铁离子在维持角膜细胞正常代谢、DNA合成和修复等生理活动中发挥关键作用，但过量的铁离子可能引发铁稳态失衡继而导致细胞毒性损伤和死亡。圆锥角膜是最常见的扩张性角膜疾病，其典型的Fleischer环是铁稳态失衡的直接证据。圆锥角膜与铁代谢相关的前期研究显示，铁稳态失衡有可能是诱发圆锥角膜发生和发展的潜在致病机制。文章总结了人体及角膜中正常的铁代谢循环以及圆锥角膜铁稳态失衡的证据，并从维持铁稳态角度出发探索可能的治疗策略，为扩张性眼病治疗提供新的思路。
Iron ions are essential for normal metabolism, DNA synthesis, and cellular repair in corneal cells. Nevertheless, an excess of these ions can disrupt iron homeostasis, leading to cellular toxicity, damage, and death. Keratoconus, the most prevalent ectatic corneal disorder, is often marked by the Fleischer ring, which indicates an imbalance in iron homeostasis. A review of early studies on keratoconus and iron metabolism suggests that this imbalance may be a potential pathogenic mechanism contributing to the onset and progression of the disease. This article aims to provide a comprehensive overview of normal iron metabolism in the human body and cornea, highlighting the evidence of iron homeostasis imbalance in keratoconus. It also explores potential therapeutic strategies focused on maintaining iron homeostasis, thereby offering novel insights into the treatment of ectatic eye diseases.
随着移植技术逐年发展，异基因造血干细胞移植患者的生存期延长，长期并发症成为影响患者预后及生活质量的主要原因。眼移植物抗宿主病是异基因造血干细胞移植术后最常见的眼部并发症，发生率可高达50%以上。根据发病时间可分为急性及慢性眼移植物抗宿主病，临床上最常以慢性炎症及眼表组织纤维化为特点，主要表现为干眼和不同程度的角结膜炎，治疗较为棘手，可不同程度影响患者视觉质量及生活质量，严重可致盲。近年来眼移植物抗宿主病越来越受到国内外学者重视，其发病机制、临床特点、诊断及治疗相关研究逐渐深入，文章针对眼移植物抗宿主病的临床诊疗新进展进行综述。总体而言，眼移植物抗宿主病早期识别仍较为困难，早期诊断策略有待进一步探索。目前治疗对眼移植物抗宿主病的效果较为有限，或缺乏充足的循证医学证据，临床上缺乏针对不同严重程度及疾病活动度的分级诊疗策略，未来有待进一步探索新的治疗靶点及疾病活动监测指标，将有助于改善患者长期预后及生活质量。
Despite advancements in allogeneic hematopoietic stem cell transplantation techniques leading to improved overall survival rates, long-term complications have emerged as the primary contributors to poor prognosis and diminished quality of life. Ocular graft-versus-host disease (oGVHD), a prevalent complication affecting over 50% of patients post-transplantation, frequently manifests as refractory dry eye, often accompanied by keratoconjunctivitis. Patients with oGVHD routinely suffer from visual impairment and a decline in their quality of life.Currently, research into the mechanisms, clinical features, diagnosis, and treatment of oGVHD has progressively deepened. This article reviews the latest advancements in the clinical diagnosis and management of oGVHD. Notably, there is a pressing need for strategies focused on early diagnosis and treatment, as early recognition of oGVHD remains challenging. Existing treatments for oGVHD either exhibit limited efficacy or lack robust clinical evidence to support their use as the best available options.Further research is imperative to develop tiered diagnostic and treatment approaches, including the exploration of novel therapeutic targets and biomarkers for disease detection. Such endeavors hold the promise of enhancing patients' long-term prognosis and quality of life.
圆锥角膜（KC）是一种典型的扩张性眼病，以角膜扩张变薄并向前锥形突起为特征，严重时可致盲。KC三联征之一铁锈色Fleischer环，主要由上皮细胞基底膜周围的铁离子沉积组成。近年来，越来越多研究表明，铁稳态失衡可能与KC的发生和发展密切相关。KC患者泪液中铁相关蛋白的异常表达，提示铁稳态失衡可能是诱发KC的潜在致病机制。此外，角膜上皮细胞内铁稳态失衡导致细胞内铁离子异常积聚，进而引发活性氧和脂质过氧化物的大量生成，最终可能触发细胞铁死亡。从恢复铁稳态角度出发，螯合过量的铁离子和调控铁死亡过程关键靶点可能是未来KC潜在的治疗方法。目前关于铁稳态失衡导致KC发病的具体机制仍存在诸多谜团。随着相关研究的不断深入，有望通过改善角膜铁稳态失衡，为KC临床治疗带来新的思路和突破，也为KC患者提供更精准和个体化的治疗策略。
圆锥角膜（KC）是一种典型的扩张性眼病，以角膜扩张变薄并向前锥形突起为特征，严重时可致盲。KC三联征之一铁锈色Fleischer环，主要由上皮细胞基底膜周围的铁离子沉积组成。近年来，越来越多研究表明，铁稳态失衡可能与KC的发生和发展密切相关。KC患者泪液中铁相关蛋白的异常表达，提示铁稳态失衡可能是诱发KC的潜在致病机制。此外，角膜上皮细胞内铁稳态失衡导致细胞内铁离子异常积聚，进而引发活性氧和脂质过氧化物的大量生成，最终可能触发细胞铁死亡。从恢复铁稳态角度出发，螯合过量的铁离子和调控铁死亡过程关键靶点可能是未来KC潜在的治疗方法。目前关于铁稳态失衡导致KC发病的具体机制仍存在诸多谜团。随着相关研究的不断深入，有望通过改善角膜铁稳态失衡，为KC临床治疗带来新的思路和突破，也为KC患者提供更精准和个体化的治疗策略。
间充质干细胞由于其独特的自我更新和多向分化能力，成为了一种替代无效的常规治疗的新兴治疗方法。间充质干细胞通过免疫调节、促修复、抗新生血管机制和细胞替代作用在眼表疾病中发挥作用，而不同来源的间充质干细胞其作用机制也不完全相同。迄今为止，已有8项注册的间充质干细胞治疗的临床试验应用于干眼、角膜烧伤、圆锥角膜等眼表疾病。
Due to its unique self-renewal and multi-directional differentiation capabilities, mesenchymal stem cells (MSCs) have become an emerging therapy that replaces of ineffective conventional options in treating multiple diseases. It plays an important role in ocular surface illnesses through a variety of functions, including immunoregulation, promoting repairing, anti-angiogenesis mechanisms, and cell replacement. MSCs from different sources have different mechanisms.So far, 8 registered clinical trials of MSCs therapy have been applied to treat dry eye, ocular burn, keratoconus and other ocular surface diseases.
干眼是以泪膜稳态丢失及伴随眼部不适症状为特征的最常见眼表疾病，泪膜不稳定、泪液高渗透性、眼表炎症及感觉神经异常为其主要病因。地夸磷索钠是一种P2Y2受体激动剂，能刺激黏蛋白及泪液分泌，其独特的作用机制为干眼的治疗开辟了新的方向，本文就地夸磷索钠近年的临床及基础研究进展作一综述。
Dry eye is one of the most common ocular surface diseases. It is characterized by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and tear hyperosmolarity, ocular surface inflammation, and neurosensory abnormalities play major etiological roles. Diquafosol tetrasodium is a purinergic P2Y2 receptor agonist that promotes mucin and aqueous tear secretion. The unique pharmacological mechanism of diquafosol tetrasodium opens up a new direction for the medical therapies of dry eye. This article reviews the clinical therapeutic effect and research progress of diquafosol tetrasodium for the past few years.
医学生在不久的将来需担起保障人民健康的重任，必须坚持正确政治方向，思想政治教育(思政教育)融入医学课程显得格外重要。眼科疾病与全身疾病息息相关，眼科学是临床医学生的一门必修课程。思政教育与眼科学专业课相融合可激励学生自觉把个人的理想追求融入国家和民族的事业中，勇做走在时代前列的奋进者、开拓者。中山大学中山眼科中心因材施教，针对临床医学专业本科生，通过生动的例子将“防盲治盲责任”“近视防控国家需求”等思政内容融入眼科学本科教学的各个章节中，旨在培养学生树立为服务人民、服务国家健康战略而努力学习的理想和价值观。课程结束后，采用问卷调查了解学生对思政教育与眼科学专业课融合的接受度、课程建议及效果评估，发现学生对眼科学课程中融入思政教育接受度较高，效果较好。
Medical students must adhere to the correct political direction because they need to protect people's health in the near future. It is particularly important to integrate ideological education into medical curriculum. Ophthalmic diseases are closely related to systemic diseases. Ophthalmology is a compulsory course of clinical medicine for medical college students. The integration of ideological education into ophthalmology professional courses can encourage students to integrate their personal ideals into national undertaking, motivate students to become strivers and pioneers in the new era. Zhongshan Ophthalmic Center, Sun Yat-sen University taught students according to their aptitude and integrated the ideological contents such as “prevention of blindness” and “myopia prevention” into each chapter of ophthalmology teaching through vivid examples for clinical medical undergraduates. It would be helpful for the students to establish the ideal and values of “serve the people”. At the end of the course, the medical students were investigated by questionnaires to evaluate the effect of ideological education integration, as well as the acceptance and suggestion from the students. The results showed that studentswere satisfied with the teaching quality of ideological contents and the curriculum integration has achieved the desired effect.
目的：分析医学人工智能通识课程“眼科人工智能的研发与应用”的开展效果，为相关医学人工智能通识课程的开展提供参考和借鉴。方法：纵向观察性研究。观察分析2020年秋季学期眼科人工智能的研发与应用通识课程学生人群，课程考核结果以及学生对课程的整体评价。结果：共有118名本科生同学参与了课程学习。其中大部分为低年级临床医学专业本科生。期中考核得分为77.21±10.07，有56位同学(47.46%)达到80分以上。期末考核得分为82.24±6.77，有91位同学(77.12%)达到80分以上。同学对课程的评分为98.76±3.55，超过90%的同学表示课程备课认真、授课条理清晰、表达准确。结论：本课程的顺利进展证明医学人工智能联合教学模式的可行性，理论和实践穿插的教学设置帮助同学们更好地掌握知识技术，完成教学目标。
Objective: To analyze the effectiveness of medical education curriculum named “Development and Application of Ophthalmic Artificial Intelligence”, and provide reference for the development of other related curriculums. Methods: Longitudinal observational study method was adopted. During the fall semester of 2020, we conducted an education curriculum named “Development and Application of Ophthalmic Artificial Intelligence” and analyzed the results of mid-term and final examinations, and curriculum evaluation of students. Results: There were 118 undergraduate students taking the course and most of them were junior students majoring in clinical medicine. The score of the mid-term examination was in the range of 77.2±10.07, and 56 students (47.46%) got more than 80 points. The score of the final examination was in the range of 82.24±6.77, and 91 students (77.12%) got more than 80 points. The score of course evaluation of students was in the range of 98.76±3.55, and more than 90% of the students thought that teachers have made full preparations before class, together with clear teaching logic and accurate expressions in class. Conclusion: The smooth progress of our course proved the feasibility of medical artificial intelligence teaching. The teaching setting interspersed with theory and practice could help students to master knowledge and technology better, so as to achieve the teaching objectives.
