目的：探索和评价“线上教学-理论小课-Wetlab实操”眼解剖整合课程在眼科住院医师规范化培训（住培）教学中的应用和效果。方法：纳入中山大学中山眼科中心2023年新入培的住培学员93名，在岗前培训时进行眼解剖整合课程教学。在课程前后分别进行测试，评价课程教学效果，并在课程结束后采用匿名线下测试考核和满意度问卷调查的形式对课程的满意度进行调查。结果：培训前（T1）和培训后（T2）总分中位数分别是60分和70分，T1最低分、25%、75%和最高分分别是10、40、62.5和90，T2最低分、25%、75%和最高分分别是30、60、80和100，T2得分显著高于T1得分，差异具有统计学意义（P<0.000 1）；T1和T2的自信度平均值分别为26.53±5.08、31.83±4.02，差异有统计学意义（P<0.001）。学员普遍表示对整合课程满意。结论：学员们接受整合课程培训后，对眼解剖学知识的掌握程度有明显提高，对整合课程满意度高。眼解剖整合课程有效性显著，是具有推广意义的教学改革。
Objective: To explore and evaluate the application and effect of an integrated ocular anatomy course comprising three main components: ‘online preview,’ ‘lecture,’ and ‘Wetlab dissection training’in the standardized training teaching of ophthalmology residents (hereinafter referred to as "resident training"). Methods: A total of 93 new resident trainees from Zhongshan Ophthalmic Center of Sun Yat-sen University in 2023 were included in the integrated course on ocular anatomy during pre-job training. Tests were carried out before and after the course to evaluate the teaching effect of the course, and questionnaires were issued after the course to investigate the satisfaction of the course. It adopts the form of anonymous offline test and satisfaction questionnaire. Results: The median total scores before (T1) and after (T2) training were 60 and 70, respectively; the lowest scores, 25%, 75% and highest scores of T1 were 10, 40, 62.5 and 90, respectively; the lowest scores, 25%, 75% and highest scores of T2 were 30, 60, 80 and 100, respectively, and the scores of T2 were significantly higher than those of T1. The difference was statistically significant (P<0.000 1). The mean confidence of T1 and T2 were 26.53±5.08 and 31.83±4.02, respectively, and the difference was statistically significant (P<0.001). Participants generally expressed satisfaction with the integrated programme. Conclusions: After receiving the training of the integrated course, the students' mastery of the knowledge of ocular anatomy has been significantly improved, and the satisfaction of the integrated course is high. The integrated course on ocular anatomy is effective, and it is a teaching reform with popularization significance.
音乐作为一种非侵入性的感官刺激，凭借其独特的治疗价值在医疗领域的应用日益广泛。文章综述了音乐在眼底诊疗领域的应用现状及研究进展。大量临床研究表明，音乐干预可以显著降低患者在眼科诊疗过程中的焦虑水平，改善医疗体验。在玻璃体腔注射、早产儿视网膜病变筛查、视野检查等不同临床场景中，音乐的应用均显示出积极效果。此外，在眼科模拟手术操作研究中，背景音乐的存在不仅没有对医生的手术操作造成干扰，反而可能通过调节术者的心理状态，优化手术环境。虽然音乐干预效果存在个体差异，不同患者对音乐类型、节奏和音量的偏好各异，但总体而言，作为一种安全、经济且易于实施的辅助手段，音乐疗法在眼底临床实践中展现出良好的应用前景。目前已有初步研究表明，音乐在糖尿病视网膜病变合并抑郁症的大鼠实验模型中可减少细胞凋亡并改善抑郁。未来需要开展更多严谨的随机对照试验，建立标准化的音乐干预方案，以充分发挥音乐在眼科诊疗中的积极作用。同时，也应该重视个体化治疗原则，根据患者的个人喜好和具体临床情况，制定合适的音乐干预策略。
Music, as a non-invasive sensory stimulus, has been increasingly applied in medical fields due to its unique therapeutic value. This article reviews the current applications and research progress of music in fundus examination and treatment. Extensive clinical studies have demonstrated that music intervention can significantly reduce patients' anxiety levels during ophthalmic procedures and improve their medical experience. Positive effects have been observed across various clinical scenarios, including intravitreal injections, retinopathy of prematurity screening, and visual field examinations. Furthermore, studies on simulated ophthalmic surgical procedures have shown that background music not only does not interfere with surgeons' operational performance but may actually optimize the surgical environment by regulating the operator's psychological state. Although the effectiveness of music intervention varies among individuals, with patients showing different preferences for music types, rhythms, and volumes, music therapy generally demonstrates promising potential in fundus clinical practice as a safe, economical, and easily implemented auxiliary measure. Preliminary studies have demonstrated that music can reduce cell apoptosis and improve depression in rat models of diabetic retinopathy complicated with depression. Looking forward, more rigorous randomized controlled trials are needed to establish standardized music intervention protocols to maximize the positive effects of music in ophthalmic treatment. Meanwhile, emphasis should be placed on the principle of individualized treatment, developing appropriate music intervention strategies based on patients' personal preferences and specific clinical conditions.
大型语言模型（large language models, LLMs）在眼科的应用为医疗领域带来了巨大的潜力，尤其是在提升诊断效率、优化医患沟通和促进个性化医疗方面。通过自然语言处理技术，LLMs可以协助医生进行临床数据的归纳和分析，可以结合患者的病史、影像资料和症状描述，提供精准的辅助诊断，并在复杂病例中提供参考。LLMs还可以帮助医生快速撰写病历报告，改善医疗记录管理效率。在医患沟通中，LLMs能够通过生成通俗易懂的解释，帮助患者理解疾病状况及治疗方案，缩短医生与患者之间的沟通障碍。在远程医疗场景下，LLMs可通过实时分析患者上传的图像文本信息，提供初步诊断建议，助力医生远程诊疗。个性化医疗也是LLMs的重要应用方向，借助患者的遗传数据和生活习惯，可以帮助医生制定更为精准的个性化治疗方案，并预测手术后的恢复情况。此外，LLMs可以通过与临床数据的不断交互进行自我优化，提升其在眼科诊疗中的智能化程度。尽管LLMs在眼科领域的应用前景广阔，但仍面临数据隐私、模型解释性、语言理解等方面的挑战。未来LLMs将继续作为医生的辅助工具，形成“人机协同”的诊疗新模式，为患者提供更好、更精准的医疗服务。
The application of Large Language Models (LLMs) in ophthalmology presents tremendous potential for the healthcare field, particularly in enhancing diagnostic efficiency, optimizing doctor-patient communication, and promoting personalized medicine. Through natural language processing technology, LLMs can assist doctors in summarizing and analyzing clinical data. They can integrate a patient's medical history, imaging data, and symptom descriptions to provide precise diagnostic support and reference for complex cases. LLMs can also help physicians quickly draft case reports, improving the management efficiency of medical records. In doctor-patient communication, LLMs can generate easy-to-understand explanations that help patients comprehend their conditions and treatment plans, thereby reducing communication barriers between doctors and patients. In telemedicine scenarios, LLMs can provide preliminary diagnostic suggestions by real-time analyzing images and textual information uploaded by patients, aiding doctors in remote diagnosis and treatment.Personalized medicine is another significant application direction for LLMs. By utilizing patients' genetic data and lifestyle habits, LLMs can assist physicians in formulating more precise personalized treatment plans and predicting postoperative recovery outcomes. Additionally, LLMs can self-optimize through continuous interaction with clinical data, enhancing their intelligence in ophthalmic diagnosis and treatment. Despite the broad application prospects of LLMs in the field of ophthalmology, challenges remain, including data privacy, model interpretability, and language understanding. In the future, LLMs will continue to serve as auxiliary tools for physicians, forming a new model of "human-machine collaboration" in diagnosis and treatment, ultimately providing better and more precise medical services to patients.
Schlemm管(Schlemm’ s canal, SC)作为房水流出的主要通道，通过调节房水外排来维持眼内压的平衡，其结构和功能的异常与高眼压及青光眼的发生发展密切相关。对SC的研究有助于阐明房水外排阻滞的发生机制、探索促进房水外排新的途径，从而为降低眼压和青光眼治疗的新药物开发提供理论基础。目前，对SC发育和功能的调节机制的认识仍然有限，缺乏针对SC的特异性治疗策略。近年来，关于SC细胞命运决定及其结构发育的细胞学机制逐渐被揭示，功能调控的关键分子靶标也相继被发现，这促进了对SC结构和功能调控的深入理解。此外，作为降眼压药物靶点和针对性手术的创新应用也在不断拓展。文章系统回顾SC的结构与功能研究，总结关键的分子和细胞学调控机制，归纳SC相关药物和手术疗法的最新进展，为青光眼的临床诊治提供了新的思路。
Schlemm管(Schlemm’ s canal, SC)作为房水流出的主要通道，通过调节房水外排来维持眼内压的平衡，其结构和功能的异常与高眼压及青光眼的发生发展密切相关。对SC的研究有助于阐明房水外排阻滞的发生机制、探索促进房水外排新的途径，从而为降低眼压和青光眼治疗的新药物开发提供理论基础。目前，对SC发育和功能的调节机制的认识仍然有限，缺乏针对SC的特异性治疗策略。近年来，关于SC细胞命运决定及其结构发育的细胞学机制逐渐被揭示，功能调控的关键分子靶标也相继被发现，这促进了对SC结构和功能调控的深入理解。此外，作为降眼压药物靶点和针对性手术的创新应用也在不断拓展。文章系统回顾SC的结构与功能研究，总结关键的分子和细胞学调控机制，归纳SC相关药物和手术疗法的最新进展，为青光眼的临床诊治提供了新的思路。
目的：像差和对比敏感度检查结果数据繁多复杂。为了高效准确地完成检查数据提取工作，自主开发一款像差和对比敏感度数据提取处理软件(Aberrations and Contrast Sensitivity Helper，ACSH)。方法：参考其他同类软件的设计模式，结合我院科研实际，采用开发工具VB6.0编程实现。结果：ACSH在Windows的运行环境下，能够准确地在局域网环境下实现对iTrace，Zywave像差仪和Optec_6500对比敏感度测试仪的检查数据进行提取。像差仪信息包括病人基本信息、屈光度、眼别、瞳孔直径，各项像差Zernike系数，高阶像差和总高阶像差均方根RMS(Root Mean Square)。对比敏感度仪数据包括：病人基本信息、检查时间、检查时的模拟光照度和眩光强度、 各空间频率的对比敏感度数值。同时软件支持对已提取的数据进行浏览、查询及导出EXCEL等功能，并开放数据接口供电子病历等其他系统对接。结论：ACSH是一款能够有效辅助视光专科科研和临床工作的应用软件。
Objective: Aberration and contrast sensitivity test results data is various and complex. In order to complete efficiently and accurately the data extraction work, we developed an aberration and contrast sensitivity data extraction software Aberrations and Contrast Sensitivity Helper (ACSH). Methods: VB6.0 was used as a development tool after we referred to other similar software design pattern and combined the reality of our scientific research. Results: The ACSH under the Windows environment can accurately extract the results’ data of iTrace and Zywave aberration meter and Optec 6500 contrast sensitivity tester in local area network. Aberration instrument information include patients’ basic information, refraction, which eye, pupil diameter, the aberration Zernike coefficients, the high-order aberration and total aberration Root Mean Square (RMS). Contrast sensitivity tester data included: patients’ basic information, time, the intensity of analog light and the glare ,the contrast sensitivity values of every spatial frequency. ACSH is able to browse and query extracted data and export to EXCEL, and open data interface for electronic medical records and other system. Conclusion: ACSH is an effective software which assists optical specialized scientific research and clinical work.
叶黄素类物质为膳食类胡萝卜素，主要存在于视网膜组织中，为黄斑色素发挥抗氧化活性和蓝光滤过作用。近年来，有研究证实，叶黄素类物质可降低色差，提高视力及对比敏感度等功能，并对于年龄相关性黄斑变性、视网膜光损伤等疾病具有防治作用。
Xanthophylls is a kind of dietary carotenoid, which is mainly located in retina, and plays an important role in antioxidant and blue light ffltration. Lutein, zeaxanthin and meso-zeaxanthin can enhance visual performance by decreasing chromatic aberration and enhancing contrast sensitivity, and they can also prevent age-related macular degeneration and retinal light-induced injury.
液相芯片技术是一种利用混悬在液相中的分类编码微球作为反应及信号检测载体，集合流式细胞技术、激光技术、数字信号处理技术及传统化学技术为一体的新型生物分子检测技术。它充分利用发展成熟的流式细胞术检测原理，对目标分子（如核酸、蛋白质等）进行高通量分析。目前已在生物医学研究中得到了广泛的应用。现就其技术原理、特点及其在泪液细胞因子检测中的应用作简要介绍。
Liquichip (Multiplexed microsphere-based flow cytometric assays) is a new biomolecular detection technology using encoded microspheres suspended in liquid as reaction and detection carrier, which is an integration of flow cytometry, laser technology, digital signal processing and traditional chemical technology. It is a high-throughput analyzer for the target molecular (e.g. nucleic acid and protein) based on the principles of flow cytometry. Liquichip is now widely used in biomedical analyses. This article briefly reviews the principle and characteristic of liquichip and its application in tear cytokine analysis.
目的：探讨全视网膜光凝及术后应用羟苯磺酸钙治疗糖尿病视网膜病变的疗效。方法：选取96例患者，共175只眼，随机分为对照组(48例，86只眼)和研究组(48例，89只眼)。两组均予全视网膜激光光凝治疗，其中研究组术后再予羟苯磺酸钙继续12周治疗。12周后，观察两组患者治疗前后视力、血液流变学的变化。结果：治疗后研究组在视力>1.0范围的患者明显多于对照组(χ2=6.779，P=0.009)， 而2组在视力≤0.4，0.4~0.6，0.7~1.0范围患者视力差异比较分别为( χ2=0.003，P=0.955)，(χ2=1.640，P=0.200)，(χ2=2.148，P=0.143)。治疗后研究组患者的血浆粘度、红细胞压积、红细胞变形指数、纤维蛋白原改善均优于对照组(P<0.05)。研究组总有效率89.9%，对照组75.6%，两组差异比较(χ2 =6.302，P=0.012)。结论：全视网膜激光光凝及术后应用羟苯磺酸钙治疗糖尿病性视网膜病，能有效提高视力及临床疗效，可能与改善患者血液流变相关。
Objective: To investigate the curative effect of the postoperative retinal laser photocoagulation and calcium dobesilate in the treatment of diabetic retinopathy. Methods: Selected 96 patients, 175 eyes, randomly divided into control group (48 cases, 86 eyes) and study group (48 cases, 89 eyes). Two groups were all given retinal laser photocoagulation treatment, while the study group continued to receive calcium dobesilate for 12 weeks after treatment. After 12 weeks, observed the eyesight, change of blood rheology of the two groups. Results: After the treatment, the patients with vision >1.0 in the study group were significantly more than the control group (χ2 =6.779, P=0.009), in the vision range of ≤0.4, 0.4~0.6, 0.7~1.0, the difference between the two groups was (χ2 =0.003, P=0.955), (χ2 =1.640, P=0.200), (χ2=2.148, P=0.143), respectively. After treatment, plasma viscosity, erythrocyte deposited, erythrocyte deformation index, fibrinogen in the study group were better than those in the control group (P<0.05). The total effectiveness in the study group was 89.9%, in the control group was 75.6%, the difference was statistically significant (χ2=6.302, P=0.012). Conclusion: The whole retinal laser photocoagulation and postoperative application of calcium dobesilate in treating the diabetic retinopathy can effectively improve eyesight and clinical curative effect, which may be associated with improving blood rheology.
大部分眼科手术/操作具有创伤小、疼痛刺激轻等特点，因此，选择眼表面麻醉即可满足手术的镇痛的需要，促进了眼科日间手术的广泛开展。其中，盐酸奥布卡因滴眼液是常用的眼科表面麻醉剂，具有麻醉起效迅速、镇痛作用强、持续时间久(约13 min)等特点，已经广泛应用在眼内手术中，在使用过程中，盐酸奥布卡因滴眼液对瞳孔及血管无影响，保证了眼内手术的安全。盐酸奥布卡因滴眼液能提供良好的眼表环境，对角膜厚度及角膜上皮厚度影响轻微，从而满足屈光手术的需要。此外，盐酸奥布卡因滴眼液能提供良好的术后镇痛，减少术后镇痛药物的使用，降低斜视术后患儿的躁动发生率。不含防腐剂的表面麻醉剂不影响麻醉剂的起效时间及镇痛效果，对眼表的影响轻微，从而创造良好的手术操作环境，提高手术效果，降低并发症和手术风险，是眼科手术中较为理想的表面麻醉药物。文章就盐酸奥布卡因滴眼液的作用机制及麻醉效果、药代动力学、临床疗效、安全性等进行综述。
Most ophthalmic surgeries are characterized by small incisions and mild pain, therein, the choice of topical anesthesia can meet the needs of surgeries and accelerate ophthalmic surgeries to be conducted in day surgery model. 0.4% oxybuprocaine hydrochloride eye drops is one of commonly used topical anesthetics for ophthalmic surgery, which has the characteristics of rapid onset and sufficient analgesia with long duration (about 13 minutes). Oxybuprocaine hydrochloride eye drops has been widely and safely used in intraocular surgery without affecting the pupil and blood vessels. Meanwhile, oxybuprocaine hydrochloride eye drops has negligible effects on corneal thickness and corneal epithelial thickness to meet the needs of refractive surgery. In addition, oxybuprocaine hydrochloride eye drops can provide sufficient postoperative analgesia, reduce the use of postoperative analgesics and the incidence of emergence agitation in children after strabismus surgery. The preservative-free topical anesthetic would be one of ideal topical anesthetics as it can provide a good surgical condition and reduce complications and risks of post-operative infections without changing the onset time and analgesia effects. This article provides a review of the mechanism, analgesia, pharmacokinetics, clinical efficacy, and safety profiles of 0.4% oxybuprocaine hydrochloride eye drops.
青光眼是一组以病理性眼压升高为主要危险因素的，以青光眼性神经萎缩和视野缺损为主要特征的全球首位不可逆性致盲眼病。超声睫状体成形术(UCP)是一种新型非侵入性青光眼治疗技术，其降眼压主要原理为利用高强度聚焦超声破坏睫状突上皮细胞以减少房水生成，并增加葡萄膜巩膜通道的房水流出。UCP适应证广泛，早期主要用于各类难治性青光眼患者，特别是晚期及绝对期患者，研究者发现其除降眼压外，还能够显著缓解该类患者的局部疼痛。近年来，UCP在未经手术治疗的青光眼患者和早、中期青光眼病例中，也表现出了良好的降眼压效果，同时显示出较少的并发症和较轻的术后反应，并可重复治疗。然而不同类型青光眼UCP疗效存在一定差异，且为达最佳治疗效果，其治疗需匹配恰当的探头型号以及适当的治疗扇区。现有较广泛应用于国外的基于眼轴和白到白参数的公式计算方法，测算精度并不适用于国人，然而精准度更高的模型法，其便捷性仍有待进一步提高。UCP虽可减少降眼压药物用量，但术后用药策略的调整仍可能导致眼压波动。综上，针对UCP手术的适应证选择、手术参数设计、疗效预判以及术后管理策略等，仍有待开展相关临床研究，以期为其临床应用提供更加可靠的依据。
青光眼是一组以病理性眼压升高为主要危险因素的，以青光眼性神经萎缩和视野缺损为主要特征的全球首位不可逆性致盲眼病。超声睫状体成形术(UCP)是一种新型非侵入性青光眼治疗技术，其降眼压主要原理为利用高强度聚焦超声破坏睫状突上皮细胞以减少房水生成，并增加葡萄膜巩膜通道的房水流出。UCP适应证广泛，早期主要用于各类难治性青光眼患者，特别是晚期及绝对期患者，研究者发现其除降眼压外，还能够显著缓解该类患者的局部疼痛。近年来，UCP在未经手术治疗的青光眼患者和早、中期青光眼病例中，也表现出了良好的降眼压效果，同时显示出较少的并发症和较轻的术后反应，并可重复治疗。然而不同类型青光眼UCP疗效存在一定差异，且为达最佳治疗效果，其治疗需匹配恰当的探头型号以及适当的治疗扇区。现有较广泛应用于国外的基于眼轴和白到白参数的公式计算方法，测算精度并不适用于国人，然而精准度更高的模型法，其便捷性仍有待进一步提高。UCP虽可减少降眼压药物用量，但术后用药策略的调整仍可能导致眼压波动。综上，针对UCP手术的适应证选择、手术参数设计、疗效预判以及术后管理策略等，仍有待开展相关临床研究，以期为其临床应用提供更加可靠的依据。
