红光是波长范围在620~760 nm的可见光，兼有良好的光化学和热作用，其穿透力较强，能够达到皮肤深层及组织内部，从而产生一系列的生物效应。在眼科领域，红光疗法最初主要应用于弱视和眼睑皮肤相关疾病的治疗，随着研究的进一步深入，红光逐渐被应用于控制近视进展和视网膜相关疾病。目前，重复低强度红光(repeat low-level red-light, RLRL)在近视进展的控制效果得到充分肯定，成为红光疗法在眼科应用最受关注的热点之一，其主要可能机制包括红光照射能激活线粒体中的细胞色素C氧化酶的活性，促进三磷酸腺苷(adenosine triphosphate, ATP) 生成，改善网膜缺氧状况；促进一氧化氮 (nitric oxide, NO)的合成和释放，引起脉络膜血管的扩张及血流量的增加；诱导巩膜细胞外基质的重塑，增加巩膜的强度。此外，红光疗法可抑制视网膜感光细胞调节通路中的氧化应激、炎症和细胞凋亡，减轻眼表炎症反应和疼痛，有助于周围神经损伤后修复等。文章针对红光疗法在近视、视网膜相关疾病、弱视及眼睑皮肤相关疾病的治疗机制、有效性及安全性进行综述，为红光疗法在眼科领域的应用提供重要的参考价值和依据。
Red light is visible light with a wavelength range of 620-760 nm, which has excellent photochemical and thermal effects. It can penetrate deeply into the skin and tissues with strong power, resulting in a series of biological effects. In the field of ophthalmology, red-light therapy was initially mainly used in the treatment of amblyopia and eyelid skin-related diseases, and with the further development of research, red light has been gradually used in the myopia control and the study of retina-related diseases. At present, the effect of repeated low-intensity red light (RLRL) on myopia progression has been fully recognized, and it has become one of the most concerned hotspots in the application of red-light therapy in ophthalmology. The main possible mechanisms include that red light therapy can activate the activity of cytochrome C oxidase in mitochondria, promote ATP production, and improve retinal hypoxia. It can also induce the synthesis and release of NO, cause the expansion of choroidal vessels with improvement of blood flow, and increase scleral strength by remodeling of scleral extracellular matrix. In addition, red- light therapy can reduce oxidative stress, inflammation and apoptosis in the regulatory pathways of photoreceptor cells, reduce eye inflammation and pain, and help repair peripheral nerves after injury. This article will review the mechanism, effectiveness and safety of red-light therapy in myopia, retinal diseases, amblyopia, and eyelid skin-related diseases, in order to provide important reference value and basis for the application of red-light therapy in ophthalmology.
儿童白内障是全球范围内可治疗儿童盲症的主要原因之一。对于这些患儿而言，手术是恢复或保护视力的主要方法。然而，手术后的并发症，特别是青光眼相关不良事件(glaucoma-related adverse events, GRAEs)，常常成为导致儿童二次致盲的主要原因，这引起了眼科医疗领域的广泛关注。文章综述了儿童Ⅱ期人工晶状体植入术后GRAEs的影响因素，包括手术设计、眼部解剖特征、其他眼部发育异常和全身疾病等。手术设计中是否植入人工晶状体(intraocular lens，IOL)以及植入的时机和位置都对GRAEs的发生有显著影响。此外，眼部解剖特征如角膜直径、眼轴长度、前房深度、中央角膜厚度和术前晶状体厚度等，也是影响GRAEs发生的重要因素。同时，其他眼部发育异常和全身疾病，如先天性无虹膜、先天性风疹综合征等，也会增加儿童白内障术后青光眼的发生率。文章还总结了预测GRAEs的方法，并推荐使用Cox回归模型建立预测模型。这种模型可以有效地预测儿童Ⅱ期IOL植入术后在特定时间段内发展为GRAEs的概率，从而为早期识别GRAEs高危儿童提供了重要的借鉴。通过对GRAEs影响因素的深入分析和预测模型的建立，文章旨在帮助眼科医生更好地理解GRAEs的发生机制，并在手术前对患儿进行风险评估，从而选择最佳的手术方案和预防措施。这对于改善患儿的术后恢复、减少并发症、保护视功能具有重要的临床意义。
Pediatric cataract is one of the leading causes of treatable childhood blindness worldwide. For these children, surgery is the primary method to restore or preserve vision. However, postoperative complications, particularly glaucoma-related adverse events (GRAEs), often become the main reason for secondary blindness in children, attracting widespread concern in the field of ophthalmology. This study reviews the impact factors of glaucoma-related adverse events after secondary intraocular lens (IOL) implantation in children, including surgical design, ocular anatomical characteristics, other ocular developmental abnormalities, and systemic diseases. Whether to implant an IOL in the surgical design and the timing and positioning of the implantation have a significant impact on the occurrence of GRAEs. In addition, ocular anatomical characteristics, such as corneal diameter, axial length, anterior chamber depth, central corneal thickness, and preoperative lens thickness, are also important factors affecting the occurrence of GRAEs. At the same time, other ocular developmental abnormalities and systemic diseases, such as congenital aniridia and congenital rubella syndrome, also increase the incidence of glaucoma after pediatric cataract surgery. The article also summarizes methods for predicting GRAEs and recommends using the Cox regression model to establish a predictive model. This model can effectively predict the probability of children developing GRAEs after secondary IOL implantation within a specific time period, providing an important reference for the early identification of high-risk children for GRAEs. Through in-depth analysis of the impact factors of GRAEs and the establishment of predictive models, the article aims to help ophthalmologists better understand the mechanisms of GRAEs and assess the risks of children before surgery, thereby selecting the best surgical plan and preventive measures. This is of great clinical significance for improving postoperative recovery in children, reducing complications, and protecting visual function.
脉络膜是视网膜的主要血供来源，脉络膜血管系统为眼内最大、最重要的血管系统，在给外层视网膜供血方面起着至关重要的作用。脉络膜是一个动态、多功能性结构，其生理性特性受多种因素影响。这些因素包括年龄、性别、解剖位置、眼轴长度、昼夜节律与饮酒等。脉络膜涡静脉根据解剖学位置可分为眼内、巩膜内和眼外三大部分，又进一步分为脉络膜静脉、壶腹前部、壶腹、壶腹后部、巩膜入口、巩膜内通道、巩膜出口和巩膜外涡静脉八个区域。在正常眼中，涡静脉的类型不仅限于传统认知中出口位于赤道部近睫状体平坦部的涡静脉，研究发现还存在出口位于后极部的后极部涡静脉。根据涡静脉的形态及解剖特点，涡静脉又分为四类：缺失型涡静脉、不完整型涡静脉、完整型涡静脉、完整型涡静脉伴壶腹。文章旨在阐述正常人眼的脉络膜血流及涡静脉解剖基础，以深入了解正常状态下的脉络膜特征，这不仅有助于辨别脉络膜的病理性变化，且对脉络膜相关眼部疾病的诊断与鉴别诊断有重要价值。
The choroid is the primary source of blood supply for the retina. As the largest and most important vascular system within the eye, the choroidal vasculature plays a crucial role in providing blood to the outer retina. The choroid is a dynamic, multifunctional structure whose physiological characteristics are influenced by a variety of factors. These factors include age, gender, anatomical location, axial length of the eye, circadian rhythm, and alcohol consumption, among others. Choroidal vortex veins can be anatomically divided into three main parts: intraocular, scleral, and extraocular. Furthermore, they can be subdivided into eight distinct regions: choroidal veins, pre-ampulla, ampulla, post-ampulla, scleral entrance, intrascleral canal, scleral exit, and extrascleral vortex vein. In the healthy eye, the types of vortex veins are not limited to the traditionally recognized veins with exits near the ciliary body pars plana in the equatorial region. Recent research has revealed the existence of posterior vortex veins with exits in the posterior pole of the eye. Based on the morphology and anatomical characteristics of vortex veins, they can be further classified into four types:absent vortex veins, incomplete vortex veins, complete vortex veins, complete vortex veins with ampulla. This paper aims to elucidate the blood flow and vortex veins anatomical foundation of the choroid in normal human eyes. Understanding these characteristics in a healthy state will aid in identifying pathological changes in the choroid, which is of significant value for the diagnosis and differential diagnosis of ocular diseases.
碳点是一种新型荧光碳纳米材料，直径一般小于10 nm，具有自发荧光、高生物组织相容性、易于修饰、成本低廉等优点，在生物医学领域拥有广阔的应用前景。眼球因其独特的屏障结构，常规药物停留时间短、穿透性差，通过局部滴眼到达病灶的药物浓度有限，需要增加给药频次以保持药效。另外，糖尿病性黄斑水肿(diabetic macular edema,DME)、脉络膜新生血管(diabetic macular edema,CNV)等疾病的治疗给药则需依赖于玻璃体腔注射，该方法属于有创操作，有引起潜在并发症的可能，且需多次注射，给患者造成了沉重的心理和经济负担。优化眼部给药方法一直是眼科学领域的研究热点。基于碳点的优异特性，碳点在眼部药物递送、眼部成像、眼疾病诊疗中已展现出优秀的应用潜力。本综述将综合介绍碳点的特点及近十年来碳点在眼科疾病诊疗中的研究进展，旨在提供关于碳点在眼科应用现状的系统性认识，为未来研究提供方向。
Carbon dots is a new type of fluorescent carbon nanomaterial, which the diameter is generally less than 10 nm, has the advantages of self-fluorescence, remarkable biocompatibility, easy modification, low cost and so on, has a broad application prospect in the biomedical field. Due to the unique barrier of the eye, conventional drugs have a short residence time and poor penetration, so the concentration of drugs that can reach the lesions through local eye drops is limited, and for what to increase the frequency of administration to maintain efficacy. Up to now, the treatment of posterior eye diseases, such as diabetic macular edema (DME), choroidal neovascularization (CNV) and other diseases still rely on repeated vitreous injection, which is an invasive procedure with potential complications, and need multiple injections, causing a heavy psychological and economic burden on patients. Optimizing the method of ocular drug delivery has always been a hot topic in the field of ophthalmology. Carbon dots have shown excellent application potential in the ocular drug delivery, ocular imaging, and diagnosis and treatment of ocular disease based on its excellent characteristics. This review will systematically introduce the characteristics of carbon dots and the application of carbon dots in the diagnosis and treatment of eye diseases, aiming to provide a comprehensive understanding of the current situation of the application of carbon dots in ophthalmology and provide directions for future research.
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.
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.
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.
甲状腺相关眼病是一种器官特异性自身免疫性疾病，其发病机制复杂，是成人最常见的眼眶疾病，且发病率逐年升高。该病不仅会导致眼球突出、眼睑退缩、睑裂扩大、眼球运动障碍等外观上的变化，且患者往往伴发眼红、眼痛、干涩、异物感、复视、视力下降等不适症状，其中眼表疾病的发病率较正常人明显增高，但其具体发病机制尚待进一步挖掘。目前研究表明甲状腺相关眼病患者的眼表损伤主要与眼表暴露增加、炎症侵犯、激素改变有关。角膜、结膜、泪膜、睑板腺等组织受累发生病理改变是患者表现出不同临床症状的直接原因。文章通过分析近年来国内外关于甲状腺相关眼病与眼表疾病等方面的相关研究，针对甲状腺相关眼病眼表损伤的病理改变及机制研究进展做一综述。
Tyroid-associated ophthalmopathy is an organ-specifc autoimmune disease with complex pathogenesis. It is the most common orbital disease in adults, and its incidence increases year by year. Tis disease can not only lead to appearance changes such as eyeball protrusion, eyelid retraction, eyelid cleat enlargement, eye movement disorders, and patients are ofen accompanied by red eyes, eye pain, dryness, foreign body sensation, diplopia, vision loss and other uncomfortable symptoms, among which the incidence of ocular surface diseases is signifcantly higher than that of normal people, but its specifc pathogenesis needs to be further explored. Current studies have shown that ocular surface injury in patients with thyroid-associated ophthalmopathy is mainly related to increased ocular surface exposure, infammatory invasion, and hormonal changes. Te pathological changes of cornea, conjunctiva, tear flm, meibomian gland and other tissues involved are the direct causes of different clinical symptoms of patients. In this paper, through the analysis of recent domestic and foreign studies on thyroid-associated ophthalmopathy and ocular surface diseases, the pathological changes and mechanism of ocular surface injury in thyroid-associated ophthalmopathy were reviewed.
外伤性视神经病变是因外力损伤视神经，进而严重损害视力的致盲性眼病。自噬是一种细胞内降解途径，有助于维持细胞正常组分合成与受损细胞器及有毒细胞成分的分解之间的平衡。视神经受创后，视神经和视网膜中自噬标志物增加。自噬在外伤性视神经病变的不同阶段对视网膜神经节细胞可能起不同作用。多数研究表明，上调自噬可以减轻外伤性视神经病变中视网膜神经节细胞的死亡；也有研究提示在视神经损伤后极早的时期抑制自噬可以抑制视网膜神经节细胞轴突变性。该文对自噬的定义及功能、自噬的发生机制、视神经创伤后自噬水平改变、自噬在视神经创伤后对视网膜神经节细胞的作用的研究结果进行综述。
Traumatic optic neuropathy is a blinding eye disease that causes severe damage to vision due to external force damage to the optic nerve.. Autophagy is an intracellular degradation pathway that helps maintain the balance between the synthesisof normal cell components and the breakdown of damaged organelles and toxic cellular components. Autophagy markers are increased in optic nerve and retina after optic nerve trauma. Autophagy may play different roles on retinal ganglion cells (RGCs) at different stages of traumatic optic neuropathy. Most studies have shown that upregulating autophagy can attenuate RGCs death in traumatic optic neuropathy; however, it has also been suggested that inhibition of autophagy at ultra-early stage after injury can inhibit RGCs axonal degeneration. In this review, we reviewed the definition and function of autophagy, the mechanism of autophagy, and summarized the change of autophagy level after optic nerve trauma, as well as the effects of autophagy in RGCs after optic nerve trauma.
随着近视人口的逐年增长，近视已经成为全球关注的热点问题。如何预防近视、控制近视进展、减少病理性近视的发生、减少近视的成本投入是临床工作及科学研究的主要目的。阿托品是目前防控近视的主要药物方法，实验室研究及临床试验均已证实其显著的近视防控效果。美国眼科学会推荐使用0.01%低浓度阿托品，目前报道其近视防控效果为50%~53%。本文汇总了近年来近视防控相关的临床与实验室研究，对阿托品近视防控效果、其相关影响因素(如浓度、个体差异、生物利用度等)以及作用机制等方面的研究进展进行归纳综述，并分析了阿托品用于临床儿童近视防控工作存在的困难与挑战。
As the population of myopia grows rapidly, myopia has become a hot issue of global concern. Preventing myopia and slowing the progression of myopia to reduce the occurrence of pathological myopia and reduce the cost of myopia is the main purpose of related clinical work and scientific researches. Currently, atropine is the main drug for the prevention and control of myopia, and both laboratory studies and clinical trials have confirmed its effect. The American Academy of Ophthalmology recommends the use of 0.01% atropine, which is reported to be 50% to 53% effective in preventing and controlling myopia. This review collects the clinical and laboratory researches in decades to summarize the study progress in atropine for preventing and controlling myopia, including the clinical application effects, the influencing factors such as concentration, individual differences, bioavailability, and the related mechanisms. We also highlight the existing difficulties and challenges in the use of atropine in clinic.
