航天飞行相关的神经-眼综合征(spaceflight associated neuro-ocular syndrome,SANS)是指宇航员在长时间航天飞行期间和之后观察到的包括视盘水肿、后极部眼球扁平、脉络膜视网膜皱褶和远视飘移等在内的一系列眼部、神经和神经影像学表现，可能会对飞行员造成短期或长期的视力改变、认知影响或其他有害的健康影响，因此，明确SANS的发病机制，进行有效的地面模拟实验及制定对应的缓解对策对未来更远、更久的航天飞行具有重要的意义。目前SANS的发病机制主要有颅内压升高、脑血容量波动与血管重塑、脑和视交叉向上移位、眼淋巴系统流动失衡、细胞毒性水肿、眼眶脂肪肿胀等。国际上研究较多的地面模拟实验为6°头朝下倾斜卧床休息，能够重现SANS的各种表现，包括视神经鞘扩张、视网膜神经层增厚、脉络膜厚度增加和视盘水肿；此外，干浸浴、抛物线飞行等地面模拟实验也观察到了SANS的部分表现。下体负压作为缓解对策能减轻脉络膜增厚和视神经鞘直径增加，正压力护目镜也有望成为应对SANS的有效对策。该文就国内外相关进展进行综述。

Spaceflight associated neuro-ocular syndrome (SANS) refers to a series of ocular, neurological and neuroimaging manifestations observed in astronauts during and after long-term space flight, including optic disc edema, posterior globe flattening, choroid-retinal folds, and hyperopic refractive shift. These effects may have short-term or longterm on vision , cognitionand other aspects of astronauts’ health. Therefore, elucidating the pathogenesis of SANS, conducting effective ground simulation experiments, and developing corresponding mitigation strategies are crucial for enabling deeper and longer-duration space exploration. Current understanding of the pathogenesis of SANSincludes increased intracranial pressure, fluctions in cerebral blood volume and vascular remodeling, upward displacement of the brain and optic chiasm, imbalance in ocular lymphatic system flow, cytotoxic edema, and orbital fat swelling, etc. Among the various ground simulation experimens, the 6 ° head-down tilt bed rest has been extensively studied and has been shown to replicate various manifestations of SANS, such as optic nerve sheath expansion, retinal nerve layer thickening, choroidal thickness increase and optic disc edema. Additionally, dry immersion and parabolic flight have also demonstrated some aspects of SANS during ground simulation experiments.The use of lower body negative pressure has been identified as a potential countermeasure to reduce choroidal thickening and increase in optic nerve sheath diameter. Furthermore, positive pressure goggles are also expected to be an effective strategy for mitigating the effectsof SANS.This article provides a comprehensive review of the relevant advancements in the field of SANS, both domestically and internationally.

该文报道了一例40岁女性患者，因“双眼渐进性视物模糊3个月”就诊。患者既往于2005年因高度近视行双眼准分子激光原位角膜磨镶术 (LASIK)。最佳矫正视力OD：0.2 (–11.00 DS/ –1.25 DC×170 °)，OS：0.7 (–4.00 DS/ –0.75 DC×25 °)。双眼角膜透明，前房中深，晶状体混浊，豹纹状眼底伴后巩膜葡萄肿。诊断为双眼并发性白内障，并行右眼白内障超声乳化联合人工晶状体 (IOL) 植入术，术中植入+14.0 D IOL一枚，目标屈光度为–0.5 D。术后1周裸眼视力0.3，验光结果示右眼屈光度+2.75 DS，最佳矫正视力0.7。术后2周行右眼IOL置换术，由+14.0 D置换为+17.0 D。右眼术后1周裸眼视力0.8，验光结果示右眼屈光度–0.75 DC×15 °。

It is reported in this article that a 40-year-old female patient presented with "progressive blurred vision of both eyes for 3 months". The patient underwent bilateral laser in situ keratomileusis (LASIK) because of high myopia in 2005. It was recorded that her best corrected visual acuity was 0.2 (–11.00 DS/ –1.25 DC×170 °) in the right eye and 0.7 (–4.00 DS/ –0.75 DC×25 °) in the left, and clear cornea, normal anterior chamber, cloudy lens, tessellated fundus with posterior staphyloma in both eyes. The patient was diagnosed with bilateral complicated cataract. Phacoemulsification combined with intraocular lens (IOL, +14.0 diopter (D)) implantation was performed on the right eye, with the target –0.5D refractive diopter . One week after surgery, it was recorded that the uncorrected visual acuity of the right eye was 0.3, and the best corrected visual acuity was 0.7 (+2.75 DS). IOL replacement of the right eye was performed two weeks after surgery, the +14.0 D IOL was replaced by +17.0 D IOL. One week after surgery, the uncorrected visual acuity of the right eye was 0.8 (–0.75 DC×15 °).

目的：比较Alcon Acrysof IQ PanOptix TFNT00 (PanOptix)晶状体常数优化前后对人工晶状体(intraocular lens,IOL)度数计算准确性的影响，以及不同眼轴长度晶状体常数优化的效果。方法：回顾性收集2021年6月—2022年3月在上海爱尔眼科医院行白内障超声乳化手术联合植入PanOptix IOL患者的术前眼球生物学测量参数、植入IOL度数和术后1~3个月的显然验光结果。联合SRK/T、Hoffer Q、Holladay 1、Haigis公式，通过回归法计算优化的晶状体常数A、pACD、SF，通过多元线性回归计算优化的晶状体常数a0、a1和a2。观察晶状体常数优化前后平均绝对预测误差值(mean absolute error,MAE)及中位绝对预测误差值(median absolute error,MedAE)，预测误差在±0.25、±0.50、±0.75、±1.00 D以内的百分比的差异，评价晶状体常数优化对IOL计算准确性的影响。随后，按照眼轴长度进行分组(非高度近视组：<26.00 mm; 高度近视组：≥26.00 mm)，比较非高度近视组和高度近视组优化晶状体常数的差异。结果：共92眼(54位患者)纳入研究。优化前的晶状体常数A、pACD、SF、a0、a1和a2分别为119.1、5.63、1.83、1.39、0.40和0.10；优化后分别为119.35、6.14、2.36、?3.42，0.12和0.34。在全部眼轴组，晶状体常数优化前，SRK/T、Hoffer Q、Holladay 1、Haigis公式的MAE值分别为0.44、0.50、0.54、0.46 D；优化后，MAE值分别为0.43、0.54、0.51、0.35 D，其中Haigis公式优化前后比较差异有统计学意义(P=0.001)。在非高度近视组，晶状体常数优化前，4条公式的MAE值分别为0.46、0.40、0.40、0.42 D；优化后，MAE值分别为0.46 D、0.38 D、0.39 D、0.38 D，比较差异均无统计学意义(均P>0.05)。在高度近视组，晶状体常数优化前，4条公式的MAE值分别为0.42、0.59、0.66、0.50 D；优化后，MAE值分别为0.36、0.48、0.47、0.31 D，其中Holladay 1和Haigis公式优化前后比较差异有统计学意义(P 分别为 0.020、0.002)。结论：PanOptix IOL的晶状体常数优化可以提高IOL度数计算的准确性，在高度近视组中比非高度近视组中优化意义更大。

Objective: To assess the benefits of intraocular lens (IOL) constant optimization of Alcon Acrysof IQ PanOptix TFNT00 (PanOptix) on the accuracy of IOL power calculation, and the effects of constant optimization between different axial length (AL) groups were further compared. Methods: Patients who underwent phacoemulsification and implantation with PanOptix IOL between June, 2021 and March, 2022 were included in this retrospective study. The preoperative biological ocular parameters, implanted IOL power, and subjective 1-3 months postoperative refraction were collected. Combined with SRK/T, Hoffer Q, Holladay 1 and Haigis formulas, the optimized IOL constant A, surgeon factor (SF), post-surgery anterior chamber depth (pACD), and a0, a1, a2 were back-calculated. Refractive outcomes using optimized IOL constants were re-calculated combined with the corresponding formulas. Compare the mean absolute error (MAE), medium absolute error (MedAE) and percentage of eyes with IOL prediction errors (PE) within ±0.25, ±0.50, ±0.75 and ±1.00 (diopter)D when using the optimized constants and the manufacture constants. Patients were divided into two groups according to AL (non-high myopia: <26.0 mm; high myopia: ≥26 mm), compare the difference of IOL constant optimization between AL subgroups. Results: A total of 92 eyes of 54 patients were enrolled. The manufacture lens constant of A, pACD, SF, a0, a1 and a2 are respectively 119.1, 5.63, 1.83, 1.39, 0.4 and 0.1; and the optimized values are respectively 119.35, 6.14, 2.36, ?3.42, 0.12 and 0.34. In all patients group, with manufacture lens constant, the MAE values of SRKT, Hoffer Q, Holladay 1 and Haigis formula are 0.44, 0.50, 0.54, 0.46 D; with optimized lens constants, the MAE values are 0.43, 0.54, 0.51, 0.35 D, and there is a statistical difference of Haigis formula after optimization (P=0.001). In non-high myopia group, with manufacture lens constant, the MAE values are 0.46, 0.40, 0.40, 0.42 D; with optimized lens constants, the MAE values are0.46, 0.38, 0.39, 0.38 D, and no statistical difference has been found(P>0.05). In high myopia group, with manufacture lens constant, the MAE values are 0.42, 0.59, 0.66, 0.50 D; with optimized lens constants, the MAE values are 0.36, 0.48, 0.47, 0.31 D, and there are statistical differences of Holladay 1 and Haigis formula after optimization (P = 0.020, 0.002). Conclusion: IOL constant optimization of PanOptix IOL can improve the accuracy of IOL calculation, which is more significant in the high myopia group.

随着人工智能(artificial intelligence,AI)技术的快速发展，其在医疗领域的应用正带来革命性的变化。白内障作为全球范围内最常见的可逆性视力障碍之一，在管理和治疗方面依然存在着医疗资源不足、诊断精度低、转诊效率低等诸多实际问题。因此，利用AI技术强大的计算分析和智能决策能力，优化传统医疗实践方式，对于保障人们的视觉健康至关重要。该文探讨AI技术在推动白内障分级诊疗新模式方面的应用，包括白内障图像自动分析与识别、远程医疗和转诊支持等，这些应用能够为白内障患者、社会以及政府带来多方面的显著益处和重要影响，有助于提高白内障诊断和治疗效率，缓解医疗资源不均衡问题，优化医疗资源的配置和管理，推动社会健康进步。然而，AI技术的实际应用也面临风险和挑战，应当充分重视和保护患者数据隐私和安全，建立严格的监管和监督机制，并持续加强技术创新，全面评估AI算法的鲁棒性、公平性和可解释性，以进一步提高AI系统的准确度和可信度。

With the rapid development of artificial intelligence (AI) technology, its application in the field of healthcare is bringing revolutionary changes. Cataracts, as one of the most common reversible visual impairments worldwide, still face many practical issues in terms of limited medical resources, low diagnostic accuracy, and low referral efficiency. Therefore, it is crucial to utilize AI technology's powerful computational analysis and intelligent decision-making capabilities to optimize traditional medical practices and safeguard people's visual health.This article investigates the applications of AI technology on a new model of hierarchic diagnosis and treatment for cataracts, including automatic analysis and recognition of cataract images, remote healthcare, and referral support. These applications can bring significant benefits and important impacts to cataract patients, society, and governments. They can help improve the efficiency of cataract diagnosis and treatment, alleviate the imbalance of medical resources, optimize the allocation and management of healthcare resources, and promote societal health progress.However, the practical application of AI technology also faces risks and challenges. It is important to fully prioritize and protect patients' data privacy and security by establishing strict regulatory and oversight mechanisms. Additionally, continuous efforts should be made to enhance technological innovation and comprehensively evaluate the robustness, fairness, and interpretability of AI algorithms to further improve the accuracy and trustworthiness of AI systems.

据统计，目前全球有近14亿近视人口，近视已成为全球主要的健康问题。近视不仅影响个人的视力健康，还可能引发多种严重的并发症，如高度近视相关的黄斑变性和视网膜脱离等，严重时可导致失明。除了对个人健康的影响，近视还带来了巨大的经济负担，包括直接医疗成本(如眼镜、隐形眼镜、矫正手术等费用)和间接成本(如生产力下降、学习能力降低和生活质量的下降)。在中国，近视的问题尤其显著，近视患病率居高不下，这不仅对个人健康构成威胁，也对社会和经济造成重大影响。国际上，近视的经济负担研究涵盖了医疗直接成本、患者时间成本及生产力损失等方面，可以帮助政府和卫生部门了解近视疾病的经济影响，从而制定合理的公共卫生政策和资源分配策略，优化医疗资源使用，减少社会成本。该文从近视疾病经济负担的构成及其测算方式、国内外经济负担现况等方面对近视疾病经济负担进行简要综述，旨在提供一个关于近视疾病经济负担的综合性认识，指出当前研究的方向和成果，以及预防近视和减轻其经济负担的重要性，为未来研究提供方向和基础。

It is estimated that there are nearly 1.4 billion myopic people in the world, and myopia becomes a significant global health problem. Myopia not only affects visual health, but also leads to serious complications such as macular degeneration and retinal detachment, which can cause blindness in severe cases. Apart from its impact on health, myopia also imposes a substantial economic burden. This burden includes direct medical costs (e.g., expenses for eyeglasses, contact lenses, and corrective surgeries) as well as indirect costs (e.g., reduced productivity, learning abilities, and quality of life). The prevalence of myopia is particularly high in China, posing a threat not only to individual health, but also to society and the economy. International studies on the economic burden of myopia have examined the direct medical costs, patient time costs and productivity loss. These studies help governments and health authorities understand the economic impact of myopia to develop effective public health and resource allocation strategies.. By optimizing medical resources and reducing social costs, these measures aim to alleviate the economic burden. This article provides an overview of the economic burden of myopia, including its definition, measurement, current status at home and abroad, and the importance of prevention and alleviation. It also highlights the current research directions and findings, to provide focusing fields and foundations for future research.

糖尿病视网膜病变是最为常见的糖尿病微血管并发症，主要由糖尿病引起的机体代谢紊乱导致。而然在临床工作中发现，部分患者通过单纯控制血糖以延缓糖尿病视网膜病变进展，所取得效果不甚理想，一些其他因素对于糖尿病视网膜病变的发生、发展，也起到不可忽视的作用。研究表明，在并发高脂血症的糖尿病视网膜病变患者中，胆固醇代谢异常是诱发视网膜病变的主要原因之一。胆固醇代谢异常通过减弱肝脏X受体，导致胆固醇在视网膜上不断积累，降低视网膜血管内皮功能，从而造成视网膜缺血、缺氧环境的形成，又可通过增加炎症因子和细胞黏附分子-1的表达，使原本病态的糖尿病视网膜血管变得更加脆弱，该文总结了糖尿病视网膜病变的病理因素，对比分析当前糖尿病视网膜病变的主要治疗手段，通过分析胆固醇逆向转运(cholesterol reverse transport,RCT)途径转运对糖尿病视网膜病变发生、发展的影响，发现降低高血脂可提高糖尿病视网膜病变的治愈率，这将为糖尿病视网膜病变的临床防治工作提供新思路。

Diabetic retinopathy is the most common diabetic microvascular complication, which is mainly caused by metabolic disorders caused by diabetes. However, in clinical work, it is found that some patients do not achieve satisfactory results in delaying the progress of diabetic retinopathy by simply controlling blood sugar, and some other factors contribute to the occurrence and development of diabetic retinopathy. Also played a role that can not be ignored. Studies have shown that abnormal cholesterol metabolism is one of the main causes of retinopathy in diabetic retinopathy patients with hyperlipidemia. Abnormal cholesterol metabolism leads to the accumulation of cholesterol in the retina and the decrease of retinal vascular endothelial function by weakening the X receptor in the liver, resulting in the formation of retinal ischemia and hypoxia environment. it can also increase the expression of inflammatory cytokines and cell adhesion molecule-1 to make the originally morbid retinal vessels more fragile. This paper summarizes the pathological factors of diabetic retinopathy. By comparing and analyzing the main treatment methods of diabetic retinopathy at present, and by analyzing the influence of cholesterol reverse transport (cholesterolreversetransport,RCT) pathway on the occurrence and development of diabetic retinopathy, it is found that reducing hyperlipidemia can improve the cure rate of diabetic retinopathy, which will provide new ideas for the clinical prevention and treatment of diabetic retinopathy.

Terson综合征又称蛛网膜下腔出血合并玻璃体积血综合征，是一种较为罕见的眼科疾病。患者多因颅内出血而存在意识障碍、沟通困难，极易漏诊，错过最佳治疗时机。该文报道了一例30岁男性患者，因弥漫蛛网膜下腔出血，突发昏迷，于发病1个月后出现双眼视物模糊，最终确诊为双眼Terson综合征，并行双眼玻璃体切割术及右眼视网膜前膜剥膜术治疗。术后54 d，患者左眼视力由指数/5 cm恢复至矫正视力0.3。术后19 d，患者右眼视力由手动/20 cm恢复至矫正视力0.12。

Terson syndrome, also known as subarachnoid hemorrhage combined with vitreous hemorrhage syndrome, is a relatively rare ophthalmic condition. Patients mostly have impaired consciousness and communication difficulties due to intracranial hemorrhage, which makes it very easy to miss the diagnosis and the best time for treatment. This article reports the basic case of a 30-year-old male patient with sudden coma due to diffuse subarachnoid hemorrhage. And he had blurred vision in both eyes 1 month later, which was finally diagnosed as binocular terson syndrome. He was treated with vitrectomy in the left eye and vitrectomy + anterior retinal detachment surgery in the right eye. The visual acuity of patient was restored from finger count/5cm to corrected visual acuity of 0.3 in the left eye when 54 days after surgery and from manual/20 cm to corrected visual acuity of 0.12 in the right eye when 19 days postoperative.

目的：评估远视儿童使用1%阿托品凝胶1周后脉络膜厚度(choroidal thickness,CT)的变化。方法：选择42例4~7岁的远视儿童，予每天使用1%阿托品凝胶两次，持续7d。使用光学相干断层成像扫描测量视网膜及CT，并分析使用1%阿托品凝胶前后中心凹以及距中心凹处间隔1.0 mm的上、下、鼻和颞侧(最多3.0mm)CT的变化。结果：在远视儿童中，基线CT随位置而变化(F=27.08, P<0.05)，与中心凹相比，鼻侧及距中心凹上方2 mm、3 mm及距中心凹颞侧3 mm处的CT较薄(P<0.05)。使用1%阿托品凝胶后，中央凹及旁中心凹CT改变比较差异无统计学意义(P＞0.05)。使用1%阿托品凝胶前后视网膜厚度无明显变化(P＞0.05)。结论：短期使用1%阿托品凝胶并没有改变远视儿童的脉络膜和视网膜厚度。

Objective: To assess changes of choroidal thickness (CT) in hyperopia children after 1 week using of 1% atropine.Methods: A total of 42 hyperopia children aged 4–7 years were included into the study.A single drop of 1% atropinegel was used twice a daily for 7 days in the subjects.The thickness of retina and choroid was measured by OCT, and the changes before and after using 1% atropine gel were analyzed at the subfovea and at 1.0 mm intervals (up to3.0 mm) from the fovea at superior, inferior, nasal, and temporal locations. Results: In the hyperopia children, baselineCT parameters were varied with the location(F=27.08,P<0.05).Compared with the fovea, the CT at the nasal side,2 mm and 3 mm above the fovea and 3 mm from the temporal side of the fovea were thinner (P<0.05).After using 1%atropine gel, there was no significant difference in the CT changes of subfoveal choroidal thickness and other sites ofparafovea (P> 0.05). There was no significant change in retinal thickness before and after using 1% atropine gel (P > 0.05).Conclusion: No changes were found in the thickness of choroid and retina in hyperopia children after short-term use of1% atropine gel.

目的：了解湿性老年性黄斑变性(age-related macular degeneration,AMD)患者自我感受负担(self-perceived burden,SPB)现状及其影响因素。方法：采用方便抽样法选取2021年1月至11月在中山大学中山眼科中心就诊的204例湿性AMD患者为研究对象，采用一般资料调查表、SPB量表、家庭支持自评量表、医学应对问卷对其进行测评。结果：患者SPB得分是(21.98±6.68)分，总体属于轻度SPB。湿性AMD患者的SPB水平与家庭支出(r=?0.326, P<0.001)和面对应对(r=?0.365, P<0.001)呈负相关，与回避(r=0.456, P<0.001)及屈服(r=0.310, P<0.001)应对方式呈正相关性。多重线性回归显示，独居、高龄、自费、双眼患病及采用回避应对的患者的SPB更高，而高文化水平、高家庭支持的患者SPB较轻。结论：湿性AMD患者有轻度SPB，但仍存在改善空间，医护工作者在工作中应重点关注高龄、文化程度低、家庭收入低、自费、独居、双眼患病及低视力的患者，及时进行心理疏导，减轻患者的SPB水平。

Objective: To understand the current status and influencing factors of self-preceived burden (SPB) in patients with wet age-related macular degeneration (AMD). Methods: 204 patiens with wet AMD who were treated in Zhongshan Ophthalmic Center, Sun Yat-sen University from January to November 2021 were enrolled as the study subjects with convenience sampling method. A general information questionnaire, SPB scale, family support self-assessment scale, and medical coping questionnaire were collected from the subjects for assessment. Results: The patient’s SPB score was 21.98±6.68, which is generally mild SPB. The SPB level of patients with wet AMD was negatively correlated with family support (r=-0.326, P<0.001) and coping (r=?0.365, P<0.001), and were positively correlated with avoidance (r= 0.456,P<0.001), and surrender (r=0.310, P<0.001) coping style. Multiple linear regression showed that the patients who lived alone, were elder and self-funded, had binoclur diseases and used avoidance coping, had higher SPB. While the patients with high education and family support had lower SPB. Conclusions: It is still needed to pay attention to the patients with AMD having mild SPB. Medical workers should focus on patients with elder age, low education level, low family income, self-funded, living alone, binocular disease and low vision in their work, and provide timely psychological counseling to reduce the SPB level of patients.

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.