光学相干断层成像(optical coherence tomography，OCT)自1991年发明以来，在生物成像尤其在眼科和心血流成像中起越来越重要的作用。OCT的发展经历了早期的时域系统及最新的频域系统。其中频域系统又分为谱域OCT(spectral domain OCT，SD-OCT)系统和扫频OCT(swept source OCT，SS-OCT)系统。随着眼科临床应用对系统速度、灵敏度及功能化要求的不断提升，眼科扫频OCT已经走向成熟并逐步商用化。本文将简介扫频OCT的原理，并归纳扫频OCT相对于时域和谱域OCT系统的优势，并展示其在眼科临床的应用。

Optical coherence tomography (OCT) has played an important role in biomedical imaging, especially in ocular and cardiovascular imaging. OCT technology has evolved to frequency domain technology from early time-domain technology due to the advantages of high sensitivity and high speed of frequency domain techniques. The swept source OCT is a type of frequency domain OCT. With the increasing requirements for system speed, sensitivity, and functionality in clinical application, swept source OCT is gradually becoming commercially available and widespread in clinical application. In this paper, the principle of swept source OCT was introduced, the advantages of swept source OCT over time domain and spectral domain OCT systems were summarized, and its clinical application in ophthalmology was demonstrated.

目的：探讨人工晶状体(IOL)预先巩膜悬吊在严重晶状体半脱位中的应用效果。方法：选取 2018年12月至2022年7月四川省人民医院收治的>180°的严重晶状体半脱位患者8例(8 眼)。术中避开脱位的晶状体，预先将IOL悬吊于玻璃体腔，再将晶状体托起置于IOL上方，必要时辅助以虹膜拉钩，稳定晶状体，确保超声乳化手术安全完成。结果：严重的晶状体半脱位患者8例，其中晶状体核N1-N3硬度的患者各1例，单独使用IOL预先巩膜悬吊于术中稳定脱位的晶状体，3例超声乳化手术均顺利完成；达N4患者3例、N5患者2例，其中4例在虹膜拉钩的辅助下安全完成超声乳化；有1例N5的患者，由于悬韧带损伤超过270°，在将晶状体托起放置于IOL之上时，坠入玻璃体腔，给予玻璃体腔超声粉碎处理。8例患者术后IOL均居中，视力有不同程度的提高，眼压正常，未见严重并发症。结论：在严重晶状体半脱位的超声乳化手术中，对于N2~N3的软核，IOL预先巩膜悬吊可以良好地稳定晶状体，确保超声乳化手术的顺利进行；对于N4~N5的硬核，IOL预先巩膜悬吊可以作为一种辅助方法，联合虹膜拉钩共同稳定晶状体，确保超声乳化手术的安全进行。

Objective: To investigate the effect of intraocular lens (IOL) pre-suspension in thetreatment of severe lens subluxation. Methods: Retrospective case study. From December 2018 to July 2022, 8 eyes of 8 patients with severe lens subluxation greater than 180 degrees admitted to our hospital were selected. During surgery, the IOL should avoid the subluxated lens and be pre-suspended in the vitreous cavity, and then the lens is lifted and placed above the IOL. If necessary, the iris hook can be used to stabilize the lens to ensure the safe completion of phacoemulsification. Results: There were 8 patients with severe subluxation of lens. Among them, the hardness of 3 patients' lens nucleus ranged from N1 to N3. In these 3 patients, we used the IOL pre-suspension alone to stabilize the subluxated lens, and phacoemulsification in these 3 patients was successfully completed. Three patients had N4 and 2 patients had N5, of which 4 patients underwent phacoemulsification safely with the assistance of iris hook. In another patient with N5, the lens fell into the vitreous cavity during surgery (the suspension ligament rapture greater than 270 degrees) when it was lifted and placed on the IOL which was crushed by the vitreous cavity ultrasound. After surgery, the IOL was centered in all 8 patients, visual acuity was improved to varying degrees, intraocular pressure was normal, and no serious complications were observed. Conclusions: In severe lens subluxation surgery, IOL presuspension in soft nuclei of N2 to N3 can stabilize the lens well and ensure the safety of phacoemulsification. For hard nuclei N4 to N5, IOL presuspension can be used as an auxiliary method in combination with iris hook to stabilize the lens and ensure the safety of phacoemulsification.

近年来随着人口老龄化的发展、人群用眼方式的改变，现有的眼科医疗资源正越来越难以满足日渐增长的医疗需求，亟需新型的诊疗模式予以补足。眼科人工智能作为眼科领域的新兴元素，在眼病的筛查诊断中发展迅速，主要表现为“眼部图像数据+人工智能”的模式。近年来，随着该模式在白内障、青光眼、糖尿病性视网膜病变(diabetic retinopathy，DR)等常见病中研究的深入，相关技术日渐成熟，表现出了较大的应用优势与应用前景，部分技术甚至成功转化并被逐渐应用于临床。眼科诊疗向智慧医学模式的过渡，有望缓解日益增长的医疗需求与紧缺的医疗资源之间的矛盾，从而提高整体的医疗服务水平。

The development of population aging and changes in the way people use their eyes over the recent years have increasingly challenged the existing ophthalmic medical resources to meet the growing medical needs, thus urgently calling for a novel diagnostic and treatment mode. Despite its status as an emerging sector in ophthalmology, ophthalmic artificial intelligence has developed rapidly in the screening and diagnosis of eye diseases, as can be seen in practices adopting the “eye imaging data + AI” mode. In recent years, with the intensified research on this mode with respect to common diseases such as cataract, glaucoma and diabetic retinopathy, relevant technologies have grown increasingly mature, presenting undeniable application superiority and prospects. Some of the relevant technical achievements have also been successfully transformed for practical usage, and are gradually being applied to clinical practices. Ophthalmic diagnosis and treatment are transitioning toward the era of intelligent medical services, which are expected to reduce the contradictions between the growing medical needs and the shortage of medical resources, as well as ultimately improve the overall experience of medical services.

登革热是由登革病毒引起的全球性虫媒传染病，近年来发病率在全球范围内呈指数级增长。随着登革热的流行，其相关眼部并发症逐渐受到眼科医生的关注。登革相关眼病（dengue-associated ocular diseases, DAOD）作为登革热感染的重要系统性并发症其病理机制涉及多个方面，包括病毒亚型、非结构蛋白 1（non-structureprotein, NS1）病毒抗原、宿主的抗 DENV NS1 抗体及免疫炎症反应等，这些因素的相互作用，引发一系列眼部并发症。DAOD的临床谱系复杂，可累及结膜、葡萄膜、视网膜、视神经和眼外肌等多个眼部结构，病变严重程度个体间差异较大，从自限性结膜出血到威胁视力的视神经炎等，临床表现多样，进一步增加了诊断和治疗的难度。由于缺乏明确的诊断金标准，DAOD的诊断通常需结合患者的全身症状、登革热特异性抗体血清学检测，以及眼部症状、临床特征和影像学检查等进行综合分析。治疗上则需根据患者具体情况制定个性化方案，以缓解症状、防止病情恶化并促进康复。本文旨在全面综述 DAOD的流行病学特征、发病机制、临床表现、诊断及治疗策略等方面的研究进展，为临床医生提供更全面、更准确的指导，从而提高 DAOD的诊治水平，降低患者致残率。

Dengue fever is a globally prevalent insect-borne disease caused by dengue virus, and its incidence has witnessed an exponential rise worldwide in recent years. Alongside the dengue fever epidemic, its related ocular complications have gradually drawn the attention of ophthalmologists. As a significant systemic complication of dengue infection, Dengue-associated Ocular Diseases (DAOD) have a multifaced pathological mechanism. This encompasses various factors, such as viral subtypes, non-structural protein 1 (NS1) viral antigens, host anti-DENV NS1 antibodies, and immune inflammatory responses. The clinical spectrum of DAOD is intricate, affecting multiple ocular structures including the conjunctiva, uvea, retina, optic nerve and extraocular muscles. The severity of lesions varies greatly among individuals, ranging from self-limited conjunctival hemorrhage to vision-threatening conditions like optic neuritis. This wide array of clinical manifestations further complicates the diagnosis and treatment process. Given the absence of a definitive gold standard for diagnosis, the diagnosing DAOD typically necessitates a thorough analysis encompassing the patient's systemic symptoms, dengue-specific antibody serological testing, ocular symptoms, clinical features, and imaging examinations. Treatment approaches are tailored to each individual, aiming to alleviate symptoms, prevent exacerbations, and facilitate recovery. The objective of this article is to conduct a comprehensively review of the research advancements in the epidemiological characteristics, pathogenesis, clinical manifestations, diagnosis and treatment strategies of DAOD. It aims to furnish clinicians with more comprehensive and precise guidance, thereby enhancing the diagnosis and treatment of DAOD and reducing the disability rate among patients.

目的：评估分析新疆地区14个地州6~18岁学龄儿童青少年屈光参差的患病率、空间分布特征和影响因素，为制定区域性眼健康干预策略提供科学依据。方法：采用横断面研究设计，纳入新疆地区14个地州的小学、初中及高中学生共64 277名，收集其人口学特征、屈光状态及地域分布数据。通过等效球镜度（spherical equivalent，SE）评估屈光状态，近视为SE ≤ -0.50 D，屈光参差为眼间SE差异≥1.0 D，采用Moran's I分析屈光参差患病率的空间分布，采用单因素及多因素回归分析探讨屈光参差的危险因素。结果：屈光参差的总体患病率为17.9%（95% CI：17.6%～18.2%），女性屈光参差患病率（18.8%）高于男性（16.9%），汉族（23.9%）高于维吾尔族（11.7%）和其他民族（18.4%）（P<0.001）。屈光参差患病率呈空间聚集分布(Moran's I = 0.450，P = 0.043，Z = 2.026)，并且存在地域差异，昌吉最高（24.1%），克孜勒苏柯尔克孜自治州最低（7.9%），城市（19.0%）高于农村（15.6%），北疆（19.9%）高于南疆（13.5%）（P<0.001）。屈光参差的患病率与年龄呈正相关，6岁为9.8%，18岁达22.4%。多因素回归分析显示，女性、北疆地区、近视和较高年龄是屈光参差的独立危险因素（P<0.05）。结论：新疆地区学龄儿童青少年屈光参差患病率较高，在空间上呈聚集分布，且存在显著的人口学及地域差异，女性、北疆地区、近视和较高年龄是屈光参差的独立危险因素，建议加强对高危人群的视力筛查及早期干预。  

Objective: To evaluate and analyze the prevalence, spatial distribution characteristics, and influencing factors of anisometropia among school-aged children and adolescents aged 6-18 across 14 regions in Xinjiang, thereby providing a scientific foundation for formulation of regional eye health intervention strategies. Methods: A cross-sectional study design was employed, including 64,277 students from primary, middle, and high schools in 14 prefectures of Xinjiang. Data on demographic characteristics, refractive status, and geographical distribution were collected. Refractive status was assessed using spherical equivalent (SE). Myopia was defined as SE ≤ -0.50 D, and anisometropia was defined as an interocular SE difference ≥ 1.0 D. Moran's I analysis was used to evaluate the spatial distribution of anisometropia prevalence. Additionally, univariate and multivariate regression analyses were conducted to identify risk factors for anisometropia. Results: The overall prevalence of anisometropia was 17.9% (95% CI: 17.6%-18.2%). The prevalence was higher among females (18.8%) compared to males (16.9%), and higher among Han Chinese (23.9%) than among Uyghurs (11.7%) and other ethnic groups (18.4%) (P<0.001). The prevalence of anisometropia showed a spatially clustered distribution (Moran's I = 0.450, P= 0.043, Z-score = 2.026) , with notable regional variations. Changji had the highest prevalence (24.1%), while Kizilsu Kirghiz Autonomous Region had the lowest (7.9%). Urban areas (19.0%) had a higher prevalence than rural areas (15.6%), and northern Xinjiang (19.9%) had a higher prevalence than southern Xinjiang (13.5%) (P<0.001). The prevalence of anisometropia was positively correlated with age, increasing from 9.8% at age 6 to 22.4% at age 18. Multivariate regression analysis showed that female gender, residing in northern Xinjiang, myopia, and older age were independent risk factors for anisometropia. Conclusions: The prevalence of anisometropia among school-aged children and adolescents in Xinjiang is relatively high, showing a spatially clustered distribution with significant demographic and regional disparities. Female gender, residing in northern Xinjiang, myopia, and older age are independent risk factors for anisometropia. It is recommended to enhance vision screening and implement early intervention for high-risk populations.

目的：通过前房注射亚硒酸钠溶液建立新西兰兔硒性白内障模型，并评估验证其在药效试验中的应用。方法：采用前房注射10 mmol/L亚硒酸钠溶液(0.1 mL/只)对动物右眼进行造模，于造模第3天根据晶状体混浊度评分选取成模动物分为模型组、吡诺克辛滴眼液(pirenoxine sodium eye drops, PSED)0.05 mg/mL组，以模型组动物左眼作为空白组，每组8只眼；分组后对各组动物眼进行滴眼给药，50 µL/眼/次，3 次/天，连续给药17 d。于给药前、给药第7、17天进行裂隙灯检查拍照在体评估晶状体混浊度，末次给药后完整分离各组动物晶状体，体外评估晶状体透明度，然后将各组动物晶状体匀浆，用于过氧化物酶(peroxidase, POD)及谷胱甘肽过氧化物酶(glutathione peroxidase, GSH-Px)活力测定。结果：与空白组相比，模型组给药前、给药第7、17天晶状体混浊度评分均升高，给药结束后晶状体透明度评分升高，晶状体中GSH-PX和POD活力均降低；与模型组相比，PSED 0.05 mg/mL组给药17d晶状体混浊度和透明度评分均降低，晶状体中GSH-PX活力升高，POD无变化。结论：前房注射亚硒酸钠溶液可诱导新西兰兔发展出稳定的白内障模型症状，适用于药物药效作用的评价。

Objective: To establish a selenium-induced cataract model in New Zealand rabbits by anterior chamber injection of sodium selenite solution and evaluate and verify its application in pharmacodynamic trials. Methods: The right eyes of the animals were modeled by anterior chamber injection of 10 mmol/L sodium selenite solution (0.1 mL per animal). On the third day of modeling, the modeled animals were selected and divided into the model group and the pirenoxine sodium eye drops (PSED) 0.05 mg/mL group based on the lens turbidity score. The left eyes of the animals in the model group were taken as the blank group, with 8 eyes in each group. After grouping, eye drops were administered to the eyes of each group of animals. The dosage was 50 µL per eye each time, three times a day, for 17 consecutive days. Slit lamp examination and photography were conducted on the 7th and 17th days of administration to evaluate the turbidity of the lenses in vivo. After the last administration, the lenses of each group of animals were completely isolated, and the transparency of the lenses was evaluated in vitro. Then, the lenses of each group of animals were homogenized. It is used for the determination of peroxidase (POD) and glutathione peroxidase (GSH-Px) activities. Results: Compared with the blank group, the lens turbidity scores of the model group were significantly increased before administration, on the 7th and 17th days of administration, the lens transparency scores were significantly increased after the end of administration, and the activities of GSH-PX and POD in the lens were significantly decreased. Compared with the model group, the scores of lens turbidity and transparency in the PSED 0.05 mg/mL group and 17 days after administration were significantly decreased, the activity of GSH-PX in the lens was significantly increased, and there was no change in POD. Conclusions: Anterior chamber injection of sodium selenite solution can induce the development of stable cataract model symptoms in New Zealand rabbits and is suitable for the screening and evaluation of drug efficacy.

慢性肝病（chronic liver disease, CLD）是一种或多种损伤因素长期作用于肝脏导致的疾病总称，其影响范围广、患者人群基数大。病毒性肝炎、非酒精性脂肪性肝病和终末期肝病等慢性肝病会累及眼底，造成视网膜渗出、出血等病变；同时眼底结构改变，如脉络膜和视网膜不同层次厚度，也与慢性肝病严重程度相关。对慢性肝病患者进行眼底检查不仅用于防治相关的眼底并发症，也对肝病临床评估及监测具有潜在应用价值。文章综述不同病因、严重程度和药物治疗下的慢性肝病患者可能出现的眼底病变，以及眼底结构功能检查在慢性肝病患者中的临床应用进展，以比较不同眼底检查方法在慢性肝病患者临床实施过程中的特点及适用场景，并提示未来在慢性肝病患者中应用眼底检查的潜在新方向。

Chronic Liver Disease (CLD) is a collective term for diseases resulting from the long-term effects of one or more damaging factors on the liver. It has a broad impact and affects a large patient population. Viral hepatitis, non-alcoholic fatty liver disease, and end-stage liver disease can involve the ocular fundus, leading to retinal exudates and hemorrhages. Additionally, structural changes in the fundus, such as the thickness of the choroid and different retinal layers, are associated with the severity of chronic liver disease. Through fundus examinations in patients with chronic liver disease, not only can ocular complications related to liver disease be prevented and treated, but these examinations may also offer potential value in the clinical assessment and monitoring of liver disease. This article reviews the potential ocular fundus abnormalities in patients with chronic liver disease under different etiologies, severities, and drug treatments. It discusses the progress in the clinical application of fundus structure and function examinations in patients with chronic liver disease. It compares the characteristics and appropriate clinical scenarios of various fundus examination methods in these patients and suggests potential new directions for the future use of fundus examinations in chronic liver disease management.

糖尿病视网膜病变(diabetes retinopathy, DR)是糖尿病常见的眼部并发症，其病理过程复杂，涉及多种细胞及炎症因子。Müller细胞作为视网膜主要支持细胞，在DR中不仅产生白介素-17(interleukin-17, IL-17)，还作为其主要靶点发挥作用，通过谷氨酸代谢异常、血管内皮生长因子(vascular endothelial growth factor, VEGF)分泌增加及调控参与DR的病理过程，加重炎症反应。IL-17主要由辅助性T细胞17(T helper cell 17, Th17)分泌，通过促进多种炎症介质(如细胞因子、趋化因子和金属蛋白酶)的分泌，增强炎症反应，导致视网膜微血管损害和神经元凋亡，促进DR的发展。高糖环境下，Müller细胞功能受损，IL-17进一步加剧其功能障碍形成恶性循环。研究表明，阻断IL-17及核因子-κB激活剂1(Nuclear factor-kappa B activator 1, Act1)/肿瘤坏死因子受体关联因子6(tumor necrosis factor receptor associated factor 6, TRAF6)/核因子-κB(Nuclear factor-kappa B, NF-κB)信号通路可减轻DR的病理改变，为DR的治疗提供了新的思路。因此，深入研究IL-17与Müller细胞在DR中的相互作用机制，对于研究该疾病的发病机制及开发精准有效的治疗策略具有重要意义。

Diabetes retinopathy (DR) is a common ocular complication of diabetes, characterized by a complex pathological process involving multiple cells and inflammatory factors. Müller cells, as the primary supporting cells of the retina, not only produce interleukin-17 (IL-17) but also serve as a primary target in DR. They participate in the pathological process of DR by contributing to abnormal glutamate metabolism, increased secretion of vascular endothelial growth factor (VEGF), and regulatory functions, thereby exacerbating the inflammatory response. IL-17 is primarily secreted by T helper cell 17 (Th17) cells and enhances the inflammatory response by promoting the secretion of various inflammatory mediators (such as cytokines, chemokines, and metalloproteinases), leading to retinal microvascular damage and neuronal apoptosis, which accelerates the progression of DR. In a high-glucose environment, Müller cell function is impaired, and IL-17 further exacerbates this dysfunction, creating a vicious cycle. Studies have shown that blocking the IL-17 and Act1/TRAF6/NF-κB signaling pathways can mitigate the pathological changes associated with DR, providing new insights for the treatment of this disease. Therefore, conducting in-depth research on the interaction mechanism between IL-17 and Müller cells in DR is of great significance for exploring the pathogenesis of this disease and developing precise and effective treatment strategies.

前段巨眼(anterior megalophthalmos, AM)是一种罕见的双侧非进展性先天性眼前段增大疾病，表现为大角膜(直径≥ 12.5 mm)、前房极深、角膜厚度正常或轻中度变薄和睫状环扩大等。并发性白内障以及晶状体脱位是导致AM视力下降的主要原因。然而，解剖结构的异常使AM白内障手术具有很大的挑战性。文章报道了一例AM合并白内障的48岁男性患者，成功为其行手法小切口白内障摘除联合人工晶状体(intraocular lens, IOL)一期植入术，患者术后视力恢复良好，IOL位置居中，未出现较大的屈光误差。对该典型AM病例的临床特点以及手术难点的回顾总结，有助于加深广大眼科临床工作者对该疾病的认识。

Anterior megalophthalmos is a rare congenital enlargement of the anterior segment, characterized by bilateral nonprogressive megalocornea (diameter ≥12.5 mm), extremely deep anterior chamber, normal or moderate thinning of the cornea, and elongation of the ciliary ring. Cataract and lens dislocation are the main causes of decreased vision in patients with AM. However, cataract surgery on patients with AM are challenging due to the anatomical abnormalities. This case reports a 48-year-old male patient diagnosed with AM and cataract, who successfully underwent a manual small incision cataract extraction combined with intraocular lens implantation. Finally, our patient showed a good visual outcome with a well centered IOL and without obvious refractive error. In this typical AM case, we reviewed and summarized the clinical characteristics and the challenges of surgical treatment so that other ophthalmologists can learn about this disease.

青光眼是全球第一大不可逆性致盲性眼病，影响全球7 000多万人，其特征是视网膜神经节细胞的退行性病变。到2040年，预计全球青光眼患者人数将增加至1.12亿，其中约10%的人至少一只眼睛失明。由高眼压诱发、多种致病因素导致的视网膜神经节细胞死亡是青光眼进展过程中视功能损伤的主要病理过程，也是青光眼病程中视功能损害不可逆的重要原因。目前降眼压治疗是唯一的干预疗法，然而其仍然不能完全遏止视网膜神经节细胞进行性损伤，并且既往病程造成的视神经损伤不可逆转。探索青光眼进程中视网膜神经节细胞退行性改变的直接致病因素，寻找关键的治疗靶点，以及开发新的具有神经保护作用的治疗药物，具有重要意义。文章回顾了近年来青光眼中视网膜神经节细胞退行性病变的机制和治疗的新进展，强调了神经血管单元的改变在青光眼发病机制中的重要作用和干预价值。同时，靶向代谢的药物应用、抑制早期炎症反应和减少氧化应激，辅以营养和运动支持等可能延缓和抑制神经退行性病变的发生，起到神经保护作用。未来青光眼发病机制的研究重点仍然在眼压之外的致病因素上，从血流、代谢和免疫串扰的病理环境中发掘对神经退行性改变重要的致病因素并进行干预治疗具有广阔的前景。在多种动物模型中验证干预手段的神经保护作用，也有望提高青光眼神经保护的临床转化成功率，以拓展青光眼的治疗理念与药物选择。

Glaucoma stands as the leading cause of irreversible blindness globally, affecting over 70 million individuals. It is characterized by progressive degeneration of retinal ganglion cells (RGCs). By 2040, the global prevalence of glaucoma is expected to rise to 112 million, with approximately 10% experiencing blindness in at least one eye. The primary pathological basis for visual function impairment in glaucoma progression is the loss of RGCs induced by elevated intraocular pressure (IOP) and various pathogenic factors. Currently, IOP-lowering treatment is the only intervention available, but it cannot completely halt the progressive injury to RGCs, nor can it reverse the optic nerve damage caused by prior disease progression. Exploring the direct pathogenic factors of RGC degeneration in glaucoma, identifying key therapeutic targets, and developing new neuroprotective treatments are of great importance. This review discusses recent advancements in the mechanisms and treatments of retinal ganglion cell degeneration in glaucoma, highlighting the significant role of neurovascular unit changes in the pathogenesis of glaucoma and the potential value of interventions. Additionally, targeting metabolites, inhibiting early inflammatory responses, and reducing oxidative stress, supplemented by nutritional and exercise support, may help delay and inhibit neurodegenerative processes, offering neuroprotective effects.Future research on glaucoma pathogenesis should focus on factors beyond IOP, exploring pathogenic factors in the pathological environment of blood flow, metabolism, and immune crosstalk for targeted therapeutic interventions. Also, verifying the neuroprotective effects of these interventions in various animal models holds promise for improving the clinical translation success rate of neuroprotection in glaucoma, thus expanding therapeutic concepts and drug options.