目的：研究雌二醇（estradiol，E2）和丙酸睾酮（testosterone propionate，TP）对兔泪腺上皮细胞凋亡及对 MMP-9 蛋白表达的影响，探讨雌二醇及丙酸睾酮对干眼的作用机制。方法：体外培养兔泪腺上皮细胞，分别给予雌二醇及丙酸睾酮处理，双氧水（H₂O₂）诱导细胞凋亡，流式细胞仪检测细胞凋亡和免疫细胞化学法检测细胞 MMP-9 蛋白表达。实验分 4 组：凋亡对照组（AC 组）、雌二醇组（E2 组）、丙酸睾酮组（TP 组）和空白对照组（BC 组）。AC 组只给予 H₂O₂ 诱导凋亡，E2 组给予 1×10⁻⁵mol/L 雌二醇处理，TP 组给予丙酸睾酮处理，BC 组未加药物干预及未加 H₂O₂ 诱导凋亡。结果：经 H₂O₂ 诱导细胞凋亡后，泪腺上皮细胞早期凋亡率和 MMP-9 蛋白表达累积光密度值与 BC 组相比，AC 组、E2 组及 TP 组均显著增加；同比 AC 组，E2 组及 TP 组细胞凋亡率和 MMP-9 蛋白表达量降低；E2 组凋亡率及蛋白表达量比 TP 组明显降低；其差异均具有统计学意义（P < 0.01）。结论：雌二醇和丙酸睾酮对 H₂O₂ 诱导兔泪腺上皮细胞凋亡有一定的抑制作用，同时泪腺上皮细胞中 MMP-9 表达含量也降低，提示雌二醇和丙酸睾酮抑制兔泪腺上皮细胞凋亡的作用机制可能与 MMP-9 有关。

Objective: To investigate the effects of estradiol （E2） and testosterone propionate （TP） on apoptosis and matrix metalloproteinase-9 （MMP-9） expression in rabbit lacrimal gland epithelial cells. Methods: The rabbit lacrimal gland epithelial cells were cultured in vitro. H₂O₂ was used to induce apoptosis in cultured lacrimal gland epithelial cells and then treated with E2 and TP respectively. Cell apoptosis was detected by flow cytometer （FCM） and MMP-9 expression was evaluated by immunocytochemistry. There were four groups: apoptosis control group （AC）, estradiol group （E2）, testosterone propionate group （TP） and blank control group （BC） respectively. The cells of group AC were administrated with H₂O₂ only, group E2 and group TP with 1×10⁻⁵ mol/L E2 and TP respectively and group BC in treated. Statistical analysis were performed with one-way analysis of variance （ANOVA test）using SPSS 16.0, P<0.05 was considered statistically significant. Results: Compared with group BC, the early cells apoptosis rate and integrated optical density of MMP-9 expression of lacrimal gland in group AC, E2 and TP increased significantly after the cells were induced by H₂O₂; Compared with group AC, group E2 and TP reduced; group E2 were significantly lower than group TP; the differences were all statistically significant （P<0.01）. Conclusion: E2 and TP had a certain inhibitory effect on rabbit lacrimal gland epithelial cells apoptosis induced by H₂O₂. Meanwhile, MMP-9 expression of the lacrimal gland cells was decreased. These results indicated that E2 and TP on the apoptosis inhibitory mechanism of lacrimal gland cells may be related with MMP-9. 

目的：探讨翼状胬肉患者手术前后泪膜质量和视力变化。方法：将 50 例（50 眼）鼻侧单头翼状胬肉患者按翼状胬肉面积大小分为大面积组与小面积组，患者均接受翼状胬肉切除联合自体角膜缘移植术。记录并比较各组患者术前、术后1周、术后 1 个月的裸眼视力、矫正视力和泪膜破裂时间。结果：与术前相比，患者术后1周、术后 1 个月裸眼视力、矫正视力均有升高，差异有统计学意义（P < 0.01)。术后平均泪膜破裂时间较术前变短，术前和术后1周、术前和术后 1 个月差异有统计学意义（P < 0.05），术后1周及术后 1 个月差异无统计学意义（P > 0.05）。此外，翼状胬肉面积与术前裸眼视力、矫正视力、平均泪膜破裂时间之间均不存在相关性（P > 0.05）。结论：翼状胬肉手术可有效提高患者裸眼视力、矫正视力，使患者获得更清晰的视觉体验；但在术后一段时间内泪膜质量有所下降，术后应积极使用人工泪液维持泪膜稳定性。

Objective: To investigate the variation trend of the tear film quality and visual acuity before and after the pterygium surgery. Methods: Fifty eyes of fifty patients with single nasal pterygium were divided into the large groups and the small groups according to the size of pterygium. All patients were performed the pterygium excision and self-bulbar conjunctiva transplantation. The value of uncorrected visual acuity （UCVA）, corrected visual acuity （CVA） and average tear film rupture time were evaluated before and 1-week after and 1-month after surgery in each group and compared with each other. Results: Compared with preoperative values, the values of UCVA and VCA were significantly improved at 1-week and 1-month after （both P < 0.01）. The value of average tear film rupture time was significantly decreased before and 1 week after surgery, and before and 1 month after surgery （both P < 0.05）. The values did not significantly differ at 1 week and 1 month after surgery （P > 0.05）. Besides, theUCVA, VCA and average tear film rupture time before surgery were not significantly correlated with size of the pterygium （all P > 0.05）. Conclusion: Pterygium surgery can improve UCVA, CVA and visual acuity. But the quality of tear film is decreased after the surgery. Consequently, the artificial tears should be used positively to maintain the stability of the tear film.

目的：应用活体共聚焦显微镜（in vivo confocal microscopy，IVCM）观察视网膜激光光凝术对角膜上皮下神经的影响。方法：收集行视网膜激光光凝术的患者 36 例 46 眼，分为糖尿病性视网膜病变（diabetic retinopathy，DR）组（14 例 22 眼）与非DR组（22 例 24 眼），在治疗前及治疗后 1 周、1 个月应用 IVCM 采集两组角膜基底层下神经纤维图像，使用 Image J和 Neuron J软件计算其长度及密度。结果：DR组术前角膜神经纤维主干密度（corneal nerve fiber density，CNFD）、角膜神经纤维分支密度（corneal nerve branch density，CNBD）和角膜神经纤维长度（corneal nerve fiber length，CNFL）均低于非 DR 组，角膜神经弯曲度（corneal nerve fiber tortuosity，CNFT）高于非 DR 组。两组间角膜神经总分支节点密度（corneal total branch node，CTBN）无显著差异。DR 组光凝术后 CNFD，CNFL 测量值持续降低，术前、术后 1 周、术后 1 个月 3 个观察时段两两之间的差异有统计学意义；光凝术后 1 个月CNFT与术前的差异有统计学意义。非DR组光凝术后 CNFD，CNFL 持续降低，术前、术后 1 周、术后 1 个月 3 个观察时段两两之间的差异有统计学意义；CNBD 持续升高，术后 1 周、术后 1 个月测量值与术前的差异有统计学意义；CNFT 持续升高，术后 1 周、术后 1 个月测量值与术前的差异均有统计学意义。结论：IVCM 结合附属软件可量化评估角膜上皮下神经，糖尿病状态和视网膜激光光凝均可对角膜上皮下神经造成损伤。

Objective: To evaluate the effect of retinal photocoagulation on corneal sub-basal nerve using in vivo confocal microscopy （IVCM）. Methods: In this study, 46 eyes of 36 cases were enrolled. All patients were divided intotwo groups, 22 eyes in the diabetic retinopathy （DR） group and 24 eyes in the non-diabetic retinopathy （NDR） group. IVCM images were obtained to observe sub-basal nerve plexus before retinal photocoagulation and 1 week, 1 mouth after the treatment. Image J and Neuron J software were used for analysis. Results: In the DR group, before retinal photocoagulation, the corneal nerve fiber density （CNFD）, corneal nerve branch density （CNBD） and corneal nerve fiber length （CNFL） were lower than those in the NDR group while the corneal nerve fiber tortuosity （CNFT） was higher than that in the NDR group. There were no significant differences in corneal total branch node （CTBN） between two groups. The CNFD, CNFL were decreased constantly in the DR group. No statistical significance was observed in either CNBD or CTBN at any time point. After the treatment, the CNFT was enhanced; however, significant differences were noted between 1 week and 1 month. In the NDR group, CNFD, CNFL were declined continually to 1 month, whereas CNBD was increased. CTBN was slightly elevated at each time point without statistical significance. After treatment, CNFT was significantly increased, whereas no statistical significance was observed between 1 week and 1 month. Conclusion: IVCM combined with assistant software could be used to quantify corneal sub-basal nerve fiber. Retinal photocoagulation as well as diabetes mellitus can injure corneal sub-basal nerve fiber.

目的：比较粉尘螨滴剂与盐酸奥洛他定治疗过敏性结膜炎的效果。方法：选取2015年1月至2017年1月期间东莞台心医院 80 例过敏性结膜炎患者，根据随机数字法分为对照组(盐酸奥洛他定)与观察组（粉尘螨滴剂），比较两组治疗前后症状及体征评分变化、临床疗效及治疗期间不良反应。结果：与对照组相比，观察组治疗后症状及体征评分均明显减少（P < 0.05）；与对照组相比，观察组治疗的总有效率明显增高（P < 0.05）；治疗期间两组患者均未出现严重不良反应（P > 0.05）。结论：粉尘螨滴剂可明显改善过敏性结膜炎患者临床症状及体征，具有较好的临床疗效及治疗安全性。

Objective: To compare the clinical efficacy of dermatophagoides farina drops and olopatadine hydrochloride in the treatment for allergic conjunctivitis. Methods: A total of 80 patients with allergic conjunctivitis in our hospital from January 2015 to January 2017 were randomized into the control group （olopatadine hydrochloride） and the observation group （dermatophagoides farina drops） according to the random number method. The score changes of symptoms and signs on pre- and post-treatment, clinical efficacy and adverse reactions during the treatment period in the two groups were compared. Results: Compared with the control group, the scores of symptoms and signs on post-treatment were significantly decreased in the observation group （P < 0.05）; compared with the control group, the total effective rate of treatment was obviously increased in the observation group （P < 0.05）; there were no serious adverse reactions in two groups during the treatment period （P > 0.05）. Conclusion: Thetreatment of dermatophagoides farina drops can significantly mitigate the clinical symptoms and signs in patients with allergic conjunctivitis, which yields higher clinical efficacy and treatment safety.

目的：评估光学相干断层扫描血管成像（optical coherence tomography angiography，OCTA）在糖尿病性黄斑水肿（diabetic macular edema，DME）患眼的黄斑区微血管改变及其与视功能的相关性。方法：采用横断面研究，纳入临床检查确诊的无糖尿病性黄斑水肿的糖尿病性视网膜病变（diabetic retinopathy，DR）患者 23 例 24 只眼（明确无 DME 组）及曾经罹患过黄斑水肿但经抗血管内皮生长因子（vascular endothelial growth factor，VEGF）治疗后水肿消退的 DR 患者 14 例 16 只眼（DME经抗VEGF水肿消退组）。受检者均行眼压（intraocular pressure，IOP）、收缩压/舒张压（systolic blood pressure/diastolic blood pressure，SBP/DBP）、黄斑中心凹敏感度（foveal sensitivity，FT）及 OCTA 技术测量黄斑区 3 mm×3 mm 范围内中心凹无血管灌注区面积（foveal avascular zone，FAZ）、浅层毛细血管密度（superior vessel density，SVD）、深层毛细血管密度（deep vessel density，DVD）。采用 Pearson 分析 FT 与其年龄，眼灌注压（ocular perfusion pressure，OPP），平均动脉压（mean arterial pressure，MAP），FAZ，SVD，DVD之间的相关性。结果：两组受检眼性别、年龄、眼灌注压对比差异无统计学意义，FT，FAZ，SVD，DVD 比较，差异亦无统计学意义（均P>0.05）。相关性检验结果显示：两组受检眼之间 FT 与 SVD，DVD 比较，差异无统计学意义（均P > 0.05）；明确无DME组中，FT 与 FAZ 之间呈中等程度负相关，差异有统计学意义（r = −0.554，P < 0.01）；而 DME 经抗 VEGF 水肿消退组中，FT 与 FAZ 比较，差异无统计学意义（P > 0.05）。结论：与明确无 DME 组相比，DME 经抗 VEGF 水肿消退组 OCTA 各参数差异无统计学意义，提示抗 VEGF 治疗 DME 具有安全性。此外，黄斑水肿对糖尿病性视网膜病变患者 OCTA 中 FAZ 与FT的相关性有影响。

Objective: To quantitatively evaluate the macular microvascular changes in optical coherence tomography （OCTA） in patients with diabetic macular edema （DME） and its relationship with visual function. Methods: Twenty-three patients （24 eyes） with diabetic retinopathy （DR） without diabetic macular edema and 14 patients with DR who had macular edema but regained edema after anti-VEGF treatment （the DME subsided group） into the study. All subjects underwent intraocular pressure （IOP）, systolic blood pressure/diastolic blood pressure （SBP/DBP）, foveal sensitivity （FT）, foveal avascular zone （FAZ）, superior vessel density（SVD）, and deep vessel density （DVD） in a 3 mm×3 mm OCTA scan of macular. Pearson was used to analyze the correlation between FT and age, ocular perfusion pressure （OPP）, mean arterial pressure （MAP）, FAZ, SVD, DVD. Results: There was no significant difference in sex, age and eye perfusion pressure between the two groups. There were no significant differences between FT, FAZ, SVD and DVD （all P > 0.05）. Correlation test showed that there were no significant differences in FT, SVD and DVD between the two groups （all P > 0.05）. In addition, there was a significant difference between FT and FAZ （P < 0.01）. However, there was no significant difference between FT and FAZ in the DME subsided group （P > 0.05）. Conclusion: There is no significant difference in OCTA parameters between two groups, indicating the safety of anti-vascular endothelial growth factor in treating DME. In addition, macular edema exerts an effect on the relationship between FAZ and FT by OCTA.

目的：分析有意愿接受准分子激光角膜屈光手术治疗近视的患者在术前检查后未行手术的原因。方法：选取 2015 年 1 月至 2017 年 6 月在安徽医科大学附属第一医院眼科激光中心检查的近视患者，分析其中未行激光手术的原因。结果：共 2875 例患者准备接受准分子激光角膜屈光手术，其中 821 例（28.6%）检查后未进行手术，男 462 例（56.3%），女 359 例（43.7%），年龄 18~51（23.69±5.85）岁。 821 例中社会心理因素影响 484 例（59.0%），角膜薄或角膜厚度不足 182 例（22.2%），超高度近视（> 10.00 D）100 例（12.2%），高眼压 19 例（2.3%），弱视 13 例（1.6%），角膜曲率异常 11 例（1.3%），眼底病变 7 例（0.9%），角膜变性 3 例（0.4%），其他 2 例（0.2%）。结论：近视治疗术前检查后未进行准分子激光角膜屈光手术的原因多种多样，其中社会心理因素及角膜厚度不足是最主要的原因。术前详细检查，严格掌握手术适应证和禁忌证以及充分医患沟通是手术安全的保障。

Objective: To analyze the reasons for not performing laser refractive keratomileusis surgery among refractive surgery candidates under regular preoperative examination. Methods: The patients with myopia examined in the Center of Ophthalmology in the First Affiliated Hospital of Anhui Medical University Laser between January 2015 and June 2017 were selected, the reasons for not performing laser refractive keraomileusis after regular preoperative examination were analyzed. Results: A total of 2 875 patients requested refractive surgery and 2 054 (71.4%) of them received refractive surgery. Among 821 (28.6%) patients who did not get laser refractive keratomileusis, 462 (56.3%) were male and 359 (43.7%) were female, aged 18–51 years (range, 23.69± 5.85 years). The most common reason for not offering refractive surgery were social psychological factors (59.0%), low central corneal thickness (22.2%), high myopia (12.2%), high intraocular pressure (2.3%), poor corrected visual acuity (1.6%), corneal topography anomaly (1.3%), retinal disease (0.9%), corneal (0.4%) and other diseases (0.2%).  Conclusion: Reasons for not performing refractive surgery are quite diverse. Social psychological factors and inadequate corneal thickness were the most common reasons in the present study. Careful preoperative examination, strictly mastering indications and contraindications and full doctor-patient communication should be done for the safety of surgery. 

暴发性脉络膜上腔出血（subchoroidal expulsive hemorrhage,SEH）是内眼手术中罕见且严重的并发症，广东省人民医院眼科收治 1 名因晶状体完全脱位继发青光眼的女性患者,73 岁，其手术过程中发生 SEH，现报告如下.通过回顾病例，讨论及分析 SEH 的原因、危险因素及治疗。

Subchoroidal expulsive hemorrhage（SEH）is one of the rarest and worst complications of intraocular surgery. We treated one patient with secondary glaucoma due to complete dislocation of the lens, who developed SEH during the surgery. In this case report, the causes, risk factors and treatment of subchoroidal expulsive were discussed and analyzed by reviewing the case.

目的：探讨县级基层医院白内障患者术前焦虑情况，以便改善护理流程。方法：本研究为回顾性研究，收集河源光明眼科医院 2017 年 1 至 9 月 2182 例行白内障复明手术患者的术前焦虑视觉模拟量表（The Anxiety Visual Analogue Scale，VAS-A）评分及阿姆斯特丹术前焦虑与信息需求表（Amsterdam Preoperative Anxiety and Information Scale，APAIS）评分，采用t检验和 Spearman 相关性检验进行术前焦虑情况分析。结果： 2182 例白内障手术患者 VAS-A 焦虑评分为 4.74±1.93 ，APAIS 焦虑评分为 6.46±1.66 ，男性患者术前焦虑程度低于女性患者，患者术前焦虑程度与年龄呈低度负相关。结论：两种术前焦虑评分均能反映患者术前焦虑程度，可根据其对麻醉或手术信息需求度的不同选择相应的护理对策，以缓解患者术前焦虑，改善护理质量。

Objective: To investigate the preoperative anxiety in patients with cataract in a township hospital. Methods: A retrospective study was conducted on preoperative anxiety of 2 182 patients with cataract according to the Anxiety Visual Analogue Scale（VAS-A） and Amsterdam Preoperative Anxiety and Information Scale（APAIS）from Jan 1, 2017 to Sep 30, 2017 in Heyuan Guangming Eye Hospital. Student’s t-test and Spearman correlation were used to evaluate the preoperative anxiety. Results: The score of preoperative anxiety was 4.74±1.93 with the VAS-A and was 6.46±1.66 with the APAIS. The preoperative anxiety in male was lower than that in female, and the degree of the preoperative anxiety was negatively correlated with age. Conclusion:The preoperative anxiety of patients with cataract can be properly evaluated using either the VAS-A or the APAIS.The nursing care should be adjusted corresponding to patients’ different needs of the information about anesthesia and surgery in order to alleviate the preoperative anxiety and improve the nursing care.

目的：探讨大泡性角膜病变（bullous keratopathy，BK）患者行飞秒激光辅助的角膜内皮移植术（endothelium keratoplasty，EK）的围手术期护理。方法：回顾性分析在南京总医院眼科行飞秒激光辅助角膜内皮移植的 BK 20 例患者，分析并总结患者术前的心理疏导、术前准备、眼科检查、术中如何配合医生、术后特殊体位、高眼压的护理及如何正确用药和出院健康教育等。结果：患者得到及时、有效的护理，术后视力均有所提高，内皮贴伏好，无排斥反应及其他并发症的发生。结论：通过对患者围手术期的护理，可提高护理质量，缩短患者住院时间。

Objective: To observe the perioperative nursing of femtosecond laser-assisted corneal endothelial transplantation in the treatment of patients with bullous keratopathy. Methods: A retrospective analysis of 20 patients with bullous keratopathy with femtosecond laser-assisted corneal endothelial transplantation in our department. The preoperative psychological counseling, preoperative preparation, ocular examination, how to cooperate with the doctors in operation, nursing of special position, high intraocular pressure after surgery, how to use eye drops correctly and health education after discharge were summarized. Results: Nursing were performed to the patients timely and effectively. Postoperative visual acuity of all the patients were improved, the endothelial and corneal stroma bed are well combined and no graft rejection and other complications occurred in the patients postoperatively. Conclusion: We concluded that the quality of nursing was improved and the time of hospitalization was shortened after perioperative nursing. 

年龄相关性黄斑变性（age-related macular degeneration, AMD）是一种与氧化应激及多基因调控异常密切相关的视网膜黄斑区域进行性退化性疾病。由于黄斑区缺乏血管，因此对氧气的高度依赖使其特别容易受到氧化应激的影响。氧化应激反应影响视网膜色素上皮细胞（retinal pigment epithelium, RPE）功能，导致RPE细胞代谢异常、RPE细胞凋亡与损伤；影响脉络膜血管功能，表现为新生血管异常和血管内皮细胞功能障碍；过度激活补体系统，使炎症细胞浸润与炎症因子释放引发炎症；这三者构成了AMD的发病机制之一。文章列举了抗氧化酶基因家族（超氧化物歧化酶、过氧化氢酶、谷胱甘肽过氧化物酶）、炎症相关基因（补体系统相关基因和细胞因子相关基因）和其他相关基因（血管内皮生长因子、血红素加氧酶-1、载脂蛋白E、铁死亡相关基因、年龄相关性黄斑病变易感因子2基因）的异常表达与AMD产生的关联性，并阐述了基因编辑技术纠正氧化应激相关基因缺陷和基于氧化应激基因靶点的药物治疗手段，以期为AMD的防治提供思路。

Age-related macular degeneration (AMD) is a retinal degenerative disease closely associated with oxidative stress and dysregulation of polygenic mechanisms. Due to the absence of blood vessels in the macular region, its high dependence on oxygen renders it particularly susceptible to oxidative stress. Oxidative stress impairs the function of retinal pigment epithelium (RPE) cells, leading to metabolic dysregulation, apoptosis, and cellular damage. It also disrupts choroidal vascular function, characterized by abnormal neovascularization and endothelial dysfunction. Moreover, excessive activation of the complement system promotes inflammatory cell infiltration and the release of pro-inflammatory cytokines. Collectively, these processes constitute one of the key pathogenic mechanisms underlying AMD. This paper highlights the pathogenic associations between AMD progression and dysregulated expression in antioxidant enzyme genes (e.g., superoxide dismutase, catalase, glutathione peroxidase), inflammation-related genes (e.g., complement and cytokine-related genes), and other relevant genes (e.g., vascular endothelial growth factor, heme oxygenase-1, apolipoprotein E, ferroptosis-related genes, age-related maculopathy susceptibility 2 gene). Potential therapeutic strategies, including gene editing to correct oxidative stress-related genetic defects and pharmacological interventions targeting oxidative stress-associated genes, are also elaborated, aiming to provide new insights into AMD prevention and treatment.