玻璃体视网膜疾病并发白内障患者行玻璃体切割术联合超声乳化白内障摘除术，即前后节联合手术，是高效的手术方式，而后囊膜破裂(posterior capsular rupture,PCR)是超声乳化白内障摘除术的术中并发症之一，能够及时、有效地处理PCR，稳定、安全地植入人工晶状体(intraocular lens,IOL)，对于顺利完成后段手术，减少术后并发症十分重要。本文将对前后段联合手术中后囊膜破裂的术中处理、以及IOL光学部夹持固定法植入IOL的手术技术要点进行总结。

Combined surgery of pars plana vitrectomy (PPV) and phacoemulsification is an effective and safe way for management of retinal diseases complicated with cataract. Posterior capsular rupture (PCR) is one of the common intraoperative complications of phacoemulsification, and it is thus very important to deal with it promptly and efficiently, and ensure the subsequent procedures of intraocular lens (IOL) implantation as well as PPV. We will summarize the key points of the surgical technique for management of PCR and capture of IOL optic during combined surgery.

眼部移植物抗宿主病发生在超过一半的慢性移植物抗宿主病患者中，涉及眼表持续的炎症以及纤维化改变，最常见的表现为干燥性角膜结膜炎。严重的眼部移植物抗宿主病不但影响患者的工作和生活质量，同时也增加了其他眼部并发症的风险。慢性眼部移植物抗宿主病的治疗主要包括局部应用人工泪液、血清类制剂、抗炎药物等药物治疗，佩戴隐形眼镜、睑板腺按摩等物理治疗、封闭泪点、重建眼表等手术治疗。随着对眼部移植物抗宿主病发病机制的深入研究，许多新的治疗药物和治疗手段涌现临床。总结目前慢性眼部移植物抗宿主病在药物治疗、物理治疗、手术治疗方面的最新研究进展，将有助于为慢性眼部移植物抗宿主病的治疗带来更多选择和更新的研究思路。

More than half of the patients developed chronic graft-versus-host disease after accepting allogeneic hematopoietic stem cell transplantation suffer from ocular graft-versus-host disease. Ocular graft-versus-host disease involves persistent inflammation and fibrosis of the ocular surface and keratoconjunctivitis sicca is the most common symptom. Severe ocular graft-versus-host disease not only affects patients’ life quality, but also increases the risk of other ocular complications. The treatment of chronic ocular graft-versus-host disease mainly includes drug treatment, such as local application of artificial tears, serum eye drops and anti-inflammatory drugs; physical treatment, such as wearing contact lenses and meibomian gland massage; surgical treatment, such as punctal occlusion and reconstructing ocular surface. With the in-depth study of the pathogenesis of ocular graft-versus-host disease, many new therapeutic drugs and methods have emerged. Summarizing the latest research progress in drug, physical and surgical therapy of chronic ocular graft-versus-host disease will give us insights into treatment options and hot spot of research.

目的：依托最新的第5代移动通信技术(5th generation wireless systems，5G)，构建基于眼底图片的5G医疗眼科远程诊断平台，促进医疗资源上下贯通，提升基层服务能力及医疗服务体系整体效能。方法：基于5G时代医院的信息化发展战略，在海南省卫生健康委员会的资助与指导下，中山大学中山眼科中心海南眼科医院与中国联通通信集团海南有限公司等进行跨行业、多学科的技术力量研究开发，构建5G条件下的平台建设模块和技术路线，确定远程眼科诊断流程，并在海南省内多地区应用。结果：远程诊断平台运行良好。2020年12月至2021年11月，本研究共在海南省17个地区的186个卫生院中开展，共收集1561例患者眼底病图片数据，筛查阳性例数为185例，检出眼底病总阳性率为11.9%。其中有42例需要转诊治疗，转诊率为23%；143例不需要转诊治疗，非转诊率为77%。在1561例眼底图像中，采集异常的眼底图像有490例。排除490例异常眼底图像后，辅助诊断系统与人工诊断结果有1 002张眼底图像诊断相同，69张眼底图像诊断不同，其辅助诊断系统准确率为93.3%。结论：5G移动通信与远程医学影像结合，运用互联网科技催生新型医疗生产力，提高卫生经济的质量和效率，是医疗领域探索5G应用场景的一项应用典范。

Objective: Relying on the latest 5th generation wireless systems (5G), a remote primary ophthalmology care diagnosis platform based on fundus images was constructed in order to promote the connectivity of medical resources and improve the primary health service capabilities and the overall effectiveness of the medical service system. Methods: Based on the 5G informatization development strategy of hospitals, and under the funding and guidance of the Hainan Provincial Health Commission, the Hainan Eye Hospital of Zhongshan Ophthalmic Center and China Unicom Communications Group Hainan Co., Ltd. conducted a cross-industry, multi-disciplinary technical research. To build platform construction modules and technical routes under 5G networks, present the remote ophthalmological diagnosis process, and apply it in many regions in Hainan Province. Results: The performance of the remote diagnosis platform is well. From December 2020 to November 2021, this study was carried out in 186 health centers in 17 regions of Hainan Province. A total of 1 561 patients with fundus disease image data were collected. The number of positive screening fundus disease cases was 185. The total positive rate was 11.9%. Among them, 42 cases required referral for treatment, with a referral rate of 23%, and 143 cases did not require referral for treatment, with a non-referral rate of 77%. Among 1 561 cases of fundus images, 490 fundus images were excluded due to abnormal quality. Compared the results of the diagnosis platform system with manual diagnosis, 1 002 fundus images were identical, and 69 fundus images were different in diagnosis. The accuracy of the auxiliary diagnosis system was 93.3%. Conclusions: The collaboration of 5G mobile communication and telemedicine imaging, combined with internet technology to promote new medical productivity, improve quality and efficiency of the health economy. This study is an application model for exploring 5G application scenarios in the medical field.

慢性移植物抗宿主病(chronic graft-versus-host disease，cGVHD)是骨髓移植后最具有破坏性并发症之一。移植物抗宿主病(graft-versus-host disease，GVHD)发生在10%~80%的造血干细胞移植(hematopoietic stem cell transplantation)受者中，而眼睛是人身体最脆弱的器官之一，有40%~60%接受HSCT的患者发生眼部GVHD，它主要影响泪腺、睑板腺、角膜和结膜等。cGVHD相关性干眼(dry eye associated with chronic graft-versus-host disease，cGVHD-DE)是眼部GVHD最多见的表现形式。cGVHD-DE的长期治疗因涉及多学科、多重结合治疗，至今仍然具有挑战性，其除了全身免疫抑制和眼部润滑剂外，通常还使用局部类固醇、环孢霉素和他克莫司滴眼液。针对中度和重度cGVHD-DE的治疗干预包括使用自体血清滴眼液和佩戴巩膜镜等，新兴起的治疗方案包括重链透明质酸 (heavy chain-hvaluronan/穿透素(pentraxin 3)结膜下注射、间充质基质细胞静脉注射、抑制纤维化药物等。

Chronic graft-versus-host disease (cGVHD) is one of the most devastating complications following bone marrow transplantation. GVHD develops in 10–80% of patients after hematopoietic stem cell transplantation (HSCT). The eye is one of the most vulnerable organs of the human body. Ocular GVHD occurs in 40–60% of patients with GVHD undergoing HSCT, and it mostly affects the lacrimal glands, meibomian glands, cornea, and conjunctiva. The most common form of ocular GVHD is dry eye disease (DED). The long-term treatment of cGVHD-related dry eye syndrome remains challenging and involves a multidisciplinary approach. Besides systemic immunosuppression and ocular lubricants, topical steroids, topical cyclosporine, and topical tacrolimus are commonly prescribed. Newer therapeutic interventions for moderate and severe cGVHD-related DED include using serum eye drops and scleral contact lenses. Emerging treatment options include subconjunctival injection of heavy chain-hyaluronan (HC-HA)/ pentraxin 3 (PTX3), intravenous injection of mesenchymal stromal cells, antifibrotic drugs, etc. This article reviews the mechanisms, clinical findings, and treatment of cGVHD-related dry eye syndrome.

目的：调查八年制临床医学生对眼科学直播课堂的满意度及教学效果。方法：基于八年制临床医 学生的直播课堂教学体验视角，进行问卷调查、课堂测验及课程考试，问卷内容包括调查对象基 本情况、直播课堂教学评价及满意度3个部分。采用SPSS 20.0统计学软件进行数据分析。结果：共 92名学生完成了问卷调查，男37名，女55名，年龄为(22.9±0.71)岁。课堂内容、课堂资源、平台设 计、平台技术及学习交流5个纬度的得分为40.60±4.582、17.43±2.814、13.07±1.759、13.14±2.052、 20.82±2.685；其中，与线下课堂交流相似性、学习交流积极性2个子条目的得分最低，分别为 3.42±1.131、3.85±0.864，这二者具有相关性(r=0.276，P=0.008)。直播课堂满意度的总得分为 13.52±1.872，课堂内容对其有显著影响(P<0.001)，标准化回归系数为0.687。相较于课前测验，课 测验成绩(65.9±11.4分)的提升差异具有统计学意义(P=0.033)；但是与2013级相比，2015级学生的 课程考试成绩(72.6±7.0分)降低，差异有统计学意义(P=0.009)。结论：课堂内容对直播课堂教学满 意度具有重要影响，需要注意直播课堂与线下课堂交流方式的差异，改进学习交流的参与积极性， 以提升教学效果。

Objective: To investigate the satisfaction and teaching effect of 8-year program medical students in live-streamed classroom on ophthalmology. Methods Based on teaching experience of live-streamed classroofrom the perspective of the 8-year program medical students, a questionnaire survey, classroom tests and course examination were conducted. The content of the questionnaire includes 3 parts: the basic information of the respondents, evaluation of live-streamed classroom teaching and its satisfaction. The SPSS 20.0 statistical software was used for data analysis. Results: A total of 92 students completed the questionnaire survey, including 37 males and 55 females, aged (22.9±0.71) years. The sores of content, resource, platform design, platform technology and learning communication of live-streamed classroom were 40.60±4.582, 17.43±2.814, 13.07±1.759, 13.14±2.052 and 20.82±2.685, respectively. Among all items, the scores of the similarity of offline classroom communication styles and enthusiasm for communication were lowest, with the points of 3.42±1.131 and 3.85±0.864, respectively, and the correlation of the two items were statistically significant (correlation coefficient =0.276, P=0.008). The total score of the live-streamed classroom satisfaction was 13.52±1.872. The classroom content has a significant effect on the satisfaction of the live-streamed classroom (P<0.001), and the standardized regression coefficient is 0.687. Compared with the pre-class test, the post-class test score was 65.9±11.4, with a statistically significant improvement (P=0.033); however, compared with grade 2013, the course test score of the students of grade 2015 was 72.6±7.0, with a statistically significant reduction (P=0.009). Conclusion: The classroom content has an important impact on the satisfaction of live-streamed classroom teaching. It is necessary to pay attention to the communication difference between live -streamed classroom and offline classroom settings, and improve the enthusiasm for participation in the study communication, in order to improve the effectiveness of teaching. 

接触镜在全球的应用日益广泛，配适方法的不断进步是目前接触镜安全性、舒适性不断提高的原因之一。在接触镜适配过程中，越来越多的先进影像技术被运用于指导接触镜的配适，这些技术的出现简化了接触镜适配的过程，为临床医生进行简便、准确、个性化的接触镜适配提供了帮助，也为接触镜的个性化设计提供了参考数据。

Contact lens has been widely applied worldwide, and the advancement of fitting strategy is one of the reasons which improve the safety and comfort of contact lens fitting. During the contact lens fitting procedure, more and more ophthalmic imaging modalities have been applied to guide the contact lens fitting. These techniques simplify the contact lens fitting procedure, help optometrists accurately perform the customize contact lens fitting, and assist the personalized contact lens design technique.

全身疾病通过一定途径累及眼球，产生眼部病变，这些眼部病变的严重程度与全身疾病的进展密切相关。人工智能(artificial intelligence，AI)通过识别眼部病变，可以实现对全身疾病的评估，从而实现全身疾病早期诊断。检测巩膜黄染程度可评估黄疸；检测眼球后动脉血流动力学可评估肝硬化；检测视盘水肿，黄斑变性可评估慢性肾病(chronic kidney disease，CKD)进展；检测眼底血管损伤可评估糖尿病、高血压、动脉粥样硬化。临床医生可以通过眼部影像评估全身疾病的风险，其准确度依赖于临床医生的经验水平，而AI识别眼部病变评估全身疾病的准确度可与临床医生相媲美，在联合多种检测指标后，AI模型的特异性与敏感度均可得到显著提升，因此，充分利用AI可实现全身疾病的早诊早治。

Systemic diseases affect eyeballs through certain ways, resulting in eye diseases; The severity of eye diseases is closely related to the progress of systemic diseases. By identifying eye diseases, artificial intelligence (AI) can assess systemic diseases, so as to make early diagnosis of systemic diseases. For example, detection of the degree of icteric sclera can be used to assess jaundice. Detection of the hemodynamics of posterior eyeball can be used to evaluate cirrhosis. Detection of optic disc edema and macular degeneration can be used to evaluate the progress of chronic kidney disease (CKD). Detection of ocular fundus vascular injury can be used to assess diabetes, hypertension and atherosclerosis. Clinicians can estimate the risk of systemic diseases through eye images, and its accuracy depends on the experience level of clinicians, while the accuracy of AI in identifying eye diseases and evaluating systemic diseases can be comparable to clinicians. After combining various detection indexes, the specificity and sensitivity of AI model can be significantly improved, so early diagnosis and early treatment of systemic diseases can be realized by making full use of AI.

目的：分析免疫抑制状态下，无猫接触史、不伴玻璃体混浊且视网膜呈现大片状黄白色坏死灶的弓形虫视网膜炎患者的误诊原因及临床表现。 方法：病例系列研究。收集2021年9月—2023年4月于中山大学中山眼科中心确诊的不典型弓形虫视网膜炎患者临床资料,分析其误诊原因、临床表现及治疗预后。结果：纳入3例患者（5眼），患者均为女性，其中1例对侧眼1年前诊断为“葡萄膜炎”导致无光感，其余2例均为双眼先后发病。年龄为31~34岁，从发病到确诊，病程1~2个月。3例患者均无猫接触史。均因全身疾病而使用大剂量免疫抑制药物：2例为慢性系统性红斑狼疮患者，不规则治疗后出现复发；1例患者因“暴发性肝坏死”，进行肝移植手术，术后使用免疫抑制抗排斥药物。眼底检查显示玻璃体无明显混浊，眼底图上有大片状黄白色视网膜病灶，在光学相干断层扫描（optical coherence tomography, OCT）上表现为坏死样改变。首诊均误诊为急性视网膜坏死或巨细胞病毒性视网膜炎，2例患者还伴有EB病毒阳性，行局部及全身抗病毒治疗，视力进一步下降伴坏死灶进一步扩大。转诊至中山大学中山眼科中心后，补充房水检测均提示弓形虫DNA强阳性。予抗弓形虫治疗后视网膜坏死灶明显吸收，视力提高。结论：在免疫抑制状态下，弓形虫视网膜炎可表现为非典型的大片状视网膜坏死、无玻璃体混浊及无猫接触史，易被误诊为其他视网膜炎症。临床医生应高度警惕免疫抑制人群中弓形虫视网膜炎的可能性，及时进行房水弓形虫DNA检测有助于明确诊断并改善预后。

Objective: Vitreous opacity and cat contact history are two major diagnostic criteria for toxoplasmic retinochoroiditis. This study aimed to explore the causes of misdiagnosis and the clinical manifestations of patients with toxoplasmic retinochoroiditis who present with large yellowish-white necrotic retinal lesions but lack both a history of cat exposure history and vitreous opacity. Methods: This was a case series study. We collected clinical data from three patients diagnosed at Zhongshan Ophthalmic Center, Sun Yat-sen University between September 2021 and April 2023. All patients presented without a history of cat contact or vitreous opacity.The causes of misdiagnosis, clinical features, and treatment outcomes were analyzed. Results: The study included three patients (five eyes), all of them were female. One patient had no light perception in the contralateral eye after a 3-year disease course, while the other two exhibited bilateral involvement. The patients’ ages ranged from 31 to 34 years, and the duration of symptoms before diagnosis was 1–2 months. None reported exposure to cats, but all were immunocompromised: two had systemic lupus erythematosus (SLE) with irregular treatment and relapse, and one had underwent liver transplantation for "fulminant hepatic necrosis" and was receiving post-transplant immunosuppression. Fundus examination revealed no vitreous opacity, and retinal lesions appeared as large yellowish-white changes on fundus photography and necrotic changes on optical coherence tomography(OCT). Initially, all cases were misdiagnosed as acute retinal necrosis or cytomegalovirus retinitis, with 2 cases testing positive for herpesvirus DNA. Antiviral therapies were applied, which led to worsened vision and progression of the lesions. Subsequent referral testing of aqueous humor confirmed the presence of Toxoplasma gondii DNA. Anti-toxoplasma treatment resulted in significant resolution of the lesions and improvement in vision. Conclusions: In immunocompromised individuals, the presence of large necrotic retinal lesions without vitreous opacity or a history of cat exposure should raise suspicion for toxoplasmic retinochoroiditis. This awareness is crucial to prevent delayed diagnosis and subsequent vision loss.

目的：了解新疆喀什地区英吉沙县7~16岁儿童青少年弱视患病情况及其相关因素，为制定科学有效的眼健康防控策略提供依据。方法：选取新疆喀什地区英吉沙县3 261名在校儿童青少年，对其进行裸眼视力、最佳矫正视力、屈光度、眼位和眼底情况等检查，并通过问卷调查收集其基本人口学信息、近视家族史、用眼情况和睡眠情况，采用Logistic回归分析7~16岁儿童青少年弱视患病的相关因素。结果：英吉沙县儿童青少年弱视的患病率为1.99%（95%·CI: 1.51~2.47）。弱视患病率在学生类型、性别、近视家族史、主观睡眠质量、每天写作业时间、每天睡眠时间等方面比较差异无统计学意义（P＞0.05），在斜视、近视、远视、屈光参差、每天使用电子产品时间等方面比较差异有统计学意义（P＜0.05）。多因素回归分析结果显示，斜视、远视、屈光参差及每天使用电子产品时间与弱视相关，对应的OR值相应为3.82（95%CI: 1.93~7.58，P＜0.001）、10.88（95%CI: 4.85~24.40，P＜0.001）、13.54（95%CI:6.84~26.78，P＜0.001）和0.25（95%CI: 0.12~0.54, P＜0.001），合并斜视、远视或屈光参差的儿童青少年患弱视的风险增加。每天使用电子产品时间＞60 min的儿童青少年患弱视风险较使用时间≤60 min降低。弱视类型以屈光不正性弱视和屈光参差性弱视为主。结论：在新疆喀什地区英吉沙县7~16岁儿童青少年人群中，屈光不正和屈光参差是弱视患病的主要原因。斜视、远视、屈光参差、每天使用电子产品时间是弱视的影响因素。

Objective: To conduct a comprehensive investigation into the prevalence of amblyopia and its influencing factors among children and adolescents aged 7-16 in Yingjisha County, Kashi, Xinjiang. The ojective is to furnish a solid basis for formulating scientific and effective eye health prevention and control strategies. Methods: A total of 3,261 school-aged children and adolescents in Yingjisha County, Kashi, Xinjiang, were selected for this study. The examinations included uncorrected visual acuity, best-corrected visual acuity, refractive error, ocular alignment, and fundus condition. A questionnaire was used to collect demographic information, family history of myopia, daily eye-use habits, and sleep status. The data were analyzed using SPSS statistical software, and logistic regression was employed to explore factors associated with amblyopia in children and adolescents aged 7-16. Results: The study revealed that the prevalence of amblyopia among children and adolescents in Yingjisha County was 1.99% （95% CI: 1.51-2.47）. There were no significant differences (P > 0.05) in the prevalence of amblyopia across student type, sex, family history of myopia, subjective sleep quality, daily homework duration, or daily sleep duration. However, significant differences (P < 0.05) were observed in cases involving strabismus, myopia, hyperopia, anisometropia, and daily screen time. Multivariate regression analysis indicated that strabismus (OR = 3.82, 95% CI: 1.93-7.58, P < 0.001), hyperopia (OR = 10.88, 95% CI: 4.85-24.40, P < 0.001), and anisometropia (OR = 13.54, 95% CI: 6.84–26.78, P < 0.001) were positively correlated with amblyopia. Conversely, children and adolescents who used electronic devices for >60 minutes per day had a lower risk of amblyopia (OR = 0.25, 95% CI: 0.12-0.54, P < 0.001) compared to those with ≤60 minutes or less of daily screen time. The most common type of amblyopia was mixed amblyopia （60.00%）, followed by anisometropic amblyopia （23.08%）, refractive amblyopia （12.31%）, and strabismic amblyopia （4.62%）. Among mixed amblyopia cases, the combination of refractive amblyopia and anisometropic amblyopia was the predominant pattern （64.10%）. Conclusions: Refractive errors and anisometropia are the main causes of amblyopia. Strabismus, myopia, hyperopia, anisometropia and the duration of electronic device use are identified as influencing factors for amblyopia.

眼睑基底细胞癌(basal cell carcinoma of eyelid, BCC)是眼附属器中最为常见的恶性肿瘤，近年来，其全球发病率呈持续上升趋势，且患者发病年龄有明显年轻化的倾向，这不仅增加了疾病的公共卫生负担，也对临床防治策略提出了更高要求。本文综述了眼睑BCC在诊疗领域的最新研究进展。在诊断方面，除传统组织病理学检查外，皮肤镜、反射共聚焦显微镜(reflectance confocal microscope, RCM)和光学相干断层扫描(optical coherence tomography, OCT)等新技术的应用不仅显著提升了诊断灵敏度与特异度，更在肿瘤亚型鉴别和边界描绘方面展现出独特优势。在分子机制研究方面，代谢组学揭示了眼睑BCC存在显著的代谢重编程，包括脂质代谢、烟酰胺腺嘌呤二核苷酸(nicotinamide adenine dinucleotide, NAD)代谢、多胺代谢以及葡萄糖代谢等多条代谢通路的异常活化。更为前沿的空间代谢组学技术则将代谢信息与组织空间位置相结合，进一步验证了磺酸、羟基吡啶硫酮等特异性代谢物在肿瘤发生发展中的潜在生物标志物价值。治疗方面，除了传统手术治疗之外，放射治疗的技术革新，以及针对Hedgehog信号通路的靶向药物及免疫抑制剂等免疫疗法的突破，为晚期/转移性患者带来了革命性的治疗转机。文章旨在为未来的眼睑BCC预防和治疗策略提供新的见解，并为临床医生提供新的诊疗思路。

Eyelid basal cell carcinoma (BCC), the most prevalent malignant tumor of the ocular adnexa, has seen a steady rise in global incidence, accompanied by a notable trend toward earlier onset. This trend not only exacerbates the public health burden but also imposes greater demands on clinical strategies for prevention and management. This article reviews the latest research progress in the diagnosis and treatment of eyelid BCC. In diagnostic practice, alongside conventional histopathological examination, the incorporation of novel technologies—such as dermoscopy, reflectance confocal microscopy (RCM), and optical coherence tomography (OCT)—has markedly enhanced diagnostic sensitivity and specificity, while offering distinct advantages in tumor subtype differentiation and margin assessment. Metabolomic analyses reveal pronounced metabolic reprogramming in eyelid BCC, with aberrant activation of lipid, NAD, polyamine, and glucose metabolism. Spatial metabolomics further supports the biomarker potential of metabolites such as taurine and pyrithione in tumor initiation and progression. Beyond conventional surgery, advances in radiotherapy, targeted Hedgehog pathway inhibitors, and immunotherapies have created new opportunities for advanced or metastatic eyelid BCC. This review highlights emerging strategies for prevention, diagnosis, and treatment, offering clinicians fresh perspectives for patient management.