年龄相关性黄斑变性（age-related macular degeneration, AMD）是一种与氧化应激及多基因调控异常密切相关的视网膜黄斑区域进行性退化性疾病。由于黄斑区缺乏血管，因此对氧气的高度依赖使其特别容易受到氧化应激的影响。氧化应激反应影响视网膜色素上皮细胞（retinal pigment epithelium, RPE）功能，导致RPE细胞代谢异常、RPE细胞凋亡与损伤；影响脉络膜血管功能，表现为新生血管异常和血管内皮细胞功能障碍；过度激活补体系统，使炎症细胞浸润与炎症因子释放引发炎症；这三者构成了AMD的发病机制之一。文章列举了抗氧化酶基因家族（超氧化物歧化酶、过氧化氢酶、谷胱甘肽过氧化物酶）、炎症相关基因（补体系统相关基因和细胞因子相关基因）和其他相关基因（血管内皮生长因子、血红素加氧酶-1、载脂蛋白E、铁死亡相关基因、年龄相关性黄斑病变易感因子2基因）的异常表达与AMD产生的关联性，并阐述了基因编辑技术纠正氧化应激相关基因缺陷和基于氧化应激基因靶点的药物治疗手段，以期为AMD的防治提供思路。
Age-related macular degeneration (AMD) is a retinal degenerative disease closely associated with oxidative stress and dysregulation of polygenic mechanisms. Due to the absence of blood vessels in the macular region, its high dependence on oxygen renders it particularly susceptible to oxidative stress. Oxidative stress impairs the function of retinal pigment epithelium (RPE) cells, leading to metabolic dysregulation, apoptosis, and cellular damage. It also disrupts choroidal vascular function, characterized by abnormal neovascularization and endothelial dysfunction. Moreover, excessive activation of the complement system promotes inflammatory cell infiltration and the release of pro-inflammatory cytokines. Collectively, these processes constitute one of the key pathogenic mechanisms underlying AMD. This paper highlights the pathogenic associations between AMD progression and dysregulated expression in antioxidant enzyme genes (e.g., superoxide dismutase, catalase, glutathione peroxidase), inflammation-related genes (e.g., complement and cytokine-related genes), and other relevant genes (e.g., vascular endothelial growth factor, heme oxygenase-1, apolipoprotein E, ferroptosis-related genes, age-related maculopathy susceptibility 2 gene). Potential therapeutic strategies, including gene editing to correct oxidative stress-related genetic defects and pharmacological interventions targeting oxidative stress-associated genes, are also elaborated, aiming to provide new insights into AMD prevention and treatment.
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：探讨环保试剂在眼科组织病理技术中的应用。方法：选取中山眼科中心2023年6月—2024年3月送检病理科手术标本190 例，一式两份分别采用环保试剂和传统试剂固定、脱水、透明、浸蜡、染色和封片，对两组试剂制片和染色的组织切片进行评价和判读、比较。结果：环保试剂组脱水、染色处理组织与传统试剂组相比，脱水效果良好，切片软硬适中，切面完整、无裂隙；苏木精-伊红(hematoxylineosin, HE)染色镜下可见细胞核结构清晰、核质对比鲜明、背景干净，两组优良片率分别为97.9%、98.4%，各级片差异无统计学意义(Z = –0.645，P=0.519)；免疫组织化学染色的组织抗原性完好，阳性信号强、定位准确，无背景染色。结论：应用环保试剂替代传统试剂在眼科组织标本中脱水、染色应用效果良好，可满足病理日常制片和染色需求，全流程无二甲苯，具有环保优点，成本可控，值得推广应用。
Objective: To investigate the utilization of environmentally-sustainable reagents in ophthalmic tissue pathology techniques. Methods: We prospectively collected 190 surgical specimens submitted to the pathology department of Zhongshan Ophthalmic Center between June 2023 and March 2024. Each specimen was divided into two sets, one treated with environmentally-sustainable reagents and the other with conventional reagents for fixation, dehydration, clearing, infiltration, staining, and mounting. The quality of histological sections from both groups was evaluated and compared. Results: Compared to the conventional reagent group, environmentally-sustainable reagent group showed good dehydration performance, moderately soft and hard tissue sections with intact cut surfaces and no cracks. H&E staining sections prepared with environmentally-sustainable reagents exhibited clear nuclear structures, distinct nuclear-cytoplasmic contrast, and clean backgrounds. The excellent section rates were 97.9% and 98.4% for the two, respectively. There was no significant difference in section quality between the two groups (Z = –0.645, P = 0.519). Tissue antigenicity was well-preserved during immunohistochemical procedures, with strong positive signals and accurate localization without background staining. Conclusions: The use of environmentally-sustainable reagents as a replacement for conventional reagents in the dehydration and staining of ophthalmic tissue yields satisfactory results, meeting the daily requirements for routine histological sectioning and staining. The entire process is xylene-free, environmentally-sustainable, cost-effective and worth being applied widely.
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.
