目的：探讨蛋白A免疫吸附联合糖皮质激素治疗对MOG抗体相关视神经炎（MOG antibody-associated optic neuritis， MOG-ON）患者的临床疗效及安全性。方法：回顾性分析2022年6月—2024年12月在广东三九脑科医院神经内科确诊并接受蛋白A免疫吸附联合糖皮质激素治疗的7例MOG-ON患者。所有患者均接受蛋白A免疫吸附治疗（隔天1次，共5次为1个疗程）并同期联合糖皮质激素治疗。评估治疗前及治疗后3个月、6个月的视力变化、扩展伤残状态量表（expanded disability status scale，EDSS）评分变化及MOG抗体滴度变化，并记录不良反应。结果：治疗后6个月，6/7患者视力较治疗前改善，其中4/7视力改善显著。左眼LogMAR视力值从治疗前的0.20(0.14，0.70)改善至0.10(0.10，0.42)，右眼LogMAR视力值从0.30(0.19，0.47)改善至0.18(0.10，0.21)，EDSS视力评分从2.86±1.68降至1.43±1.51（P < 0.05）。治疗前血清MOG抗体滴度几何平均数为1:52.0（几何标准差GSD = 3.7），治疗后3个月降至1:8.8（GSD = 1.9）（P = 0.027），治疗后6个月降至1:13.0（GSD = 4.1）（P = 0.027）。7例患者共接受35次免疫吸附治疗，未观察到严重不良反应，仅有轻微可控的不良事件。结论：蛋白A免疫吸附联合糖皮质激素治疗能够有效降低血液中MOG抗体水平，改善MOG-ON患者的视力。

Objective: To investigate the clinical efficacy and safety of protein A immunoadsorption combined with glucocorticoid therapy in patients with myelin oligodendrocyte glycoprotein antibody-associated optic neuritis（MOG-ON）. Methods: A retrospective analysis was conducted on 7 patients with MOG-ON who were diagnosed and treated with protein A immunoadsorption combined with glucocorticoid therapy at the Department of Neurology，Guangdong Sanjiu Brain Hospital from June 2022 to December 2024. All patients underwent protein A immunoadsorption therapy （once every other day, with 5 sessions constituting one course） in conjunction with concurrent steroid therapy. Visual acuity changes, EDSS score changes, and MOG antibody titer changes were assessed before treatment, as well as at 3 and 6 months after treatment. Additionally, adverse events were meticulously recorded. Results: At the 6 months post-treatment mark, 6 patients （85.7%） demonstrated an improvement in visual acuity compared to their baseline levels, with 4 patients （57.1%） achieving a significant improvement. The median LogMAR visual acuity values in the left eye  improved from 0.20(0.14,0.70) to 0.10(0.10,0.42), and in the right eye, they improved from 0.30(0.19,0.47) to 0.18(0.10,0.21). MeanWhile, the EDSS visual score decreased from 2.86±1.68 to 1.43±1.51（P < 0.05）. The geometric mean serum MOG antibody titer declined from 1:52.0（GSD = 3.7） before treatment to 1:8.8（GSD = 1.9） at 3 months after treatment（P = 0.027）, and further decreased to 1:13.0（GSD = 4.1） at 6 months after treatment（P = 0.027）. A total of 35 immunoadsorption sessions were administered to the 7 patients, and no serious adverse reactions were observed; only minor and manageable adverse events occurred. Conclusion: Protein A immunoadsorption combined with glucocorticoid therapy can effectively lower serum MOG antibody levels and enhance visual outcomes in patients with MOG-ON.

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.

目的：了解干眼患者相关知识、管理态度及防治行为的现状及影响因素，为临床制定针对性的干预措施提供依据。方法：采用便利抽样法，选取2025年1—3月在中山大学中山眼科中心干眼与眼表疾病门诊就诊的患者为研究对象。调查工具为一般资料调查表、中国干眼问卷及干眼患者知信行问卷。知信行问卷包括知识（16个条目）、态度（7个条目）、行为（9个条目） 3个维度，共32个条目。使用单因素分析及多元线性回归分析确定影响因素。 结果：有效回收调查问卷325份，325例干眼患者的知信行问卷平均得分为（62.89±9.00）分；标准分为（78.61±11.25）分，处于中等水平。其中知识维度平均得分为（9.89±4.88）分，134例（41.2%）处于较差水平；态度维度得分较高，总均分为（26.92±2.24）分，标准分（96.16±8.03）分，处于较高水平；行为维度总均分为（26.06±5.43）分，标准分（72.41±15.09）分，处于中等水平。单因素分析结果显示，不同年龄、文化程度、家庭人均月收入、是否经常使用电子设备、是否主动查询疾病知识的干眼患者，其知信行得分比较差异有统计学意义（P<0.05）。年龄、文化程度、是否主动查询疾病知识是干眼患者知信行得分的影响因素（P<0.05）。 结论：干眼患者知信行水平处于中等，表现为疾病知识掌握片面、防治态度较积极但行为水平有待提高，且受多因素影响，应制订精准、个性化健康教育内容，以提高干眼患者的知信行水平。

Objective: To investigate the current status and identify the influencing factors regarding the knowledge, attitudes, and practices related to dry eye disease (DED) among patients. This study aims to provide a solid foundation for the development of targeted clinical interventions. Methods: With convenience sampling, patients diagnosed with DED were selected at the Dry Eye and Ocular Surface Disease Clinic of Zhongshan Ophthalmic Center from January to March 2025 as study subjects. The survey tools consisted of a general information questionnaire, the Chinese Dry Eye Questionnaire, and the Knowledge, Attitudes, and Practices (KAP) Questionnaire for DED patients. The KAP questionnaire was structured into three dimensions: knowledge (16 items), attitudes (7 items), and practices (9 items), making a total of 32 items. Univariate analysis and multiple linear regression were employed to identify influencing factors. Results: A total of 325 valid questionnaires were collected. Among the 325 DED patients, the average KAP score was 62.89±9.00, and the standardized score was 78.61±11.25, indicating a moderate level. In the knowledge dimension, the average score was 9.89±4.88 and 134 patients (41.2%) had poor scores. The attitudes dimension showed a relatively high level, with a total mean score of 26.92±2.24 and a standardized score of 96.16±8.03, reflecting that the patients generally held positive attitudes towards the prevention and treatment of DED. For the practices dimension, the total mean score was 26.06±5.43, and the standardized score was 72.41±15.09, indicating a moderate level of behaviorial practices. Univariate analysis revealed significant differences in KAP scores among patients with different ages, education levels, monthly household income per capita, frequencies of electronic device use, and whether they actively sought disease-related knowledge (P<0.05). Further, age, education level, and proactive information-seeking behavior were identified as significant influencing factors for KAP scores (P<0.05). Conclusions: The KAP level of DED patients is moderate. Their disease knowlege is fragmented, while they exhibit positive attitudes toward prevention and treatment. However, their behavioral practices are subptimal and are influenced by multiple factors. Therefore, it is essential to develop tailored and personalized health education programs to enhance the KAP level of DED patients.

目的：通过计算机体层扫描（computed tomography，CT）平扫和三维重建等利用图像后处理系统软件，评估视网膜母细胞瘤（Retinoblastoma，RB）病灶的钙化水平，并探究其与患者性别、眼别、年龄及影像学分期之间的相关性。方法：选取2022年5月—2024年12月经我院眼眶病与眼肿瘤科手术病理证实及临床确诊的108例RB患者127眼进行分析。应用CT重建和工作站分割技术对眼球、肿瘤、钙化进行分割和采用容积定量分析方法，运用R语言进行统计学处理，比较不同性别（男/女）、眼别（左/右）、年龄分层及影像学分期间的钙化最高CT值、肿瘤钙化容积(calcified regional volume，CRV)、肿瘤容积(tumor volume，TV)、患侧容积(eyeball volume，EV)、CRV/EV、TV/EV、CRV/TV比值的差异。结果：不同性别组其EV比较差异有统计学意义（P<0.05）；不同年龄组RB其CRV、EV、CRV/EV比较差异有统计学意义（P<0.05）；影像分期（眼内期、青光眼期、眼外期组）和晶状体位置变化（位置改变、形态位置密度改变、无变化组）的CRV 、TV、CRV/EV、TV/EV差异均有统计学意义（P< 0.05）。结论：RB患者的钙化沉积水平随着病程推进，在眼球内期、青光眼期至眼外期的不同阶段呈现逐级升高的态势。晶状体位置变化随病情进展、RB患者钙化程度逐渐增加。

Objective: To evaluate the calcification level of retinoblastoma (RB) lesions using image post-processing system software, such as that for computed tomography (CT) noncontrast scanning and three-dimensional reconstruction. Additionally, this study aimed to explore the relationship between retinoblastoma (RB) and patient gender (male/female) , as well as the correlation among ocular (left/right), age, and radiographic stage (e.g., international intraocular RB stage).  Methods: The study enrolled 108 patients (127 eyes) with tumors confirmed by both surgical pathology and clinical diagnosis. These patients received treatment at the Orbital Disease and Ocular Oncology Department of Zhongshan Ophthalmic Center, Sun Yat-sen University (ZOC, SYSU) from May 2022 to December 2024. CT reconstruction and workstation segmentation techniques were used to delineate the eyeball, tumour, and calcification. A quantitative volumetric analysis method was applied, and statistical processing was conducted using R language (version 4.2.1). Comparisions were made across different genders (male/female), eye segmentation (left/right), age stratifications, and imaging stages. The t-test was applied to analyze the highest CT value, calcified regional volume (CRV), tumor volume (TV), eyeball volume (EV), CRV/EV ratio, TV/EV ratio, and CRV/TV ratio in these tumor patients. Results: There was no significant differences in CT value, CRV, TV,  CRV/EV ratio, TV/EV ratio, and CRV/TV ratio among patients with different eye sides, genders and age groups (P>0.05). Only EV showed statistical significant across different age groups. Statistically significant changes were observed in CRV, TV, CRV/EV ratio, TV/EV ratio , and CRV/TV ratio with respect to both intraocular stage (including intraocular stage, glaucoma stage, extraocular stage) and lens position changes (inculding position changes, morphological position density changes, no change groups) (P< 0.05), No other statistically significant differences were found (P>0.05). Conclusions: In this group of tumor patients, the level of calcification deposition gradually increased as the disease progressed through the intraocular stage, glaucoma stage, and extraocular stage. Lens positional changes were associated with a gradual increase in the degree of calcification in patients with retinoblastoma (RB) as the disease advanced.

Purpose: To evaluate the prevalence of plateau iris diagnosed by ultrasound biomicroscopy after laser peripheral iridotomy in Whites as compared to Asians in a U. S. clinic setting.
Methods: This was a prospective, observational study of narrow angle patients(n=55)who underwent laser peripheral iridotomy. Ultrasound biomicroscopy was performed in 4 quadrants of only one eye of each patient 4~6 weeks before and after surgery. The images were randomized and interpreted qualitatively by a single observer. Plateau iris was diagnosed in eyes with persistent appositional angles after laser peripheral iridotomy when at least 2 quadrants fulfilled the following criteria:1. The ciliary process was directed anteriorly. 2. The ciliary sulcus was absent. 3. The central iris plane was flat.
Results: Twenty eight subjects (50.1%)were Whites, and 27 subjects (49.0%)were Asians. Plateau iris was assessed in 18 subjects (32.7%):9 of 28 Whites (32.1%)and 9 of 27 Asians (33.3%). The proportion of plateau iris did not differ between Whites and Asians (P>0.99).
Conclusion: The prevalence of plateau iris did not differ between Whites and Asians.  Both groups had a substantial proportion of narrow angle patients with this clinical entity. (Eye Science  2012:27:13-18)

Purpose: To evaluate the prevalence of plateau iris diagnosed by ultrasound biomicroscopy after laser peripheral iridotomy in Whites as compared to Asians in a U. S. clinic setting.
Methods: This was a prospective, observational study of narrow angle patients(n=55)who underwent laser peripheral iridotomy. Ultrasound biomicroscopy was performed in 4 quadrants of only one eye of each patient 4~6 weeks before and after surgery. The images were randomized and interpreted qualitatively by a single observer.  Plateau iris was diagnosed in eyes with persistent appositional angles after laser peripheral iridotomy when at least 2 quadrants fulfilled the following criteria:1. The ciliary process was directed anteriorly. 2. The ciliary sulcus was absent. 3. The central iris plane was flat.
Results: Twenty eight subjects(50. 1%)were Whites, and 27 subjects(49. 0%)were Asians. Plateau iris was assessed in 18 subjects(32. 7%):9 of 28 Whites(32. 1%)and 9 of 27 Asians (33. 3%). The proportion of plateau iris did not differ between Whites and Asians(P>0. 99).
Conclusion: The prevalence of plateau iris did not differ between Whites and Asians.  Both groups had a substantial proportion of narrow angle patients with this clinical entity. (Eye Science  2012:27:13-18)

目的：分析视网膜前巨噬细胞样细胞（epiretinal macrophage-like cells，eMLC）和视网膜脉络膜血流在急性黄斑神经视网膜病变（acute macular neuroretinopathy，AMN）患眼的临床特征。方法：回顾性分析2022年12月—2023年5月在中山大学中山眼科中心就诊的病程2周内的AMN患者21例（37眼）及年龄匹配的健康对照组33例（38眼）的临床资料。通过黄斑区内界膜上3 μm的en face 光学相干断层扫描（optical coherence tomography，OCT）分层信息对eMLC进行半自动分析提取和定量，同时测量OCT血管成像（optical coherence tomography angiography，OCTA）6 mm x 6 mm 的黄斑区域内视网膜脉络膜血流参数进行分析对比。结果： AMN组黄斑区eMLC数量为（329.78±77.38）个，密度为（9.16±2.15）个/mm²，均较对照组（202.63±41.72）个、（5.63±1.16）个/mm²增加（均P＜0.001）。AMN组浅层和深层视网膜血流密度分别为（33.00±6.49）%和（32.59±7.41）%，均较对照组（36.18±5.63）%和（37.08±5.65）%减少（均P＜0.05）。视网膜全层中心凹无血管区（foveal avascular zone，FAZ）面积、视网膜全层血流密度、脉络膜毛细血管和脉络膜大中血管血流密度在两组间比较差异无统计学意义（P＞0.05）。浅层及深层视网膜血流密度和FAZ面积对eMLC密度无影响（P＞0.05）。13例AMN患者（23眼）1个月时的随访资料显示：AMN组末次随访时eMLC数量为（248.70±59.88）个、密度为（6.91±1.66）个/mm²较初次就诊时（307.87±82.98）个和（8.55±2.30）个/mm²减少（均P＜0.001），但仍高于同期对照组（176.58±27.89）个和（4.91±0.77）个/mm²（均P＜0.001）。视网膜和脉络膜血流参数较初次就诊时比较差异无统计学意义（均P＞0.05）。结论：AMN患眼中eMLC异常增多和聚集，同时存在轻度的视网膜血流密度下降，但无脉络膜血流参数变化，且eMLC变化与AMN病程相关但与视网膜血流变化无关，提示eMLC所代表的炎症可能独立参与了AMN的发生。

Objective: To investigate the clinical characteristics of epiretinal macrophage-like cells (eMLC) and retinochoroidal blood flow in eyes affected by acute macular neuroretinopathy (AMN). Methods: This retrospective case series study included 21 (37 eyes) patients diagnosed with AMN and 28 (33 eyes) healthy age-matched subjects. A 3 mm En-face optical coherence tomography (OCT) slab on the inner limiting membrane of the macular region was used to visualize and binarize the MLCs. The MLCs were binarized and quantified using a semiautomated method. Optical coherence tomography angiography (OCTA) was used to evaluate the perfusion status and obtain the structural data of macular within a 6 x 6 mm² macular region. Results: The number and density of macular eMLC in AMN eyes were significantly increased in comparison to control eyes: 329.78±77.38 vs. 202.63±41.72, (P＜0.001) and 9.16±2.15 cells/mm² vs. (5.63±1.16) cells/mm² (P＜0.001). In the macular region, both superficial and deep retinal vessel densities were significantly lower in the AMN eyes than in the control eyes: (33.00±6.49)% vs. (36.18±5.63)% (P=0.040); (32.59±7.41)% vs. (37.08±5.65)% (P=0.008). There were no significant differences in the vessel densities and foveal avascular zone (FAZ) area of full retina and choroidal vessel density between the two groups (P＞0.05). The eMLC density was not associated with the superficial and deep retinal FAZ area and vessel densities (all P＞0.05). At the one-month follow-up data of 13 patients (23 eyes), the number and density of macular eMLC were significantly lower in comparison to the initial visit: 248.70±59.88 vs. 307.87±82.98, P＜0.001 and (6.91±1.66) cells/mm² vs. (8.55±2.30) cells/mm² (P＜0.001). However, the number and density of macular eMLC are still noticeably higher than those of the control group during the same timeframe: 248.70±59.88 vs. 176.58±27.89 (P＜0.001) and (6.91±1.66) cells/mm² vs. (4.91±0.77) cells/mm² (P＜0.001). There was no significant difference in the vessel density of retina and choroidal during the follow-up (P＞0.05 ). Conclusions: The aggregation and activation of eMLC and a mild decrease in retinal blood flow density are observed in AMN, yet there is no corresponding shift in choroidal vessel density. The changes of eMLC are linked to the course of AMN, but they are not related to retinal vessel density. The inflammatory response represented by eMLC might independently contribute to the pathogenesis and progression of AMN.

目的：分析慢性泪囊炎患者鼻内镜下泪囊鼻腔造瘘口术后的远期肉芽增生情况，评价物理清除联合曲安奈德（triamcinolone acetonide，TA）局部注射治疗慢性泪囊炎鼻内镜术后造瘘口肉芽组织增生的效果。方法：回顾性分析接受鼻内镜手术的慢性泪囊炎患者98例115眼。随访收集术后造瘘口肉芽组织增生发生情况，分析肉芽增生与无肉芽增生患者的临床特征。对有肉芽增生的患者26例31眼，根据治疗方式分为物理清除联合TA局部注射组13例16眼和单纯物理清除组13例15眼，比较2组间治疗有效率。结果：鼻内镜术后造瘘口肉芽增生病例共31眼（26.96%）。物理清除联合TA组的治愈率、好转率分别为93.75%、6.25%，物理清除组相应为60%、33.33%，组间比较差异有统计学意义（P < 0.05）。结论：物理清除联合TA局部注射治疗泪囊炎鼻内镜术后造瘘口肉芽组织增生安全、有效。

Objective: This study aimed to analyze the formation of ostium granulomas following endonasal endoscopic dacryocytostomy (DCR) in patients with chronic dacryocystitis and to evaluate the efficacy of excision combined with triamcinolone (TA) injection for treating ostium granulosis after endoscopic dacryocystorhinostomy. Methods: A retrospective analysis was conducted on 98 patients (115 eyes) with chronic dacryocystitis who underwent endoscopic dacryocystorhinostomy.  Postoperative growth of the ostium granulomas was monitored, and clinical characteristics were compared between patients with and without ostium granulomas. Among these, 26 cases (31 eyes) of ostium granuloma were identified and randomly assigned to either an excision combined with triamcinolone injection group (13 cases with 16 eyes) or excision-only group (13 cases with 15eyes) based on the treatment method. The effective rates between two groups was compared. Results: Ostium granulomas occurred in 31 eyes (26.96%). The cure rate and improvement rate in the excision combined with TA group were 93.75% and 6.25%, respectively, whereas in the excision-only group, they were 60% and 33.33%. These differences were statistically significant (P < 0.05).  Conclusion: Excision combined with intralesional triamcinolone acetonide injections proved effective in promoting the regression of ostium granuloma after DCR.

目的：分析日间病房模式下原发性获得性鼻泪管阻塞(primary acquired nasolacrimal duct obstruction, PANDO)患者行经鼻内镜下泪囊鼻腔吻合术(endoscopic dacryocystorhinostomy, En-DCR)的术后自我护理现状并进行早期效果评价。方法：纳入2021年11月—2022年8月在中山大学中山眼科中心眼整形与泪道科日间病房行En-DCR手术治疗的90例PANDO患者，术后常规给予术后自我护理指导。术后1个月复查，采用调查问卷的方式记录患者的术后自我护理情况及不适症状，评估患者手术效果，并进一步探究术后自我护理因素与手术效果及术后不适症状的相关性。结果：90例行En-DCR手术治疗的PANDO患者共计90眼，术后1个月手术总成功率为92.22%（其中治愈率为65.56%、好转率为26.67%）。术后自我护理与手术效果的特征分析显示，术后遵医嘱鼻腔冲洗每日至少1次（P = 0.002）、遵医嘱喷鼻每日至少1次（P = 0.008）、术后无上呼吸道感染（P = 0.047）的患者手术效果更好。术后自我护理与术后不适症状的特征分析显示，每日至少1次鼻腔冲洗（P = 0.006）和义管在位（P = 0.003）的患者术后不适症状较少。同时对置管患者进行心理负担相关性分析，结果显示置管不适与心理负担呈正相关（r = 0.421, P < 0.001）。结论：在日间病房模式下，医护人员对En-DCR术后患者进行详细的自我护理指导，有助于患者的术后恢复及保证良好的手术疗效。指导重点包括术后1个月内每日至少1次鼻腔冲洗，规律使用抗炎喷鼻剂并防止上呼吸道感染；另外应重点关注泪道置管患者术后局部不适症状，针对术后不适症状优化用药，使用互联网护理门诊或电话随访做好护理指导和心理疏导，促进患者术后康复。

Objective: To investigate  postoperative self-care practices and evaluate the early outcomes of patients with Primary Acquired Nasolacrimal Duct Obstruction (PANDO) undergoing Endoscopic Dacryocystorhinostomy (En-DCR) in a day ward setting. Methods: 90 PANDO patients who underwent En-DCR surgery at the Oculoplastic and Lacrimal Surgery day ward at Zhongshan Ophthalmic Center, Sun Yat-sen University, between November 2021 and August 2022, were enrolled in this study. All patients received standardized postoperative self-care instructions. At the one-month follow-up, a questionnaire survey was used to record patients' self-care adherence to self-care practices, postoperative discomfort symptoms, and assess surgical outcomes. Furthermore, the correlation between self-care factors and surgical outcomes/discomfort symptoms was explored. Results: A total of 90 eyes from 90 PANDO patients undergoing En-DCR were included. The overall surgical success rate at one month was 92.22% , comprising a cure rate of 65.56% and an improvement rate of 26.67%. Analysis of self-care practices related to surgical outcomes showed significantly better results in patients who adhered to nasal irrigation at least once daily (P = 0.002), used prescribed nasal spray at least once daily (P = 0.008), and avoided upper respiratory tract infections (P = 0.047). Regarding postoperative discomfort, patients who performed nasal irrigation at least once daily (P = 0.006) and had the lacrimal stent (tube) in situ (P = 0.003) experienced significantly fewer symptoms. Furthermore, correlation analysis in stented patients indicated a positive correlation between stent discomfort and psychological burden (r = 0.421, P < 0.001). Conclusion: In the day ward model, detailed self-care guidance provided by healthcare professionals for En-DCR patients contributes to postoperative recovery and ensures favorable surgical outcomes. Key instructions include performing nasal irrigation at least once daily, using anti-inflammatory nasal spray regularly, and preventing upper respiratory infections during the first postoperative month. Additionally, particular attention should be paid to localized discomfort in patients with lacrimal stents. Optimizing medication regimens for discomfort, utilizing internet-based nursing clinics or telephone follow-ups for guidance and psychological support are crucial to promote postoperative rehabilitation.

目的：回顾2型神经纤维瘤病(neurofibromatosis type 2, NF2)患者的眼部表现，分析NF2眼部病变的临床和影像学特征，以助该病的早期诊断。方法：收集来自深圳市眼科医院的1例和来自中山眼科中心的3例NF2患者完整的临床资料并进行总结分析。结果：这4例患者均因眼部异常首诊于眼科且符合曼彻斯特诊断标准。4例患者中，3例为NF2早发型(<20岁)，1例为晚发型(>20岁)，男女比例1∶1。3例患者因视力下降、1例患者因复视首诊于眼科。3例行眼底光学相干断层成像(optical coherence tomography, OCT)检查显示，视网膜错构瘤2例，视网膜前膜2例，视盘隆起2例，视网膜神经纤维层和节细胞层变薄1例。其他表现包括麻痹性斜视2例，复视1例，白内障1例，球后段视神经增粗1例，眼眶肿瘤1例。结论：NF2的眼部表现多种多样，可出现在神经症状和听力损失之前。详细的眼科检查及影像学检查对年轻患者的早期诊断非常有价值，有助于选择更好的治疗计划。

Objective: To review the ocular manifestations of patients with neurofibromatosis type 2 (NF2), and analyze the clinical and imaging features of the ocular lesions in NF2, so as to facilitate the early diagnosis of this disease. Methods: The complete medical records of 1 case from Shenzhen Eye Hospital and 3 cases of NF2 from Zhongshan Ophthalmic Center were collected. Results: All four patients were first diagnosed in ophthalmology due to eye symptoms and met the Manchester diagnostic criteria. Of the four patients, three were NF2 early hairstyles (<20 years old), one was late hairstyle (>20 years old), and the male-to-female ratio was 1:1. Three patients were first diagnosed in the ophthalmology department due to decreased visual acuity, and one patient was first diagnosed due to diplopia. Optical coherence tomography (OCT) examinations were performed on three patients, which showed that there were two cases of retinal hamartoma, two cases of epiretinal membrane, two cases of optic disc elevation, and one case of thinning of the retinal nerve fiber layer and ganglion cell layer. Other manifestations included two cases of paralytic strabismus, one case of diplopia, one case of cataract, one case of thickening of the retrobulbar optic nerve, and one case of orbital tumor. Conclusions: The ocular manifestations of NF2 are diverse and can precede neurological symptoms and hearing loss. Detailed ophthalmic examinations and imaging studies are highly valuable for early diagnosis in young patients, aiding in the selection of a better treatment plan.

       小泪囊型慢性泪囊炎是泪道阻塞性疾病中的特殊亚型，目前尚无针对小泪囊的确切定义，传统内镜下泪囊鼻腔吻合术(endoscopic dacryocystorhinostomy, En-DCR)治疗小泪囊型慢性泪囊炎因泪囊体积小手术操作难度大、术后吻合口易闭锁和成功率低而被视为相对禁忌。本研究通过CT泪囊造影(CT dacryocystography, CT-DCG)三维精准测量、定义小泪囊(水平径≤3 mm、前后径≤3 mm、垂直径≤6 mm)，提出开放泪总管平面技术以扩大泪囊鼻腔吻合口，同时联合双管人工泪管植入术的En-DCR治疗方案，术后予以肾上腺皮质激素(激素)喷鼻剂辅助，显著提升手术疗效。

      研究纳入61例小泪囊型泪囊炎患者，术后9个月随访显示，解剖成功率达80. 33%(49/61)，功能成功率为75.41%(46/61)。术中开放泪总管平面技术有效扩大手术窗口；短期双管人工泪管植入(术后3个月取出)联合激素喷鼻剂使用可降低吻合口闭锁风险同时未增加肉芽增生和感染风险。与传统治疗相比，该方案突破小泪囊手术禁忌，为患者提供更优选择。

       小泪囊型慢性泪囊炎是泪道阻塞性疾病中的特殊亚型，目前尚无针对小泪囊的确切定义，传统内镜下泪囊鼻腔吻合术(endoscopic dacryocystorhinostomy, En-DCR)治疗小泪囊型慢性泪囊炎因泪囊体积小手术操作难度大、术后吻合口易闭锁和成功率低而被视为相对禁忌。本研究通过CT泪囊造影(CT dacryocystography, CT-DCG)三维精准测量、定义小泪囊(水平径≤3 mm、前后径≤3 mm、垂直径≤6 mm)，提出开放泪总管平面技术以扩大泪囊鼻腔吻合口，同时联合双管人工泪管植入术的En-DCR治疗方案，术后予以肾上腺皮质激素(激素)喷鼻剂辅助，显著提升手术疗效。

      研究纳入61例小泪囊型泪囊炎患者，术后9个月随访显示，解剖成功率达80. 33%(49/61)，功能成功率为75.41%(46/61)。术中开放泪总管平面技术有效扩大手术窗口；短期双管人工泪管植入(术后3个月取出)联合激素喷鼻剂使用可降低吻合口闭锁风险同时未增加肉芽增生和感染风险。与传统治疗相比，该方案突破小泪囊手术禁忌，为患者提供更优选择。