目的：应用彩色多普勒超声造影检查测定不同类型原发性青光眼患者的视神经血液供应情况，探讨血流变化与青光眼的关系。方法：选取2012年12月至2014年3月在哈尔滨医科大学附属第二医院眼科经临床确诊的原发性闭角型青光眼(primary angle closure glaucoma，PACG)患者16例(20只眼)和原发性开角型青光眼(primary open angle glaucoma，POAG)患者8例(10只眼)，分别设为PACG组和POAG组；同时，选取10例10只正常眼设为对照组。所有受试者分别行彩色多普勒及超声造影检查，观察眼动脉(ophthalmic artery，OA)、视网膜中央动脉(central retinal artery，CRA)、睫后短动脉(short posterior ciliary artery，SPCA)的血流动力学指标，包括收缩期最大血流速度(peak systolic velocity，PSV)、舒张末期血流峰值速度(diastolic peak velocity，EDV)、血流阻力指数(resistance index，RI)、造影剂到达时间(arrival time，AT)及消退时间(departure time，DT)等指标，并对结果进行统计学分析。结果：超声造影测定POAG组的眼动脉造影剂AT较正常对照组延长(P=0.035)，PACG组及POAG组的眼动脉造影剂DT均较正常对照组延长(P=0.010)；彩色多普勒测定PACG组及POAG组的OA和SPCA，以及POAG组的CRA的PSV、EDV均较正常对照组减低(P=0.003)；同时，PACG组及POAG组的OA以及POAG组的CRA的RI较正常对照组增高(P<0.001)。结论：彩色多普勒及超声造影可以检测青光眼患者的眼部血供明显低于正常人群，为临床诊治青光眼及评价眼部疾病患者的眼部血供状态提供了一种新的技术手段。

Objective: This study used Doppler imaging and contrast-enhanced ultrasound to measure ocular haemodynamic of patients with primary angle-closure glaucoma (PACG) and primary open-angle glaucoma (POAG), to investigate the association between the blood flow changes and glaucoma. Methods: Doppler imaging and contrast-enhanced ultrasound were performed on 16 PACG patients (20 eyes, PACG group), 8 POAG patients (10 eyes, POAG group) who were diagnosed in the Department of Ophthalmology, the Second Affiliated Hospital of Harbin Medical University from Dec. 2012 to Mar. 2014. The normal eyes from 10 persons were selected as control group. The flow velocity of ophthalmic artery, central retinal artery, and posterior ciliary artery were observed, including the peak systolic velocity, diastolic peak velocity, resistance index, and the arrival time and departure time of the ultrasound microbubbles (SonoVue). Results: Compared to control group, the arrival time of the ultrasound microbubbles (SonoVue) of ophthalmic artery of patients with POAG increased (P=0.035), and the departure time of ophthalmic artery of patients with PACG and POAG increased (P=0.010). Both peak systolic velocity and diastolic peak velocity of the ophthalmic artery and short posterior ciliary artery of patients with PACG and POAG and the central retinal artery of patients with POAG decreased (P=0.003). Meanwhile, the resistance index of ophthalmic artery of patients with PACG and POAG and the central retinal artery of patients with POAG were higher than those in the control group (P<0.001). Conclusion: The flow velocity of ocular vascular was worse than that of normal group respectively. This study provides a new technology for the diagnosis of glaucoma and the evaluation of the flow velocity of ocular vascular.

目的：观察并分析慢性闭角型青光眼患者小梁切除术后早期眼前节及屈光状态变化。方法：采用前瞻性研究方法，收集青光眼小梁切除手术病例20例20只眼，分别测定术前、术后1周、1个月及3个月的球面镜度数、角膜曲率、眼轴长度、前房深度，并进行统计学分析。结果：小梁切除术后1周球面镜度数较手术前差异均具有统计学意义(P<0.05)，差值为(?1.20±0.55) D；术后1个月、3个月球面镜度数较手术前差异无统计学意义(P>0.05)。术前、术后1周、1个月垂直方向角膜曲率分别为(44.89±1.20) D、(45.72±1.54) D、(45.65±1.35) D，术后1周、1个月垂直方向角膜曲率较手术前显著性增加，差异具有统计学意义(P<0.05)；术后3个月垂直方向角膜曲率较术后1个月差异无统计学意义(P>0.05)。术前眼轴长度(22.49±0.43) mm和前房深度(2.75±0.45) mm与术后1周眼轴长度(21.60±0.59) mm和前房深度(2.25±0.34) mm比较差异具有统计学意义 (P<0.01)；术后1个月和3个月前房深度、眼轴长度较手术前差异无统计学意义(P>0.05)。结论：小梁切除术后早期(术后1个月)可发生球面镜度数增加，前房变浅、眼轴变短、垂直方向曲率增加的眼前节和屈光改变。从而发生近视飘移、而影响术后视力。随时间推移(术后3个月)，前房加深、眼轴长度逐渐增加、垂直散光和近视飘移度数逐渐减少，眼前节和屈光变化逐渐趋于稳定，术后视力逐渐恢复。

Objective: To observe and analyze the changes of anterior segment and refractive state in patients with chronic angle closure glaucoma after trabeculectomy. Methods: It was a prospective study. A total of 20 cases with 20 eyes that have met the inclusion criteria undergoing trabeculectomy were collected. The diopter of spherical power, corneal curvature, axial length (AL) and anterior chamber depth (ACD) were measured before the surgery and 1 week, 1 month, and 3 months after the surgery respectively. Results: There was significant difference (P<0.05) for the diopter of spherical power before and 1 week after the trabeculectomy, the difference was (?1.20±0.55) D. After 1 month and 3 months, the diopter of spherical power was not statistically significant (P>0.05). The corneal curvature in the vertical direction was (44.89±1.20) D, (45.72±1.54) D, (45.65±1.35) before, 1 week and 1 month after operation. The corneal curvature in the vertical direction increased significantly at 1 week and 1 month after operation (P<0.05), and there was no significant difference (P>0.05) after 3 months. The preoperative mean ocular axis length (22.49±0.43 mm) and mean anterior chamber depth (2.75±0.45 mm) compared with postoperative mean ocular axis length (21.60±0.59 mm) and mean anterior chamber depth (2.25±0.34 mm) were statistically significant (P<0.01). Comparing 1 month and 3 months after operation, there was no significant difference in the depth of the anterior chamber and the length of the eye axis (P>0.05). Conclusion: In the early stage after trabeculectomy (1 month after operation), the diopter of spherical power can be increased. The ACD became shallower, the eye axis became shorter, and the curvature of vertical direction increased resulting in myopic drift, which affected postoperative visual acuity. Over time (3 months after operation), the anterior chamber deepened, the axial length gradually increased, the vertical astigmatism and myopia drift degree gradually decreased, the anterior segment and refractive changes gradually stabilized, and the postoperative visual acuity gradually recovered.

目的：评估与原发性慢性青光眼患者生活质量最具相关性的视觉指标。方法：回顾性病例系列研究。收集2010年3月至2010年8月就诊于首都医科大学附属北京同仁医院且符合入选及排除标准的原发性慢性闭角型青光眼和原发性开角型青光眼患者131例262只眼。采用Humphrey Field Analyzer II 750i型视野分析仪对入选患者分别进行单眼Central 24-2程序和Esterman双眼视野检查程序(Esterman Binocular Visual Field Test，EBVFT)各两次检查，以保证所得数据的可靠性。使用LogMAR视力表检查并记录受试者日常单眼生活视力和日常双眼生活视力、非接触式眼压计测量眼压、直接眼底镜检查视神经的杯盘比。记录病史及目前所使用抗青光眼药物，角膜及晶状体状态。应用视功能相关生活质量量表-25(25-Item National Eye Institute Visual Function Questionnaire，VFQ-25)对患者进行生活质量评估，并将双眼日常生活视力、较好眼生活视力、较差眼视野MD(mean defect)值、较好眼视野MD值、(Esterman Visual Field Test，EVFT)效用值和VFQ-25得分进行相关性分析。结果：共有131例受试者符合入选条件。在患者生存质量的统计中，自我评价视力、近距离活动、远距离活动、社会功能、依赖程度、色觉、视野这7项得分较好，即受试者完成该7项的能力较高。VFQ-25总分与EBVFT效用值成正相关(r=0.24998，P=0.004<0.05)，与双眼日常生活视力成负相关(r=?0.37778，P<0.0001)，与较差眼视野MD值成正相关(r=0.22917，P=0.0187<0.05)，与较好眼生活视力、较好眼视野、较差眼生活视力无明显相关关系。结论：原发性慢性青光眼患者双眼视觉(双眼视野和双眼日常生活视力)和VFQ-25有良好的相关性，可用于评估慢性青光眼患者的生活质量。

Objective: To assess the correlation between the Esterman binocular visual field (EBVF) and the visual function quality of life (VFQ) in primary chronic glaucoma patients. Methods: It is a retrospective case series study. One hundred and thirty-one patients, that is to say, two hundreds and sixty-two eyes, with primary chronic glaucoma satisfying the methodological criteria were recruited for this study, who were chosen from Beijing Tongren Hospital, Capital Medical University from March 2010 to August 2010. The Humphrey Field Analyzer Model II 750i (Humphrey Instruments, Zeiss Company) was used to perform an Esterman binocular visual field test (EBVFT) and bilateral monocular full-threshold central visual field testing using the 24-2 SITA Standard program. Visual acuities were examined by logarithm of the minimum angle of resolution (logMAR) scale. Intraocular pressure and cup-disc ratio were also recorded. The history with glaucoma and anti-glaucoma drugs, and the state of the cornea and crystalline lens were also remarked. All interviews were administered face to face by the same experienced interviewer, by using the 25-Item National Eye Institute Visual Function Questionnaire (VFQ-25). Agreement between the scores from these tests and the VFQ-25 was evaluated. Results: A total of 131 patients were recruited. In the statistics of the quality of life, seven domain scores of the VFQ-25 (self-assessment vision, color vision, near action, distant action, social function, mental health and peripheral vision) were better than the others, which meant the ability of completing the seven domain was higher. Substantial agreement was found between the composite score of the VFQ-25 and the Esterman test (r=0.24998, P=0.004<0.05), strong negative correlation was found between the composite score of the VFQ-25 and the binocular visual acuity of daily life (r=?0.37778, P<0.0001), and positive correlation was found between the composite score of the VFQ-25 and the MD of the worse eye (r=0.22917, P=0.0187<0.05). Conclusion: In this sample of clinic-based patients with primary chronic glaucoma, the efficiency score of the binocular visual field tests correlated well with the composite score of the VFQ-25. Binocular visual function can be well used in evaluating the quality of life of the glaucoma patients.

目的：分析玻璃体腔注射术后眼内炎的发生并总结原因，旨在进一步提高手术安全性。方法：回顾性分析中国人民解放军总医院第六医学中心2010年9月至2019年11月行玻璃体腔注射术的421例患者(973眼)的术后1 d、1周、1个月的随访资料。归纳注射药物种类、注射病因、患者全身病史，总结术后眼内炎的发生及治疗情况。结果：玻璃体腔注射术安全性高，但严重并发症眼内炎(0.41%)仍偶有发生。4例眼内炎患者中2例为Irvine-Gass综合征患者行曲安奈德玻璃体腔注射后，1例为视网膜中央静脉阻塞患者行曲安奈德玻璃体腔注射后，1例为中心性渗出性视网膜脉络膜病变患者行雷珠单抗玻璃体腔注射后。其中曲安奈德引起的眼内炎(1.99%)明显高于抗血管内皮生长因子(vascular endothelial growth factor，VEGF)药物引起的眼内炎(0.12%)。结论：严格按照操作指南操作，当针对高血压老年群体尤其是Irvine-Gass综合征患者玻璃体腔注射曲安奈德时尤其防范眼内炎的发生。

Objective: To analyze the incidence and causes of endophthalmitis after intravitreal injection and to further improve the safety of the surgery. Methods: The follow-up data of 973 eyes of 421 patients who received intravitreal injection in our hospital in the past 9 years at 1 day, 1 week and 1 month were retrospectively analyzed. The types of injected drugs, the cause of injection and systemic history were summarized, and the occurrence and treatment of postoperative endophthalmitis were summarized. Results: The intravitreal injections were safe. However, the severe complication of endophthalmitis (0.41%) occurred occasionally. Among these 4 patients with endophthalmitis, 2 patients were intravitreal injected triamcinolone acetonide because of Irvine-Gass syndrome; 1 patient accepted intravitreal injection by Ranibizumab because of central retinal vein occlusion; 1 patient accepted intravitreal injection by Ranibizumab because of central exudative chorioretinopathy. The incidence of endophthalmitis (1.99%) after intravitreal injection of triamcinolone acetonide was higher than that of anti-vascular endothelial growth factor (VEGF) agents (0.12%). Conclusion: The clinical operating guideline of intravitreal injection should be followed strictly. Furthermore, the elderly people with hypertension diagnosed of Irvine-Gass syndrome have a higher risk of endophthalmitis after intravitreal injection of triamcinolone acetonide than others and should be paid more important attention.

目的：探讨品管圈在提高玻璃体切除术后患者俯卧位执行率中的应用效果。方法：成立品管圈活动小组，选定提高玻璃体切除术后患者俯卧位执行率作为活动主题，运用品管圈工具和方法，对现状进行分析，找出影响因素，制定相应的措施并组织实施，比较品管圈活动前后玻璃体切除术后患者俯卧位执行率情况。结果：玻璃体切除术后患者俯卧位执行率由活动前的64.70%提高到95.83%。结论：运用品管圈能显著提高玻璃体切除术后患者俯卧位执行率，值得临床推广。

Objective: To explore the effect of quality control circle on improving the prone position execution rate of patients after vitrectomy. Methods: Establish quality control circle activity group, select improving the prone position execution rate of patients after vitrectomy as the activity theme, use quality control circle tools and methods to analyze the status quo, find out the influencing factors, formulate corresponding measures and implement them, and compare the prone position execution rate of patients before and after quality control circle activity. Results: The prone position execution rate of patients after vitrectomy increased from 64.70% to 95.83%. Conclusion: The application of quality control circle can significantly improve the prone position implementation rate of patients after vitrectomy, which is worthy of clinical promotion.

目的：探讨光学相干断层扫描血管成像(optical coherence tomography angiography，OCTA)扫描信号强度对视盘周围血管密度的影响。方法：本研究为单中心横断面研究，所有受试者分别接受了身高、体重、血压、眼压、眼轴及视盘OCTA检查，利用广义估计方程分析OCTA扫描信号强度对视盘周围血管密度的影响。结果：共186人359眼纳入本研究，年龄为(47.86±17.86)岁，视盘周围血管密度为(17.75±1.99) mm?1。单因素分析显示视盘周围血管密度与眼轴呈负相关(β=?0.5120，P<0.001)，与扫描信号强度呈正相关(β=1.0240，P<0.001)。在校正了年龄、性别、视盘面积及眼轴后的多因素分析中，OCTA扫描信号强度依然与视盘周围血管密度显著正相关(β=0.9721，P<0.001)。结论：视盘周围血管密度不仅与眼轴和视盘面积显著负相关，而且与OCTA扫描信号强度显著正相关，在临床应用或研究中，需要考虑其影响。

Objective: To explore the effect of scanning signal intensity on the peripapillary vessel density measured by optical coherence tomography angiography (OCTA). Methods: This study was a single-center cross-sectional study. All the participants received comprehensive examinations including height, weight, blood pressure, intraocular pressure, axial length, and OCTA scan of the optic disc. The effect of OCTA scanning signal intensity on the peripapillary vessel density was analyzed using the generalized estimation equation. Results: A total of 186 participants with 359 eyes were included in this study. The mean age of all the participants was (47.86±17.86) years old, and the average peripapillary vessel density was (17.75±1.99) mm?1. In a univariate analysis, peripapillary vessel density was associated with the axial length (β=?0.5120, P<0.001) and the scanning signal intensity (β=1.0240, P<0.001). After adjusting for age, gender, axial length, and optic disc area in the multivariate analysis, the OCTA scanning signal intensity was still significantly associated with the peripapillary vessel density (β=0.9721, P<0.001). Conclusion: The peripapillary vessel density is significantly negatively associated with the axial length and optic disc area, significantly positively associated with the scanning signal intensity. In clinical practice, the influence needs to be considered.

目的：观察并分析不同类型黄斑裂孔的患病相关影响因素。方法：回顾性分析2012年1月至2018年12月在兰州大学第二医院住院治疗的1 150例(1 202只眼)全层黄斑裂孔患者的年龄、性别、民族、最佳矫正视力、黄斑裂孔类型以及是否继发孔源性视网膜脱离等临床资料。结果：黄斑裂孔患病人数随年龄增长呈趋势性分布，60~69岁年龄段患病人数最多；男女患病差异有统计学意义(P<0.05)，眼别差异无统计学意义(P>0.05)；特发性黄斑裂孔继发孔源性视网膜脱离的占比明显低于其他类型；特发性黄斑裂孔的入院最佳矫正视力较高，与高度近视黄斑裂孔相比，差异有统计学意义(P<0.05)。结论：黄斑裂孔多发于老年人，女性多见，高度近视黄斑裂孔容易继发孔源性视网膜脱离，可考虑尽早安排手术治疗；外伤性黄斑裂孔好发于中青年男性，常见于眼球钝挫伤，若未引发视网膜脱离等并发症，应适当观察而不急于手术。每1例黄斑裂孔都可能有其特殊性，需要认真分析病情综合判断，酌情选择观察或手术。

Objective: To observe and analyze the disease related factors of different types of macular hole. Methods: Clinical data including age, sex, ethnicity, best corrected visual acuity, macular hole type and whether accompanied by rhegmatogenous retinal detachment were retrospectively analyzed in 1 150 patients (1 202 eyes) hospitalized in our hospital from January 2012 to December 2018. Results: The number of patients with macular hole increased with age. There was statistically significant difference between male and female patients (P<0.05), and no statistically significant difference between eyes (P>0.05). The rate of rhegmatogenous retinal detachment caused by idiopathic macular hole was significantly lower than other types. The optimal corrected visual acuity of idiopathic macular hole was higher in admission, which was statistically different from that of high myopia macular hole and ametropia macular hole (P<0.05). Conclusion: Macular hole is more common in the elderly and more common in women. High myopia and ametropia macular hole are easily associated with rhegmatogenous retinal detachment, so surgical treatment should be arranged as soon as possible. Traumatic macular hole often occurs in young and middle-aged men and is often seen in blunt contusion of the eyeball. Each case of macular hole may have its particularity, which requires careful analysis of the condition, comprehensive analysis, and appropriate choice of observation or surgery.

角膜神经性疼痛(neuropathic corneal pain，NCP)的患者具有眼部及躯体症状，但临床体征不典型，治疗效果不理想。随着干眼诊治的规范化程度不断提升，NCP的患者日益增多。NCP与全身慢性疼痛综合征相互交织。角膜共聚焦显微镜及活体印迹细胞检测可以发现特征性神经形态及相关蛋白改变。NCP的治疗应基于个体化、多学科联合的原则。本文综述近年来，NCP的病因学、病理生理学、综合治疗等取得新的进展以指导临床及转化医学研究。

Patients with neuropathic corneal pain (NCP) have local and physical symptoms, but the clinical signs are atypical, and the treatment is not effect. With the improvement of standardization of diagnosis and treatment of dry eye, the number of patients with NCP has been increasing. The NCP is intertwined with systemic chronic pain syndrome. Corneal confocal microscope and in vivo blot cytology can find the signs of morphology and associated proteins variation. The treatments of NCP should be based on the principle of individualized, multidisciplinary treatment (MDT). This article reviews recent advances in the etiology, pathogenesis, and comprehensive treatment of NCP to guide clinical translational medicine research.

抗血管内皮生长因子(vascular endothelial growth factor，VEGF)治疗视网膜静脉阻塞(retinal vein occlusion，RVO)继发黄斑水肿(macular edema，ME)的有效性及安全性已得到广泛证实。但抗VEGF治疗方案尚无统一标准。现行的治疗方案主要包括固定治疗方案、按需(pro re nata，PRN)治疗方案、稳定性标准驱使的按需(stabilization criteria-driven PRN)治疗方案、治疗与延长(treat and extend，T&E)方案。近年来不少研究综合比较了各个治疗方案在改善视功能、量化评估疾病活动性、调整随访频率等多个维度的表现，为临床医生提供选择抗VEGF治疗方案的参考依据。本文旨在回顾并总结近年来对抗VEGF药物治疗RVO继发ME的研究，阐述抗VEGF治疗方案的研究进展。

The efficacy and safety of anti-vascular endothelial growth factor (VEGF) in the treatment of macular edema (ME) secondary to retinal vein occlusion (RVO) have been widely confirmed. However, there is no unified standard for anti-VEGF treatment regimens. Current treatment regimens mainly include fixed treatment regimen, pro re nata (PRN) treatment regimen, stabilization criteria-driven PRN treatment regimen, and treat and extend (T&E) regimen. In recent years, many studies have compared different treatment regimens in composite dimensions, including improving visual function, assessing disease activity quantitatively and adjusting the follow-up frequency, to provide clinicians with a reference of choosing anti-VEGF treatment regimens. The purpose of this article is to review and summarize recent researches on anti-VEGF drugs in the treatment of ME secondary to RVO, and to clarify the research progress in the anti-VEGF treatment regimens.

暴露性角膜炎是角膜失去眼睑保护而暴露在空气中，引起角膜干燥、上皮细胞脱落进而继发感染的角膜炎症，多见于眼睑缺损、眼球突出、睑外翻、面神经麻痹、手术麻醉等。泪液的缺失、眼睑闭合不全、眼表暴露等因素皆会影响角膜健康，使其处于炎症、溃疡及穿孔的危险中。暴露性角膜炎治疗目的是去除暴露因素、保护角膜上皮和维持眼表湿润，目前常用的治疗手段有手术治疗与药物治疗，有些是暂时性的，有些是永久性的。

Exposure keratitis is an inflammation of the cornea that occurs when the cornea loses the protection of the eyelid and is exposed to air, resulting in dryness, epithelial exfoliation, and secondary infection. Most of them are found in eyelid defect, protopsis, eyelid ectropion, facial palsy, and anesthesia. Loss of tears, lagophthalmos and exposed ocular surface all affect the health of the cornea, putting it at risk of inflammation, ulceration, and perforation. The purpose of treatment is to remove exposure factors, protect the corneal epithelium and keep ocular surface moist. Currently, the commonly used treatments are surgical treatment and medical treatment, and some of them are temporary while others are permanent.