.33±0.66)mL，外观恢复满意。4例患者术前存在复视，2例患者术后新发复视，术前已存在复视的患者，术后复视程度并未加重，新发的2例复视患者均为轻度复视。术后CT检查显示眼眶减压效果良好。结论：内下壁骨性减压与脂肪减压术联合，可以有效扩大眼眶容积，对眼球进行回纳，减少眼球突出程度，改善容貌外观，且手术切口隐蔽美观，具有较好的临床疗效果。

Objective: To observe the clinical efficacy of medial-inferior wall orbital decompression combined with fat decompression in the treatment of moderate-to-severe thyroid associated ophthalmopathy (TAO). Methods: A retrospective analysis was performed on 25 patients (31 eyes) with moderate-to-severe TAO from January 2020 to January 2022 in Eye Hospital of Zhejiang University, who were treated with medial-inferior wall orbital decompression combined with fat decompression. All of patients were given orbital computed tomography to measure visual acuity, exophthalmos, diplopia and ocular appearance before operation. The preoperative and postoperative exophthalmos, visual acuity and diplopia before and after operation were taken as efficacy evaluating indicators. The related data was counted and analyzed statistically. Results: After operation, the reduction of exophthalmos was 2-6 mm, with an average of (3.45±0.93) mm, the volume of intrazonal fat-removal was 1.4-3.6 mL, with an average of (2.33±0.66) mL, with a satisfactory appearance. There were 4 cases of preoperative diplopia and 2 cases of new diplopia after operation, all of which were mild diplopia. Diplopia did not exacerbate after operation in the patients who had diplopia before operation. Conclusion: Medial-inferior wall orbital decompression combined with fat decompression in the treatment of moderate-to-severe TAO can effectively expand orbital volume, reduce exophthalmos, improve appearance with a concealed beautiful surgical incision, showing its good clinical efficacy.

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).

报道1例睫状体无色素上皮腺瘤(adenoma of nonpigmented ciliary epithelium，ANPCE)并进行相关文献复习。患者主要症状为左眼视力逐渐下降3个月，视物不清半个月。经眼部检查及左眼超声生物显微镜(ultrasound biomicroscopy，UBM)检查显示左眼虹膜周边隆起，边界清晰。予虹膜睫状体肿物切除术并行常规病理检查：光镜下肿瘤组织由分化好的上皮细胞组成，排列成腺泡状及条索状，细胞间可见红染无结构的基底膜样物；免疫组织化学表达：S-100(+)、Vimentin(+)、EMA(+)、CKpan(+)、Melan-A(+)；最终病理诊断ANPCE。手术后截至随访日期，术后3个月无疾病进展。

A case of adenoma of nonpigmented ciliary epithelium (ANPCE) was reported and relevant literatures were reviewed. The left eye visual acuity of the patient gradually decreased for 3 months, and half a month was blurred vision. The vision examination and ultrasound biomicroscopy (UBM) from the left eye examination revealed a bulge in the peripheral iris in the left eye, with the boundaries are clear. The left eye was treated with ciliary mass resections and routine pathological examination: microscopy showed that the tumor tissue consists of well-differentiated epithelial cells, the tumor cells were arranged in tubes and cords, between the cells were seen red-stained unstructured basement membrane; immunohistochemistry showed: S-100 (+), Vimentin (+), EMA (+), CKpan (+), Melan-A (+); the final pathological diagnosis was ANPCE. There was no progression of the disease during the 3 months following the surgery on the follow-up date.

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(relative afferent pupillary defect，RAPD)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).