外泌体(exosome)是直径30 nm~150 nm的纳米级囊泡，由脂质双分子层、蛋白质和遗传物质组成。人体内几乎所有类型的细胞都能分泌外泌体。它们在细胞通信、免疫调节、炎症反应和新生血管形成中起着关键作用。目前，外泌体已在肿瘤、心血管及泌尿系统中得到广泛研究。近年来，外泌体在眼科疾病中的作用受到越来越多的关注。外泌体在角膜病变、年龄相关性黄斑病变、糖尿病视网膜病变、青光眼等常见眼科疾病的发生、发展中发挥重要作用。不同间充质干细胞来源的外泌体在眼科疾病中的治疗潜力是当下的热点。间充质干细胞来源的外泌体具有与间充质干细胞相似的抗炎、抗凋亡、神经保护和组织修复的作用，因此外泌体可能是多种眼科疾病无细胞疗法治疗研究的新方向。进一步了解外泌体的生物学特性以及外泌体在眼科疾病的最新研究进展，将为相关眼病的发生机制和防治策略提供参考依据。
Exosomes are nanoscale vesicles with a diameter of 30 nm to 150 nm, which are composed of lipid bilayers, proteins, and genetic material. Almost all types of cells in the human body can secrete exosomes. Tey play key roles in cellular communication, immune regulation, infammatory responses and neovascularization. At present, exosomes have been widely studied in tumors, cardiovascular and urinary systems. In recent years, the role of exosomes in eye diseases has attracted more and more attention. The exosomes play an important role in the occurrence and development of common eye diseases such as keratopathy, age-related macular disease, diabetic retinopathy, glaucoma, etc. Currently it is a hot topic that the therapeutic potential of extracellular vesicles derived from diferent mesenchymal stem cells in eye diseases. Te exosomes derived from mesenchymal stem cells have anti-infammatory, anti apoptotic, neuroprotective and tissue repairing effects, which are similar to those of mesenchymal stem cells. Thus, exosomes may be a novel direction of research in the treatment of many eye diseases without cell therapy. Further understanding of the biological characteristics of exosomes and the latest research progress of exosomes in common eye diseases will provide reference for the pathogenesis and prevention strategies of related eye diseases.
随着智能手机覆盖率的增加与可用性的提升，实现智能健康管理的应用程序成为新兴研究热点。新一代智能手机可通过追踪步数，监测心率、睡眠，拍摄照片等方式进行健康分析，成为新的医学辅助工具。随着深度学习技术在图像处理领域的不断进展，基于医学影像的智能诊断已在多个学科全面开花,有望彻底改变医院传统的眼科疾病诊疗模式。眼科疾病的常规诊断往往依赖于各种形式的图像，如裂隙灯生物显微镜、眼底成像、光学相干断层扫描等。因此，眼科成为医学人工智能发展最快的领域之一。将眼科人工智能诊疗系统部署在智能手机上，有望提高疾病诊断效率和筛查覆盖率，改善医疗资源紧张的现状，具有极大的发展前景。综述的重点是基于深度学习和智能手机的眼病预防与远程诊疗的进展，以糖尿病性视网膜病变、青光眼、白内障3种疾病为例，讲述深度学习和智能手机在眼病管理方面的具体研究、应用和展望。
With the increasing coverage and availability of smart phones, the application of realizing intelligent health management has become an emerging research hotspot. The new generation of smart phones can perform health analysis by tracking the step numbers, monitoring heart rate and sleep quality, taking photos and other approaches, thereby becoming a new medical aid tool. With the continuous development of deep learning technology in the field of image processing, intelligent diagnosis based on medical imaging has blossomed in many disciplines, which is expected to completely change the traditional eye diseases diagnosis and treatment mode of hospitals. The conventional diagnosis of ophthalmic diseases often relies on various forms of images, such as slit lamp biological microscope, fundus imaging, optical coherence tomography, etc. As a result, ophthalmology has become one of the fastest growing areas of medical artificial intelligence (AI). The deployment of ophthalmological AI diagnosis and treatment system on smart phones is expected to improve the diagnostic efficiency and screening coverage to relieve the strain of medical resources, which has a great development prospect. This review focuses on the prevention and telemedicine progress of eye diseases based on deep learning and smart phones, taking diabetic retinopathy, glaucoma and cataract as examples to describe the specific research, application and prospect of deep learning and smart phones in the management of eye diseases.
近视防控已经上升到我国国家战略层面，高度近视引起的视神经病变会损害视功能，但在临床上常常被忽视。OCT可以非侵入、高分辨率、快速以及可重复地定量视网膜各层厚度，是评估高度近视相关视神经病变的有力工具。由于高度近视常合并视盘和盘周的改变，视神经纤维层厚度的定量常出现误差。近年来，学者开始聚焦于黄斑区神经节细胞复合体(ganglion cell complex,GCC)厚度的研究，但其在高度近视眼中的变化规律尚不统一。该文针对近年来高度近视眼黄斑区GCC的测量规范、诊断价值、变化规律等进行综述，以期提高眼科医师对高度近视视神经病变的重视和研究水平。
Myopia prevention and control has risen to the national strategic level in China. Optic neuropathy caused by high myopia can damage visual function, but it is often ignored in clinical practice Optical coherence tomography (OCT) characterized by non-invasiveness, high resolution, rapid, and repeatable quantifying the thickness of each layer in the retina has emerged as a powerful tool for evaluating high myopia related optic neuropathy. Due to the changes in and near the optic disc in high myopia, errors often occur in the quantification of the thickness of the optic nerve fiber layer. In recent years, researchers have gradually focused on the study of the thickness of ganglion cell complex (GCC), but the regularity of its changes in high myopia is not yet unified. This article reviews the measurement specifications, diagnostic values, and change rules of GCC in the macular region of high myopia in recent years, in order to improve the attention and research level of ophthalmologists on high myopia optic neuropathy.
目的：建立高效液相色谱法（high-performance liquid chromatography，HPLC）测定曲伏噻吗滴眼液中曲伏前列素有关物质。方法：采用Agilent SB-C18色谱柱（50 mm×2.1 mm，2.7 μm）；以磷酸溶液（取磷酸2.0 mL，加水稀释并定容至1 000 mL，用氢氧化钠溶液调节pH至3.0）为流动相A，乙腈为流动相B，洗脱梯度；流速为每分钟3.0 mL；柱温为30 ℃；检测波长为220 nm；进样体积100 μL。结果：在该色谱条件下，曲伏前列素与各杂质均可良好分离；在酸、碱、氧化、高温和强光破坏条件下，曲伏前列素峰纯度合格，物料守恒。曲伏前列素、5,6-反式曲伏前列素和15-酮曲伏前列素分别在0.041~3.245 μg/mL（r=1.000 0）、0.040~3.229 μg/mL（r=1.000 0）、0.039~3.088 μg/mL（r=0.999 9）范围内线性关系良好，其最低检测限分别为0.020、0.020和0.020 μg/mL；6份样品中5,6-反式曲伏前列素的含量相对标准偏差（relative standard deviatio，RSD）为0.2% (n=6)，15-酮曲伏前列素的含量RSD为0.3% (n=6)，重复性良好；对照品溶液和供试品溶液在室温条件下放置100h稳定，5,6-反式曲伏前列素的平均回收率为95.2%，相对标准偏差RSD为0.5% (n=9)，15-酮曲伏前列素的平均回收率为92.7%，RSD为1.2% (n=9)该方法重现性好。结论：本方法简便、快速、准确。适用于检测曲伏噻吗滴眼液中的曲伏前列素有关物质。
Objective: To develop a high-performance liquid chromatography (HPLC) method for the determination of related substances in Travoprost and Timolol Maleate Eye Drops, sepcifically focusing on Travoprost and its impurities. Methods: The analytic column used was an Agilent SB-C18 (50 mm × 2.1 mm，2.7 μm) . A phosphoric acid solution (prepared by diluting 2.0 mL of phosphoric acid with water tto final volume of 1,000 mL and adjust the pH to 3.0 with sodium hydroxide solution) was used as mobile phase A, while acetonitrile served as mobile phase B. The elution was performed using a gradient program at a flow rate of 3.0 mL/min. The detection wavelength was set at 220 nm, and the column temperature was maintained at 30 ℃. The injection volume is 100 μL. Results: Under the described chromatographic condition, Travoprost and its various impurities were well separated. The purity of the Travoprost peak was qualified, and the material remained stable under conditions of acid, alkali, oxidation, high temperature, and strong light exposure. The linear ranges for Travoprost, 5,6-trans-Travoprost, and 15-keto-Travoprost were determined to be 0.041~3.245 μg/mL(r=1.0000), 0.040~3.229 μg/mL(r=1.0000), 0.039~3.088 μg/mL(r=0.9999), respectively. The lowest detection limits for these compounds were all 0.020 μg/mL, The relative standard deviation (RSD) for the content of 5,6-trans-travoprost and 15 keto trovopros in six samples were 0.2% (n=6) and 0.3% (n=6), respectively, indicating good reproducibility. Both the reference solution and the test solution remained stable at room temperature for 100 hours,The average recovery rates for 5,6-trans-Travoprost and 15-keto-Travoprost were 95.2% (RSD 0.5%,n=9) and 92.7% (RSD 1.2%, n=9) respectively, further confirming the high reproducibility of the method. Conclusions: The developed HPLC method is simple, rapid, and accurate, making it suitable for the determination of related substances in Travoprost and Timolol Maleate Eye Drops.
睑缘炎是一种普遍存在的慢性眼部炎症，主要影响睑缘的皮肤和黏膜。患者常表现为眼部干痒、异物感等刺激症状，以及睑缘充血、肥厚和睫毛反复脱落等。睑缘清洁可以抑制部分眼表细菌生长，也可以去除睑缘油脂、分泌物、角化上皮细胞，清洁眼表环境，对治疗睑缘炎具有较好效果。为确保患者的治疗安全，并指导和规范临床眼科医护人员的操作，由中山大学中山眼科中心牵头，联合全国17所医疗机构进行反复修订，于2023年12月17日在全国团体标准信息平台发布《基于眼睑清洁仪的睑缘清洁操作流程》的团体标准。文章对该团体标准进行深度解读，详细解读睑缘清洁操作的适应证与禁忌证、具体操作的重点、难点与细节等内容，以更好地指导临床医护人员实施规范有效的治疗操作，保证患者治疗效果与确保患者治疗安全。旨在规范和推进基于眼睑清洁仪的睑缘清洁操作流程的精准化发展，更为促进我国眼前段疾病医学和护理精准应用的水平提供重要的标准依据。
Blepharitis is a common chronic eye inflammation that mainly affects the skin and mucosa of the eyelid margin. It is characterized by eye irritation symptoms such as dryness, itching, and foreign body sensation, accompanied by clinical manifestations such as eyelid congestion, thickening, and repeated eyelash loss. It can damage the conjunctival tissue even. Eyelid cleaning can inhibit the growth of some bacteria on the ocular surface, remove eyelid oil, secretions, and keratinized epithelial cells, clean the ocular environment, and have a good effect on treating blepharitis. In order to ensure the safety of patient treatment and guide and standardize the operation of clinical ophthalmic medical staff, led by the Zhongshan Ophthalmic Center, Sun Yat-sen University, and jointly revised by 17 medical institutions across the country, the group standard " Operation procedure of eyelid margin cleaning based on eyelid cleaning device" was released on the National Group Standard Information Platform on December 17, 2023. This article provides an in-depth interpretation of the group's standards, detailing the indications and contraindications, key points, difficulties, and details of eyelid cleaning procedures, in order to better guide clinical medical staff in implementing standardized and effective treatment procedures, ensuring patient treatment effectiveness and safety. Aiming to standardize and promote the precise development of eyelid margin cleaning procedures based on eyelid cleaning devices, and provide important standard basis for promoting the level of medical and nursing precision application of anterior segment diseases in China.
