目的：通过真实的临床病例，分析青光眼与非青光眼性视神经病变的不同表现，提高疾病的鉴别诊断能力。方法：采用病例研究与文献回顾方法，记录3例易误诊为正常眼压性青光眼（normal tension glaucoma, NTG）的神经眼科病例，通过视力、眼压、瞳孔对光反应、视盘形态、RNFL厚度、视野损害等特点，抽丝剥茧，得出诊断。结果：病例1视野呈弓形缺损，但视盘凹陷不深，且对侧眼“视盘拥挤”，随访期间发生急性前部缺血性视神经改变(anterior ischaemic optic neuropathy, AION)，最终确诊“AION遗留视神经萎缩”。病例2视力下降、视野缺损与视神经结构损害不相符，经完善MRI确诊为“左侧视神经鞘膜瘤”。病例3青年男性，中心视力下降，视盘凹陷不深，根据DNA结果确诊Leber遗传性视神经病变（Leber hereditary optic neuropathy, LHON）。结论：通过几个典型的神经眼科病例，掌握AION、视神经鞘膜瘤、LHON的结构和功能损害特征，如视盘凹陷不深、中心视力下降、视神经结构损害与视功能不相符，与NTG相鉴别。

Objective: To analyze the differentiating manifestations of glaucomatous and non-glaucomatous optic neuropathies using real clinical cases and to enhance the ability to make differential diagnosis. Methods: By using case study and literature review methods, we recorded three neuro-ophthalmic cases that were prone to being misdiagnosed as normal tension glaucoma (NTG). The diagnosis was established by extracting features related to visual acuity, intraocular pressure, pupillary light reflex, optic disc morphology, retinal nerve fiber layer (RNFL) thickness and visual field damage. Results: Case 1 presented with arcuate visual field defects, shallow optic disc cupping, and contralateral crowded discs. During follow-up, the patient subsequently developed acute anterior ischemic optic neuropathy (AION), and the final diagnosis confirmed was confirmed as optic atrophy secondary to AION. Case 2 exhibited a disproportionate visual acuity decline and visual field defects that were inconsistent with glaucomatous structural damage. MRI confirmed the diagnosis of left optic nerve sheath meningioma. Case 3 involved a young male who presented with central vision loss and shallow optic disc cupping. Genetic testing confirmed Leber's hereditary optic neuropathy (LHON). Conclusions: Through these representative neuro-ophthalmology cases, we illustrate the characteristic patterns of structural and functional damage associated with  AION, optic nerve sheath meningioma, and LHON, such as shallow optic disc cupping, central vision loss, and inconsistency between  optic nerve structural damage and visual function. These findings highlight the key differentiating features of these conditions from NTG.

        文章报道了一例5岁女性Dandy-Walker综合征（Dandy-Walker syndrome，DWS）患儿的临床表现、眼科检查及影像学特征。该患儿在确诊DWS后行后颅窝蛛网膜囊肿部分切除术，然而术后视力仍进行性下降，眼科随访过程中发现视网膜神经纤维层（Retinal Nerve Fibers Layer，RNFL)进行性变薄，提示颅内压尚未有效控制，视神经损害在进一步发展。由于DWS病变位置特殊性，头颅磁共振成像（Magnetic Resonance Imaging，MRI）及常规腰椎穿刺未能确定幕上颅内高压，后经侧脑室直接测压，证实仍然存在颅压异常增高。行右侧脑室-腹腔分流术后，患儿双眼视力有所提高，双眼RNFL）厚度无继续变薄。目前DWS的治疗方式包括后颅窝囊肿切除术、脑脊液分流术及内镜下第三脑室造瘘术。 术后DWS患者的颅内压的测量有特殊性，幕上与幕下区域之间的脑实质内压力可能形成显著的压力梯度，腰椎穿刺测压可能无法准确反映颅内压，脑室内测压方法则创伤更大。此时需要眼科检查提供支持颅内高压的证据，如RNFL厚度进行性下降、视盘水肿及视网膜血管形态异常，这些检查无创、简便、可多次重复，是临床医生评估颅内压的有效手段，建议纳入DWS患者术后颅内压的常规管理中。

This article reports the clinical presentation, ophthalmologic examination, and imaging features of a 5-year-old girl with Dandy-Walker syndrome (DWS). She underwent partial resection of an arachnoid cyst in the posterior cranial fossa after the diagnosis of DWS. However, her visual acuity continued to deteriorate after the surgery, and the ophthalmologic follow-up revealed progressive thinning of the retinal nerve fibers layer (RNFL), suggesting that the intracranial pressure (ICP) had not yet been effectively controlled, and the damage to the optic nerve was further developing. However, due to the special pathological changes of DWS, MRI and routine lumbar puncture was not able to exactly identify the supratentorial ICP, subsequent ICP measurement through the lateral ventricle confirmed that increased ICP was still existed. After performing a right ventriculoperitoneal shunt, the child's binocular vision improved, and the thickness of the RNFL in both eyes remained stable. Current treatment modalities for DWS include cystectomy, cerebrospinal fluid shunt and endoscopic third ventriculostomy. The measurement of postoperative ICP in DWS patients is complicated, because there may be a significant pressure gradient between the supratentorial and infratentorial regions, which is not accurately reflected by lumbar puncture manometry, and intraventricular manometry is much more invasive. Ophthalmologic examinations including progressive decrease in RNFL thickness, optic disc edema, and abnormal retinal vascular morphology are required to provide evidences of increased ICP. These examinations are noninvasive, simple, and repeatable. They are an effective means of assessing ICP, and are recommended to be included in the routine management of ICP in patients with DWS after surgery.

        本文报告两例单眼无痛性视力下降病例。病例1为47岁男性，表现为右眼亚急性视力下降，伴视盘水肿及黄斑区星芒状渗出，血清汉塞巴尔通体（Bartonella henselae）IgG抗体阳性（滴度1:256），结合猫接触史及跳蚤叮咬史，诊断为猫抓病相关视神经视网膜炎。经口服多西环素联合球周注射曲安奈德治疗后，视力显著恢复至1.0。病例2为33岁男性，表现为右眼急性视野缺损伴轻度视力下降，视盘水肿伴出血及棉绒斑。血清学检查示汉塞巴尔通体IgG阳性（滴度1:256）及梅毒螺旋体抗体阳性（TPPA+, TRUST+）。初始经验性抗猫抓病（多西环素+利福平）及抗梅毒（苄星青霉素）治疗无效，视力持续下降。随访1个月时光学相干断层扫描（OCT）显示视盘周围视网膜色素上皮（RPE）局灶性钉状突起，符合梅毒眼部特征性改变，结合患者抗汉塞巴尔通体治疗反应不佳，最终修正诊断为梅毒性视神经病变。继续抗梅毒治疗后视力稳定于0.63，但遗留视神经萎缩。两例病例提示感染性视神经病变的诊断需综合病史、临床表现、辅助检查、治疗反应及特征性体征进行鉴别，尤其需审慎解读汉塞巴尔通体抗体血清学阳性结果。

This paper reports two cases of unilateral painless vision loss. Case 1 involved a 47-year-old male presenting with subacute vision loss in the right eye, accompanied by optic disc edema and macular stellate exudates. Serological testing revealed positive IgG antibodies against Bartonella henselae (titer 1:256). Combined with a history of cat contact and flea bites, a diagnosis of cat scratch disease-associated optic neuroretinitis was made. After treatment with oral doxycycline combined with periocular triamcinolone acetonide injection, the patient's vision significantly improved to 1.0. Case 2 involved a 33-year-old male presenting with acute visual field defect in the right eye accompanied by mild vision loss, optic disc edema with hemorrhage, and cotton-wool spots. Serological tests showed positive IgG antibodies against Bartonella henselae (titer 1:256) and positive antibodies against Treponema pallidum (TPPA+, TRUST+). Initial empirical treatment for cat scratch disease (doxycycline + rifampicin) and syphilis (benzathine penicillin) was ineffective, with continued vision decline. Optical coherence tomography (OCT) at the one-month follow-up revealed focal spiculated protrusions of the retinal pigment epithelium (RPE) around the optic disc, consistent with characteristic ocular changes of syphilis. Considering the patient's poor response to anti-Bartonella henselae treatment, the diagnosis was revised to syphlitic optic neuropathy. After continued anti-syphilis treatment, the patient's vision stabilized at 0.63, but optic atrophy persisted. These two cases suggest that the diagnosis of infectious optic neuropathy requires comprehensive differentiation based on medical history, clinical manifestations, auxiliary examinations, treatment responses, and characteristic signs, with particular caution in interpreting positive serological results for Bartonella henselae antibodies.

目的：探讨术区旁角膜缘上皮移植治疗翼状胬肉的手术方法和临床效果。方法：对 69 例（ 82 眼）翼状胬肉行术区旁角膜缘上皮移植术，随访 1 年，观察手术效果。结果： 79 眼（96.34%）临床治愈， 3 眼（3.66%）复发。结论：术区旁角膜缘上皮移植治疗翼状胬肉是较好的手术方法。

Objective: To investigate the operation method and clinical effect of modified pterygium excision with limbalconjunctival flap grafting beside the operation area. Methods: Excision of pterygium and limbal conjunctival autografting were performed on 82 eyes of 69 cases. The surgical effects were observed after 1 year of follow-up. Results: A total of 79 eyes （96.34%） were cured and 3 eyes （3.66%） recurred. Conclusion: Modified pterygium excision with limbal-conjunctival flap grafting beside the operation area is a efficacious method in the treatment of pterygium.

      视网膜中央动脉阻塞（central retinal artery occlusion，CRAO）是一种严重致盲性眼病。糖尿病性视网膜病变玻璃体切除联合眼内光凝术后中央动脉阻塞的临床表现及预后有其特点。南通大学附属医院收治的 2 例糖尿病性视网膜病变患者在经过玻璃体切除联合眼内光凝术后出现 CRAO。本文通过回顾 2 例患者的临床病例资料，讨论及分析其 CRAO 的原因、危险因素及诊疗方法。

Central retinal artery occlusion (CRAO) is a severe eye disease causing blindness. The clinical manifestations and prognosis of posterior artery occlusion after vitrectomy combined with intraocular photocoagulation for diabetic retinopathy are specific. Two patients with diabetic retinopathy in Affiliated Hospital of Nantong University developed central retinal arterial occlusion after vitrectomy combined with intraocular photocoagulation. In this article, the clinical data of two patients with CRAO were retrospectively analyzed. The causes, risk factors, diagnosis and treatment of CRAO were analyzed.

      睑缘炎相关性角结膜病变（Blepharo Kerato conjunctieitis，BKC）是临床上容易误诊的一类疾病，其治疗方法也多集中于激素治疗，病情易反复，毒副作用多。中医综合疗法不仅方法灵活多变，疗效可靠，长期使用无不良反应，患者乐于接受，符合“易、便、灵、验”的原则，是目前治疗本病最安全有效、便利的方法。本研究通过分析小柴胡汤内服联合中药塌渍和刺络放血治疗 1 例肝胆火炽证 BKC 的治疗，探究其机制及疗效。经治疗后患者睑缘炎症消除，角膜云翳消退，视力提高，全身情况也得到良好改善。采用中医特色综合治疗，能安全有效地控制病情发展，极大降低因治疗带来的二次伤害，最大程度提高患者康复概率。

Blepharokeratoconjunctivitis (BKC) is easily misdiagnosed in clinical practice and hormone therapy is frequently chosen. The high recurrence rate of BKC causes multiple side effects. However, Chinese herbal therapy yields slight adverse events and it can be given for a relatively long period of time. In this study, one BKC patient with liver and gallbladder fire syndrome was given with Xiaochaihu decoction, Chinese medicine sloughing combined with bloodletting puncture. Comprehensive treatment combined with Chinese medicine sloughing can safely and effectively prevent the progression of BKC, significantly reduce the secondary injury induced by treatment, and accelerates the recovery of the patients.

目的：比较急性闭角型青光眼（acute primary angel-closure glaucoma，APACG）患者在瞳孔散大、瞳孔缩小、瞳孔正常状态下前房形态变化。方法：选取 APACG 患者 81 例 81 眼，在瞳孔散大（Time1）、瞳孔缩小（Time2）、瞳孔正常（Time0）状态下，分别用 Pentacam 测量前房容积（anterior chamber volume，ACV）、中央前房深度（central anterior chamber depth，CACD）、周边前房深度（peripheral anterior chamber depth，PACD）、前房角角度（anterior chamber angle，ACA），并将这些前房参数进行对比分析。结果：与 ACV0 相比，ACV1 ，ACV2 均减小，而 ACV2 较 ACV1 增加（P < 0.01）；CACD0 ，CACD1 ，CACD2 间差异无统计学意义（P > 0.01）；与 PACD0 相比，PACD1 明显减小，PACD2 明显增加，PACD2 较 PACD1 显著增加（P < 0.01）；与 ACA0 相比，ACA2 明显增加（P < 0.01），ACA1 变化差异无统计学意义（P > 0.01）；ACA2 与 ACA1 差异无统计学意义（P > 0.01）。结论：PCAD，ACV 是反映 APACG 患者瞳孔大小变化时前房形态敏感指标；患者停用毛果芸香碱眼液后 ACV 增加证实缩瞳剂并不适合长期使用。

Objective: To observe the changes of anterior chamber morphology in mydriasis （Time1）, miosis （Time2） and normal pupil （Time0） of acute primary angel-closure glaucoma （APACG） patients using Pentacam. Methods: Eighty-one eyes in 81 patients with APACG, aged 51 to 79 years, were included in this study. All subjects with different pupil sizewere evaluated by Pentacam. We measured the anterior chamber volume （ACV）, central anterior chamber depth （CACD）, peripheral anterior chamber depth （PACD） and anterior chamber angle （ACA）. The Pentacam metrics were compared in three different pupil size under different conditions. Results: ACV1 and ACV2 were significantly lower than ACV0, whereas ACV2 was significantly higher than ACV1 （both P<0.01）. CACD showed no significant changes under different conditions （P>0.01）. Compared with PACD0, PACD1 was significantly decreased, PACD2 was increased and PACD2 was significantly higher than PACD1. ACA2 was significantly higher than ACA0 （P<0.01）. ACA1 did not change significantly. No significant difference was found between ACA2 and ACA1 （P>0.01）. Conclusion: PCAD and ACV are sensitive parameters to reflect the changes of anterior chamber morphology in three different pupil size of APACG patients, long-term use of pilocarpin eyedrops is not suitable for APACG patients.

目的：通过运用现代物联网技术，实现构建覆盖眼视光诊疗和验光配镜、医疗器械和耗材采购等多流程、多业务、多体系的眼视光综合管理信息系统。方法：依托现有移动互联网、云平台和现代物联网等技术，在传统眼科医疗信息系统技术基础上，上下延伸覆盖物流采购、仪器设备互联互通、移动支付和数据挖掘等业务流程和功能，推进眼视光管理综合运营。结果：实现供应链和物流全流程，眼视光门诊业务全流程，移动支付全流程，数据采集到数据挖掘全流程。结论：系统优势在于建立了一套完整的患者视光健康档案，为集团化视光产业走可持续发展道路提供优势资源。

Objective: To establish a multi-process,-service and –system integrated optometry information system, which covers optometry service, medical equipment and consumable procurement. Methods: Depending upon the Internet, cloud platform and Internet of things, the work flows integrating logistics procurement, equipment connection, mobile payment and data acquisition were achieved to promote the comprehensive management of optometry service on the basis of original information system for ophthalmic hospital. Results: The full-flow process was realized in the sessions of supply chain and logistics, optometry outpatient service, mobile payment, data acquisition, etc. Conclusion: The highlight of this system is to establish complete database for patients admitted to the optometry outpatient, which offer data and evidence for sustainable growth of optometry service.

      近视的患病率逐年增长，尤其是在东亚国家的人群中发病率高，现已经成为一个备受关注的公共健康问题。近视所造成的危害不容忽视，随着近视的形成和加重，可引起不同程度的视网膜和脉络膜的改变及损害。

The prevalence of myopia is increasing year by year, especially in East Asian countries. It has become a public healthy issue of concern. The harm caused by myopia cannot be ignored. With the formation and aggravation of myopia, different degrees of retinal and choroidal changes and damage can be caused.

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 （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 = 0.00 17 和P = 0 . 01 13） ，但白光组双侧眼间差异无统计学意义（P = 0 . 93 71） 。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 intothree 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.