Aims: This study describes vascular abnormalities in X-linked retinoschisis (XLRS) using fundus fluorescein angiography (FFA) and ultra-widefield swept-source optical coherence tomography angiography (UWF SS-OCTA) to better understand the disease's vascular features and impact. Methods: A retrospective cross-sectional study was conducted on 26 XLRS patients (46 eyes). A comprehensive ophthalmic examination was performed, including FFA and UWF SS-OCTA. FFA abnormalities were divided into peripheral schisis-associated and optic disc-associated types. Results: The mean age of patients was 11.3±6.5 years. Macular schisis appeared in 97.8% of eyes, peripheral schisis in 89.1%, and peripheral bullous schisis (PBS) in 67.39%. Major vascular changes identified by FFA included dendritic capillary dilation/leakage (91.3%), internal residual vessel leakage (78.3%), and capillary dropout/ischemia (71.7%). Minor changes included zonal retinal pigment epithelium (RPE) proliferation (6.5%), bridging vessels (4.4%), and capillary sheathing (4.4%). peripapillary choroidal neovascularization (PPCNV) was noted in 10.9% and situs inversus of optic disc in 13.0% of eyes. Additionally, situs inversusof optic disc and zonal RPE proliferation were novel findings. Major FFA changes correlated with broader PBS (P = 0.045) (P ＜ 0.001) (P = 0.003). Clock hours of PBS were significant predictors for internal residual vessel leakage (OR = 0.30, P = 0.03). No significant correlation was found between gene mutation type and FFA abnormalities(P = 1.000)(P = 0.539). Conclusions: This study highlighted the significant prevalence (95.7%) of vascular abnormalities in XLRS and emphasized the importance of combining FFA with UWF SS-OCTA for comprehensive evaluation, enhancing the understanding of XLRS pathophysiology and aiding in targeted treatment approaches.

Aims: This study describes vascular abnormalities in X-linked retinoschisis (XLRS) using fundus fluorescein angiography (FFA) and ultra-widefield swept-source optical coherence tomography angiography (UWF SS-OCTA) to better understand the disease's vascular features and impact. Methods: A retrospective cross-sectional study was conducted on 26 XLRS patients (46 eyes). A comprehensive ophthalmic examination was performed, including FFA and UWF SS-OCTA. FFA abnormalities were divided into peripheral schisis-associated and optic disc-associated types. Results: The mean age of patients was 11.3±6.5 years. Macular schisis appeared in 97.8% of eyes, peripheral schisis in 89.1%, and peripheral bullous schisis (PBS) in 67.39%. Major vascular changes identified by FFA included dendritic capillary dilation/leakage (91.3%), internal residual vessel leakage (78.3%), and capillary dropout/ischemia (71.7%). Minor changes included zonal retinal pigment epithelium (RPE) proliferation (6.5%), bridging vessels (4.4%), and capillary sheathing (4.4%). peripapillary choroidal neovascularization (PPCNV) was noted in 10.9% and situs inversus of optic disc in 13.0% of eyes. Additionally, situs inversusof optic disc and zonal RPE proliferation were novel findings. Major FFA changes correlated with broader PBS (P = 0.045) (P ＜ 0.001) (P = 0.003). Clock hours of PBS were significant predictors for internal residual vessel leakage (OR = 0.30, P = 0.03). No significant correlation was found between gene mutation type and FFA abnormalities(P = 1.000)(P = 0.539). Conclusions: This study highlighted the significant prevalence (95.7%) of vascular abnormalities in XLRS and emphasized the importance of combining FFA with UWF SS-OCTA for comprehensive evaluation, enhancing the understanding of XLRS pathophysiology and aiding in targeted treatment approaches.

目的：结合眼科住院医师规范化培训(住培)的特点，建立基于钉钉平台的全面质量管理模式(total quality management, TQM)，探索一种高效的顺应时代特征的眼科教学管理模式。方法：研究团队依托中山大学中山眼科中心，选取82名眼科四证合一的住培一年级的学生作为研究对象，并将其随机分为两组，试验组41人采用基于钉钉平台的TQM模式进行全过程教学管理，采用全员参与、全程跟踪、全面评价的管理模式以保障教学质量。对照组41人接受传统的教学管理模式。观察指标为两组间教学前后测试分数、教学后满意度调查的问卷得分等。结果：通过对两组学生进行课前课后的测试，TQM模式组相较于传统模式组在学习成绩有所提升，课前课后分数的差值分别为40(30,40)分和30(20,50)分，比较差异有统计学意义(P =0.031)。问卷调查结果显示，两组满意度总分比较差异无统计学意义[10(10,10) 分 vs. 10(9,10)分，P =0.207]，但在满意度分项内容掌握性上，TQM模式组分值高于传统模式组[5(5,5)分 vs. 5(4,5)分，P =0.046]。结论：基于钉钉平台的TQM模式在眼科教学中能够有效提高住培的教学质量与学生满意度，相比传统教学管理模式具有更大的教学优势，可为眼科住培提供了一种创新且实用的教学管理模式，对于培养适应时代需求的高水平眼科医师具有重要意义。

Objective: To combine the characteristics of standardized training for ophthalmic resident physicians, establishes a Total Quality Management (TQM) model based on the DingTalk platform, and explored an efficient ophthalmic teaching management model that adapts to the characteristics of the times. Methods: The research team, based at Zhongshan Ophthalmic Center, selected 82 first-year postgraduate students undergoing the national standardized training for resident doctors (STRD) as participants, randomly allocating them into two groups. The experimental group consisting of 41 trainees received TQM-modeled online learning via the DingTalk platform, adopting a management model of full participation, full process tracking, and comprehensive evaluation to ensure teaching quality. While the control group, also comprising 41 trainees, underwent traditional offline instruction. The TQM group engaged in live streaming lectures on the DingTalk platform, whereas the conventional group continued with face-to-face teaching in classroom. Data including pre- and post-teaching scores, as well as scores from satisfaction surveys are analyzed. Results: Comparing pre- and post-teaching scores, significant statistical differences were found between the TQM and traditional groups, with mean score improvements of 40(30,40) points and 30(20,50) points, respectively, indicating statistical significance (P =0.013). Furthermore, the questionnaire survey revealed that the TQM group scored higher than the traditional group in aspects such as course design, clinical relevance, content mastery, and instructor satisfaction. In addition, the questionnaire survey showed that there was no statistically significant difference in the total satisfaction score between the two groups (10(10,10) points vs. 10(9,10)points P =0.207), but in terms of mastery of satisfaction sub items, the TQM model group scored higher than the traditional model group (5(5,5) points vs. 5(4,5) points, P =0.046). Conclusions: The application of a TQM-based model on the DingTalk platform significantly enhances the teaching quality and student satisfaction in the residency training of ophthalmologists, demonstrating greater pedagogical advantages over traditional methods. This efficient ophthalmic teaching management model thus provides a promising solution for standardized residency training in ophthalmology, and holds considerable importance for nurturing highly competent ophthalmologists who can meet the demands of the current era.

目的：以提升进行住院医师规范化培训(住培)的眼科医生临床诊疗思维能力为导向，建立LRC渐进协作教学体系(LRC Stepwise Collaborative Learning Model)。方法：2023年7月—2023年12月，以26名进行眼科住培的医生为试验组的研究对象，采用小讲课(Lecture)、教学查房(Rounds)及病例讨论(Case discussion)的LRC渐进协作教学体系，通过定量分析方法评估教学效果。结果：实施LRC渐进协作教学模式后，住培医生平均成绩由培训前的50.00 (40, 50)分提高至培训后的90.00 (80, 100)分，差异具有统计学意义(P＜0.001)。问卷调查满分5分，小讲课、教学查房和病例讨论三种教学形式的满意度满分比例分别为92.3%(24/26)，84.6%(22/26)、76.9%(20/26)，三种教学形式的满意评分分别为5.00 (5.00, 5.00)、5.00 (5.00, 5.00)、5.00 (4.75, 5.00)分。结论：LRC渐进协作教学体系作为住培教学新体系，得到眼科住培医生的认可，促进临床诊疗思维的整体提升，有助于岗位胜任力的培养，为未来教学模式的设计与实施提供了重要参考。

Objective: To introduce the LRC Stepwise Collaborative Learning Model, a novel teaching approach designed to improve clinical thinking skills in ophthalmology training. Methods: From July 2023 to December 2024, 26 ophthalmology residents were included in the experimental group, underwent training using LRC Stepwise Collaborative Learning Model of Lectures, Rounds and Case Discussions. Their educational outcomes were quantitatively analyzed. Results: The LRC Stepwise Collaborative Learning Model improved average resident scores from pre-training [50(40, 50) points] to post-training [90(80,100) points], with a statistical significance (P < 0.001). The questionnaire survey had a maximum score of 5 points, and the rates of full marks for the three teaching forms of lectures, rounds, and case discussions were 92.3% (24/26), 84.6% (22/26), and 76.9% (20/26), respectively. The satisfaction scores for the three teaching forms were 5.00 (5.00, 5.00), 5.00 (5.00, 5.00), and 5.00 (4.75, 5.00) points, respectively. Conclusions: The LRC Stepwise Collaborative Learning Model, as a new training system for residency education, has been recognized by ophthalmology residents. It facilitates the overall improvement of clinical thinking, contributes to competency development, and provides valuable insights for future teaching model designs.