脉络膜是视网膜的主要血供来源，脉络膜血管系统为眼内最大、最重要的血管系统，在给外层视网膜供血方面起着至关重要的作用。脉络膜是一个动态、多功能性结构，其生理性特性受多种因素影响。这些因素包括年龄、性别、解剖位置、眼轴长度、昼夜节律与饮酒等。脉络膜涡静脉根据解剖学位置可分为眼内、巩膜内和眼外三大部分，又进一步分为脉络膜静脉、壶腹前部、壶腹、壶腹后部、巩膜入口、巩膜内通道、巩膜出口和巩膜外涡静脉八个区域。在正常眼中，涡静脉的类型不仅限于传统认知中出口位于赤道部近睫状体平坦部的涡静脉，研究发现还存在出口位于后极部的后极部涡静脉。根据涡静脉的形态及解剖特点，涡静脉又分为四类：缺失型涡静脉、不完整型涡静脉、完整型涡静脉、完整型涡静脉伴壶腹。文章旨在阐述正常人眼的脉络膜血流及涡静脉解剖基础，以深入了解正常状态下的脉络膜特征，这不仅有助于辨别脉络膜的病理性变化，且对脉络膜相关眼部疾病的诊断与鉴别诊断有重要价值。

The choroid is the primary source of blood supply for the retina. As the largest and most important vascular system within the eye, the choroidal vasculature plays a crucial role in providing blood to the outer retina. The choroid is a dynamic, multifunctional structure whose physiological characteristics are influenced by a variety of factors. These factors include age, gender, anatomical location, axial length of the eye, circadian rhythm, and alcohol consumption, among others. Choroidal vortex veins can be anatomically divided into three main parts: intraocular, scleral, and extraocular. Furthermore, they can be subdivided into eight distinct regions: choroidal veins, pre-ampulla, ampulla, post-ampulla, scleral entrance, intrascleral canal, scleral exit, and extrascleral vortex vein. In the healthy eye, the types of vortex veins are not limited to the traditionally recognized veins with exits near the ciliary body pars plana in the equatorial region. Recent research has revealed the existence of posterior vortex veins with exits in the posterior pole of the eye. Based on the morphology and anatomical characteristics of vortex veins, they can be further classified into four types:absent vortex veins, incomplete vortex veins, complete vortex veins, complete vortex veins with ampulla. This paper aims to elucidate the blood flow and vortex veins anatomical foundation of the choroid in normal human eyes. Understanding these characteristics in a healthy state will aid in identifying pathological changes in the choroid, which is of significant value for the diagnosis and differential diagnosis of ocular diseases.

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.

Purpose: The surgical risk and complication rate after cataract surgery are extremely high in patients with nanophthalmos. This study is designed to compare the visual and refractive outcomes before and after coaxial micro-incision phacoemulsification and evaluate postoperative complications．

Methods: Fifty nine patients (89 eyes) with axial length (AL)＜21 mm diagnosed with nanophthalmos were enrolled in this retrospective study. All patients underwent coaxial micro-incision phacoemulsification and IOL implantation. The main outcome measures included anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), intraocular pressure (IOP) and best corrected visual acuity (BCVA). Wilcoxon signed rank test or Mann-Whitney test, and Chi-square test and logistic regression analysis were performed for statistical tests as appropriate．

Results: The median AL was 19．63 mm. Sixty-six eyes (74.16％) had a history of surgical intervention. Postoperative ACD, ACV and ACA were increased significantly (all P＜0.001), whereas postoperative IOP was decreased significantly. (P＜ 0.001) after surgery. Previous surgical intervention was related to a reduction in the postoperative ACD and ACA (P＜0.01), and both preoperative and postoperative IOP (P＜0.001). Postoperative BCVA was improved in 94．38％ of the cases. Intraoperative complications mainly included iridoschisis (6 eyes, 6.74％). Early postoperative complications included temporary corneal edema (TCE) (23 eyes, 25.84％), anterior inflammatory response (AIR) (19 eyes, 21.35％), cystoid macular edema (CME) (14 eyes, 15.73％), and uveal effusion (4 eyes, 4.49％). Late postoperative complications included CME (8 eyes, 8.99％),  uveal effusion (8 eyes, 8.99％), malignant glaucoma (2 eyes, 2.25％) and posterior capsular opacification (PCO)(10 eyes, 11.24％). The majority of complications (80％) were successfully resolved by pharmacotherapy or operation. The risk of surgical complications was greater in patients with lower AL, ACD, ACV or ACA and higher nuclear hardness or mean keratometry (Km).

Conclusion: With reasonable preoperative management, prudent selection of the lens, rigorous surgical technique and unerring cognition of potential complications, coaxial microincision phacoemulsification lens surgery can be performed in patients with nanophthalmos and yield favorable outcomes and a low incidence of complications.

Purpose: The surgical risk and complication rate after cataract surgery are extremely high in patients with nanophthalmos. This study is designed to compare the visual and refractive outcomes before and after coaxial micro-incision phacoemulsification and evaluate postoperative complications．

Methods: Fifty nine patients (89 eyes) with axial length (AL)＜21 mm diagnosed with nanophthalmos were enrolled in this retrospective study. All patients underwent coaxial micro-incision phacoemulsification and IOL implantation. The main outcome measures included anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), intraocular pressure (IOP) and best corrected visual acuity (BCVA). Wilcoxon signed rank test or Mann-Whitney test, and Chi-square test and logistic regression analysis were performed for statistical tests as appropriate．

Results: The median AL was 19．63 mm. Sixty-six eyes (74.16％) had a history of surgical intervention. Postoperative ACD, ACV and ACA were increased significantly (all P＜0.001), whereas postoperative IOP was decreased significantly. (P＜ 0.001) after surgery. Previous surgical intervention was related to a reduction in the postoperative ACD and ACA (P＜0.01), and both preoperative and postoperative IOP (P＜0.001). Postoperative BCVA was improved in 94．38％ of the cases. Intraoperative complications mainly included iridoschisis (6 eyes, 6.74％). Early postoperative complications included temporary corneal edema (TCE) (23 eyes, 25.84％), anterior inflammatory response (AIR) (19 eyes, 21.35％), cystoid macular edema (CME) (14 eyes, 15.73％), and uveal effusion (4 eyes, 4.49％). Late postoperative complications included CME (8 eyes, 8.99％),  uveal effusion (8 eyes, 8.99％), malignant glaucoma (2 eyes, 2.25％) and posterior capsular opacification (PCO)(10 eyes, 11.24％). The majority of complications (80％) were successfully resolved by pharmacotherapy or operation. The risk of surgical complications was greater in patients with lower AL, ACD, ACV or ACA and higher nuclear hardness or mean keratometry (Km).

Conclusion: With reasonable preoperative management, prudent selection of the lens, rigorous surgical technique and unerring cognition of potential complications, coaxial microincision phacoemulsification lens surgery can be performed in patients with nanophthalmos and yield favorable outcomes and a low incidence of complications.

报道一例发生在41岁中年女性左眼上睑的无色素性黑色素瘤，曾在当地医院误诊为霰粒肿。体检见左眼上睑结膜面一大小约2 cm × 2 cm红色肿物，手术切除肿物送病理检查，标本经10%福尔马林固定，常规石蜡包埋切片，HE染色及免疫组织化学染色。光镜下见肿瘤细胞呈片状及巢状排列，瘤细胞圆形及梭形，部分瘤细胞胞浆空泡状呈气球样形，部分细胞核仁明显。免疫组化显示肿瘤细胞S-100、HMB-45阳性，CK及EMA阴性，最终病理诊断为左眼上睑无色素性黑色素瘤。对于临床上患者年龄较大无典型霰粒肿特征的眼睑肿物，术后标本均应送病理检查以除外其它肿瘤的可能。

To report a case of amelanotic melanoma located in the leff upper eyelid misdiagnosed as chalazion in a 41-yearold woman. Examination showed a red 2 cm × 2 cm mass in the left upper palpebral conjunctiva. The tumor was excised and regular fixed in 10% formalin, embedded, sectioned, HE stained and immunohistochemistry stained. Histopathological examination revealed nests of round atypical tumor cells with vacuolated cytoplasm and sheets of spindle atypical tumor cells. Some tumor cells had conspicuous nucleoli. Immunohistochemistry some tumor cells were positive for melanocytic markers S-100, HMB-45 and negative for CK, EMA. So the pathological diagnosis was palpebral conjunctiva amelanotic melanoma in the leff upper eyelid. For the mass in palpebral conjunctiva of senile patients without typical characteristics of chalazion, the surgical specimen should be performed for pathologic examination to rule out other tumors.

目的：探讨3种不同的滴眼液在麻醉小鼠晶状体浑浊中的保护作用。方法：将20只6周龄C57BL/6j小鼠分为4组，A组为自然暴露组(对照组)，B组为滴用透明质酸钠组，C组为滴用甲基纤维素滴眼液组，D组为滴用生理盐水组。分别于麻醉后10，20，30，45和60 min观察小鼠晶状体浑浊情况。结果：与A组相比，3种滴眼液均不同程度地延长小鼠晶状体浑浊的时间；30 min时，4组小鼠浑浊 发生率分别为90%，50%，50%和10%，并延缓晶状体浑浊的进展；60 min时，4组小鼠3级浑浊的发生率为30%，10%，10%和0，其中生理盐水的作用效果最优，可以明显延迟晶状体变浑浊的时间。结论：麻醉小鼠的晶状体浑浊程度可以被相关滴眼液延缓，适用于短时间的眼科检查和处理，又因其经济易得，可广泛应用于小鼠活体的眼科检查中。

Objective: To study the effect of saline, carboxymethylcellulose sodium eye drops and sodium hyaluronate gel to stop the development of cataract in anesthetized mice. Methods: Twenty C57BL/6j mice, aged 6 weeks, were divided into four groups, group A was naturally exposed to air, group B was treated with sodium hyaluronate gel, group C was treated with carboxymethylcellulose sodium eye drops and group D was treated with saline. The lens opacity was observed at 10, 20, 30, 45 and 60 min after the start of the experiment. Results: Compared with group A, the eye drops delayed the development of lens opacity in varying degrees. At 30 min, the incidence rate of cataract in group A, B, C and D was 90%, 50%, 50% and 10%, respectively. At 60 min, the incidence rate of grade 3 cataract in group A, B, C and D was 30%, 10%, 10% and 0 respectively, saline did the best, which can significantly slow the process. Conclusion: Cataract development can be slowed by the protective eye drops. This finding is relevant for those experimental settings in which clear ocular media are required. 

目的：了解中山大学中山眼科医院门诊重症疑难眼病会诊的现状，探讨门诊重症疑难眼病会诊亚专科的分布情况及会诊效果，为建立科学的门诊重症疑难眼病会诊体系提供支持和依据，同时也为合理安排会诊流程提供依据。方法：对中山大学中山眼科医院2016年3月至2017年4月收集的265例门诊重症疑难病例，通过时间、地区、性别、年龄、会诊原因、会诊亚专科、会诊后的转归及效果等方面进行统计分析，所有数据均通过Excel软件进行录入，根据分析目的和资料的类型，采用相应的统计指标进行描述，并进行统计推断，检验水准为α=0.05。结果：2016年3月至2017年4月期间中山大学中山眼科医院门诊重症疑难眼病会诊人数265例。在地区分布中，广东省地区最多，为145例，外国最少，为3例。人群分布中，男167例，女98例，男女比例为1.70:1。年龄分布中，30~44岁及45~59岁的病例数最多，均为53例(20%)，70岁以上老年病例最少，为13例(4.9%)。中山大学中山眼科医院门诊重症疑难眼病会诊中，2016年3月至2017年4月期间，各眼科亚专科共参加会诊714次，眼底外科参加会诊次数最多，为147次(20.5%)，结膜科参加会诊的次数最少，为1次(0.1%)。在分析会诊原因方面，因诊治涉及多个专科而会诊的病例数最多，为161例，因病因不明会会诊的病例最少，为20例；会诊后比会诊前明确治疗方案的病例数增加190例。结论：中山大学中山眼科医院门诊组织实施重症疑难眼病会诊使明确治疗方案率大幅提高，在提高疑难眼病治疗效果方面起到一定的促进作用。

Objective: To understand the current situation of the consultation for outpatients with severe eye disease in Zhongshan Ophthalmic Center, and to explore the distribution and effects of sub-specialty consultation for outpatients with severe eye disease. To set up a scientific system of the consultation for outpatients with severe eye disease, and also provide a basis for reasonable arrangement of consultation process. Methods: We analyzed 265 severe cases from March 2016 to April 2017 in Zhongshan Ophthalmic Center by time, region, gender, age, cause of consultation, sub-specialty, and outcomes after consultation. And all data was analyzed by Excel software, according to the purpose and the type of data, and the corresponding statistical index and statistical inference, inspection level for α=0.05. Results: There were 265 cases with severe eye disease from March 2016 to April 2017. As for the regional distribution, Guangdong province was the largest, with 145 cases, while the lowest number was from foreign countries, which was 3 cases. In the population distribution, 167 cases were males, 98 were females and the ratio was 1.70. In age distribution, patients aged from 30 to 44 years and 45 to 59 years predominated and the number of cases were both 53, accounting for 20% of the total number. Patients over 70 were the least which were 13 cases, accounting for 4.9% of the total number. From March 2016 to April 2017, all sub-specialties attended consultation for 714 times, as Ocular Fundus Department attended the most, accounting for 20.5% of the total number while Conjunctive Department attended the least, for only one, accounting for 0.1% of the total number. As for the reason of the consultation, the number of cases involving multiple specialties was the largest, with 161 cases, while the lowest number of cases due to unexplained causes, which were 20 cases. The number of cases of explicit treatment was increased by 190 after consultation. Conclusion: Consultations organized by Zhongshan Ophthalmic Center improves the treatment for outpatients with severe eye disease.

目的：评估Smart plug泪小管塞治疗水液缺乏型干眼的长期并发症。方法：收集汕头国际眼科中心2011至2016年门诊确诊的水液缺乏型干眼患者300例(600眼)，进行Smart plug泪小管塞治疗，随访观察术后临床并发症，中位随访时间为术后3年(术后1~5年)。结果：3例患者(3眼)术后患有泪小管炎(0.5%)，发病时间为术后1~3(中位2)年，取出泪小管塞后并给予局部抗生素滴眼液治愈。2例患者 (4眼)因植入上下泪小管塞后流泪症状不能耐受，单纯取出下泪小管塞后症状缓解(0.7%)；4例患者(8眼)因只植入下泪小管塞症状未能明显好转，1个月后再次植入上泪小管塞(1.3%)；291例患者干眼主观症状改善，有效率为97.5%，长期随访未发现并发症。结论：虽然Smart plug泪小管塞治疗水液 缺乏型干眼具有明确的疗效，但Smart plug泪小管塞植入后的长期并发症不容忽视，需要长期观察。

Objective: To evaluate the long-term complication associated with the use of the Smart plug in the treatment of aqueous tear deficiency dry eye. Methods: A total of 300 patients (600 eyes) were collected in Joint Shantou International Eye Center from 2011 to 2016, all the patients accepted the treatment with Smart plug, and were followed up for clinical complications. The median follow-up time was postoperative 3 years (1–5 years after surgery). Results: Three patients (3 eyes) developed canaliculitis, the rate was 0.5%. The median time from Smart plug insertion to the onset of canaliculitis was 2 (1–3) years, leaving the Smart plug and resolved the application of topical antibiotics. Two patients (4 eyes) could not suffer from implantation of the upper and lower Smart plug, removed the below, the ratio was 0.7%; 4 patients (8 eyes) need upper Smart plug insertion after implantation of the lower one month later, the rate was 1.3%; 291 cases of dry eye improved by long-term followup, the effective rate was 97.5%. Conclusion: Although the Smart plug is effective in the treatment of aqueous tear deffciency dry eye, the later complications of Smart plug insertion cannot be neglected and need the long-term follow-up.