目的：开发一款可自动校准测试距离的智能手机视力检测APP(WHOeye的iOS版本)，并评估其实用性。方法： WHOeyes在经过验证的视力检测APP “V@home”的基础上新增自动距离校准(automatic distance calibration, ADC)功能。研究招募了3组不同年龄(≤20岁、20~40岁、>40岁)的中国受试者，分别使用糖尿病视网膜病变早期治疗研究(Early Treatment Diabetic Retinopathy Study, ETDRS)视力表和WHOeyes进行远距离和近距离的视力检测。ADC功能用于确定WHOeyes的测试距离。红外测距仪用于确定ETDRS的测试距离以及WHOeyes的实际测试距离。通过问卷调查评估用户满意度。结果：WHOeyes ADC确定的实际测试距离在3个年龄组中均与预期测试距离总体上表现出良好的一致性(P > 0.50)。在远距离和近距离视力检测方面，WHOeyes的准确性与ETDRS相当。WHOeyes与ETDRS之间的平均视力差异范围为–0.084 ~ 0.012 log^MAR，各组的二次加权卡帕系数(quadratic weighted kappa, QWK)均大于0.75。WHOeyes在近距离和远距离视力检测中的重测信度高，平均差异范围为–0.040 ~ 0.004 log^MAR，QWK均大于0.85。问卷调查显示WHOeyes具有较好的用户体验和接受度。结论：与金标准ETDRS视力表方法相比，WHOeyes测试距离较为准确，可以提供准确的远距离和近距离视力测量结果。

Background: To develop and assess usability of a smartphone-based visual acuity (VA) test with an automatic distance calibration (ADC) function, the iOS version of WHOeyes. Methods: The WHOeyes was an upgraded version with a distinct feature of ADC of an existing validated VA testing APP called V@home. Three groups of Chinese participants with different ages (≤20, 20-40, >40 years) were recruited for distance and near VA testing using both an Early Treatment Diabetic Retinopathy Study (ETDRS) chart and the WHOeyes. The ADC function would determine the testing distance. Infrared rangefinder was used to determine the testing distance for the ETDRS, and actual testing distance for the WHOeyes. A questionnaire-based interview was administered to assess satisfaction. Results: The actual testing distance determined by the WHOeyes ADC showed an overall good agreement with the desired testing distance in all three age groups (p > 0.50). Regarding the distance and near VA testing, the accuracy of WHOeyes was equivalent to ETDRS. The mean difference between the WHOeyes and ETDRS ranged from -0.084 to 0.012 log^MAR, and the quadratic weighted kappa (QWK) values were greater than 0.75 across all groups. The test-retest reliability of WHOeyes was high for both near and distance VA, with a mean difference ranging from -0.040 to 0.004 log^MAR and QWK all greater than 0.85. The questionnaire revealed an excellent user experience and acceptance of WHOeyes. Conclusion: WHOeyes could provide accurate measurement of the testing distance as well as the distance and near VA when compared to the gold standard ETDRS chart.

马方综合征 (Marfan syndrome, MFS) 是一种由原纤维蛋白-1(fibrillin-1,FBN-1)突变引起的全身性遗传性疾病，FBN-1基因突变与MFS相关表型的联系相关，目前已报道的MFS常见的眼部表现包括角膜扁平、长眼轴、晶状体异位以及视网膜病变等异常，这些眼部异常将对MFS患者的视力产生影响，如角膜异常可影响角膜高阶像差的异常，可能导致近视或散光等屈光状态异常，从而影响视觉质量，损害视力清晰度。此外，MFS的眼底血管病变，也可能导致MFS患者的视力丧失，研究发现，MFS视网膜血管及脉络膜血管的密度较正常人减少，并与最佳矫正视力相关，由于光感受器的代谢与营养供应与视网膜及脉络膜血管息息相关，血管异常可能与视力损失相关。由于MFS患者存在视力损害的风险，其早期诊断和治疗尤为重要，因此，了解MFS眼部病变的特点及其对视力的影响，对制定针对MFS眼病的治疗方案具有重要的意义。另外，由于MFS眼部异常与FBN1基因突变相关，其基因突变类型多样，致病机制复杂，总结MFS眼部特点对其发病机制的继续探索有一定的指导作用，因此，文章拟就MFS患者眼部生物学参数特点及其对视力的影响这一领域国内外的相关研究进展进行综述。

Marfan syndrome (MFS) is a systemic hereditary disease caused by fibrillin-1 (FBN-1) mutations. FBN-1 gene mutations are associated with MFS-related phenotypes. Common ocular manifestations of MFS reported so far include corneal flattening, long axial length, ectopia lentis, and retinal abnormalities. These ocular abnormalities will affect the vision of MFS patients. For example, corneal abnormalities can affect abnormalities in corneal higher-order aberrations, which may lead to abnormal refractive states such as myopia or astigmatism, thereby affecting visual quality and compromising visual acuity. In addition, retinal vascular abnormalities may also lead to vision loss in MFS patients. Studies have found that the density of retinal and choroidal blood vessels in MFS patients is lower than that in normal individuals and is associated with best corrected visual acuity. Given the close relationship between the metabolism and nutrient supply of photoreceptors and retinal and choroidal vasculature, vascular abnormalities may be linked to visual impairment. Since MFS patients are at risk of visual impairment, early diagnosis and treatment are particularly important. Therefore, understanding the characteristics of ocular manifestations in MFS and their impact on vision is crucial for devising effective treatment strategies for MFS-related ocular conditions. Additionally, as ocular abnormalities in MFS are linked to mutations in the FBN1 gene, which exhibit diverse mutation types and complex pathogenic mechanisms, summarizing the ocular features of MFS can provide valuable insights for further exploration into its pathogenesis. Therefore, this article aims to review the progress of domestic and international research on the ocular biological parameters of MFS patients and their impact on vision.

      叶黄素类物质为膳食类胡萝卜素，主要存在于视网膜组织中，为黄斑色素发挥抗氧化活性和蓝光滤过作用。近年来，有研究证实，叶黄素类物质可降低色差，提高视力及对比敏感度等功能，并对于年龄相关性黄斑变性、视网膜光损伤等疾病具有防治作用。

Xanthophylls is a kind of dietary carotenoid, which is mainly located in retina, and plays an important role in antioxidant and blue light ffltration. Lutein, zeaxanthin and meso-zeaxanthin can enhance visual performance by decreasing chromatic aberration and enhancing contrast sensitivity, and they can also prevent age-related macular degeneration and retinal light-induced injury. 

目的：评估低视力青少年使用电子助视器对其阅读速度的影响。

方法：在泉州市盲校筛查 10 名使用光学助视器有阅读能力的低视力青少年学生进行屈光矫正和常规外眼、内眼检查，分别测量其使用各种光学助视器及电子助视器阅读5号字卡的阅读速度。

结果：10 名低视力青少年学生在使用光学助视器后阅读速度为 (18.50±6.54) 字/分，使用电子助视器后阅读速度为 (34.36±5.06) 字/分，两组比较差异有统计学意义 (P < 0.05)。低视力青少年的近视力与阅读速度无关 (P > 0.05)。

结论：使用电子助视器较光学助视器可以明显提高低视力青少年的阅读速度，不同病因所致的低视力青少年其近视力与阅读速度无关。

Purpose: To evaluate the reading speed of adolescents with different causes of low vision using electronic visual aids.
Methods: The screening of 10 young students from Quanzhou Blind School who could read Chinese N5 print by different optical aids. After refractive correction and ophthalmic examination, the reading speeds with Chinese N5 print were measured using various optical and electronic visual aids.
Results: The reading speed of (34.36 ± 5.06) words/min by electronic visual aids performed faster than the reading speed of (18.50 ± 6.54) words/min by optical visual aids in 10 young students with low vision (P < 0.05). The reading speed of young people with low vision due to different causes had no direct linear correlation with their near visual acuity (P > 0.05).
Conclusion: The electronic visual aids could more significantly improve the reading speed of young people with low vision than the optical visual aids did. The reading speed of young people with low vision due to different causes was not related to their near visual acuity.

目的: 探讨 ETDRS 对数视力表对儿童视力检查的可重复性及其影响的相关因素。

方法: 在流行病学调查的过程中, 随机使用 ETDRS 对数视力表, 为 250 位裸眼视力低于 0.5 和 98 位视力正常儿童进行裸眼视力重复检查。
结果: 两次视力测量之间差异的均数为0.004log^±0.07; Kappa 分析结果具有很好的一致性(k = 0.71) ; 性别与视力检查一致性无明显相关(P = 0.845) ; 年龄与视力检查一致性有显著相关性(P = 0.019) , 年龄越小视力检查一致性越差; 屈光不正与视力检查一致性也有显著相关性(P = 0.000) , 近视度数在- 1.00D～- 5.00D 之间的儿童视力检查一致性相对差, 而正视眼的视力检查一致性较好。

结论: 结果提示 ETDRS 对数视力表适合儿童视力检查, 建议推广使用。

Purpose: To evaluate repeatability of the ETDRS log MAR visual acuity measurementin children and the relative influence factors.

Methods: The children (n = 348) with visual acuity less than 0.5 ( equal to 0.3 logunit) in either eye,or one tenth in children with normal visual acuity were chosen todo repeatable uncorrected VA measurement with Bland-Altman analysis and Kappa analysis using ETDRS acuity chart.

Results: The mean difference of visual acuity was 0.004log^±0.07. There was a significant repeatability (k = 0.71) between two visual acuity examination. There were significant consistent results both on male and female patients (P = 0.845) . A significant relationship was found between age and VA repeatability(P = 0.019) . The VA repeatability could also be influenced by refractive error (P = 0.000) . The acuity measurement in children with emmetropia (k = 0.82) had a higher repeatability than in the children with myopia (k = 0.66) .

Conclusions: The ETDRS visual acuity chart can provide a repeatable measure of visual acuity in children. It is recommended for clinic examination of children. 

该文报道一例30岁的男性患者因“双眼自幼视力不佳，强光下视物模糊加重4年余”就诊，经过眼部检查评估，诊断为双眼瞳孔残膜、双眼屈光不正。患者接受一期双眼瞳孔残膜切除、二期双眼行有晶状体眼后房型环曲面人工晶状体(toric implantable collamer lens,TICL)植入手术，术后视力恢复良好。文章回顾了该例患者的诊治过程，为临床屈光不正同时伴有瞳孔残膜患者的诊治提供参考。

A 30-year-old male patient presented at our institution with a history of poor vision in both eyes since childhood, exacerbated by blurriness under bright light for over four years. Following a comprehensive ophthalmic examination, the patient was diagnosed with bilateral pupillary membrane remnants and refractive errors. The patient underwent a two-stage surgical intervention, starting with the removal of the pupillary membrane remnants, followed by the implantation of toric implantable collamer lenses (TICL) in the posterior chamber of the lensless eyes. Postoperative outcomes were favorable, with significant improvement in visual acuity. This article reviews the therapeutic journey of the patient, offering insights into the diagnosis and management of individuals with concurrent refractive anomalies and pupillary membrane remnants, thereby contributing to the clinical discourse on the subject.

因不同的眼部和神经性疾病，导致视觉功能严重受损，为低视力患者日常活动(如阅读及驾驶)及生活质量、心理健康带来严重的影响。人们对外界信息的感知主要来源于视觉，除威胁生命的重大疾病外，对人感官影响最大的损害当属视觉损伤。且随着人口日益老龄化，该问题日趋加重，低视力已成为目前全球范围内一个严重的公共卫生问题。目前，低视力康复发展面临着临床和科研的巨大挑战，要研发出一种能有效改善视觉功能，同时能兼顾多种功能的视障辅助技术，这需要医学、生物学、工程学、微电子学、计算机学等多学科的共同发展和相互合作。低视力康复通过为患者提供适宜的视障辅助技术，最大化利用患者的残余视力及视觉功能，改善与低视力相关的功能限制，有效改善其独立性和整体生活质量，使其独立生活、工作并融入社会成为可能。该文对经典的助视器、人工视觉(视觉假体/视觉感官替代设备)、经颅刺激及视觉生物反馈训练等视障辅助技术在低视力康复中的应用进展进行综述。

Patients with low vision are severely impaired in visual function due to different ocular and neurological disorders,which have a serious impact on their daily activities (such as reading and driving), quality of life and mental health.People's perception of external information mainly comes from vision. Expect for the life-threatening major diseases,visual damage has the greatest impact on people's senses. With the ageing of the population, the problem is getting worse, and low vision has become a serious public health problem in the world. Currently the development of low vision rehabilitation is facing a huge challenge in clinical and scientific research, to develop a visual impairment assistance technology that can effectively improve visual function while balancing multiple functions. It requires the joint development and cooperation of multiple disciplines such as medicine, biology, engineering, microelectronics, and computer science. Low vision rehabilitation provides patients with appropriate visual impairment assistance technology,maximizing the use of residual vision and visual function of patients, improving the functional limitations associated with low vision, effectively improving their independence and overall quality of life, and makes it possible for them to live, work and integrate into the society independently. This article reviews the progress in the application on visual impaired assistive technologies such as classic visual aids, artificial vision (visual prostheses/visual sensory replacement devices), transcranial stimulation and visual biofeedback training in low vision rehabilitation.

目的：比较不同受检者在相同近视屈光欠矫下使用C字视力表和E字视力表所测得的视力差别及探讨导致这种差别的原因。方法：选取不同年龄段250名受检者，在完全矫正屈光度[最正之最佳视力(maximum plus to maximum visual acuity，MPMVA)]情况下附加相应的球镜造成相应的近视度数后比较使用2种不同的视力表测出的视力值变化情况。同时根据2种视力表的设计原理及视力表的不同记录法探讨造成数值不同的可能原因。结果：同一附加度情况下分别用C字视力表组和E字视力表组行方差分析，不同年龄组间差异无统计学意义(P>0.05)。相同附加度情况下同一受检者使用C字视力表组和E字视力表组行t检验，两者差异具有统计学意义(t=?15.798，P<0.05)，C字视力表测得视力平均值小于E字视力表测得视力平均值。结论：受检者使用C字视力表比E字视力表检测视力结果更加优异；C字视力表和E字视力表的视标形状及开口方向不同是2种视力表检测结果差异的主要原因。

Objective: To compare the difference of visual acuity measured by C-chart and E-chart in the same myopic refractive undercorrection and to explore the causes of the difference. Methods: Two hundred and fifty subjects of different ages were selected to compare the changes of visual acuity measured by two different visual meters after adding corresponding spherical lenses to the maximum plus to maximum visual acuity (MPMVA) corrected diopter. At the same time, according to the design principle of the two kinds of visual acuity meters and the different recording methods of visual acuity tables, the possible reasons for the different values were discussed.Results: There was no significant difference between different age groups (P>0.05). Under the same degree of additionality, the visual acuity of the same subjects was tested by t-test with C visual acuity chart and E visual acuity chart. The difference was statistically significant (t=?15.798, P<0.05). The average visual acuity of C visual acuity table was smaller than that of E visual acuity table. Conclusion: The visual acuity of myopic patients tested by C visual acuity chart is better than by E visual acuity chart. The main reason for the difference between C visual chart and E visual chart was the different shape and opening direction of visual icons.

目的：调查引导式教育训练对视力障碍学生生活质量的影响。方法：前瞻性随机对照临床研究。选取2020年在泉州特殊教育学校就读视力障碍学生，按照入组条件随机分为引导式教育训练组和对照组，引导式教育训练组进行引导式教育训练，对照组进行常规康复训练。采用中文版低视力者生活质量量表(Chinese-version low vision quality of life questionnaire，CLVQOL)评估视力障碍学生的基线和训练3个月的生活质量，并进行比较分析。结果：72例视力障碍学生全部完成了基线和随访时的生活质量问卷调查。进行基线检查时，各组CLVQOL评分总分差异无统计学意义(P>0.05)。3个月后，各组CLVQOL评分总分均增加，引导式教育训练组从基线59(48.5，80.5)上升到105(97.5，119.5)，差异有统计学意义(Z=?4.781，P<0.001)；对照组从基线69(56，85)上升到106(80，112)，差异有统计学意义(Z=?4.438，P<0.001)；引导式教育训练组在CLVQOL评分总分(P=0.021)及阅读和精细工作维度(P=0.004)、日常生活能力维度(P=0.003)的评分差值均高于对照组。结论：引导式教育训练是一种重要的低视力康复训练方法，可以明显提高患者的生活质量。

Objective: To investigate the effect of conductive education training on the quality of life in visually impaired students. Methods: It was a prospective randomized controlled trial. The visual impairment students who had registered in Quanzhou Special Education School in 2020 were selected and randomly divided into two groups: conductive education training group and control group. The conductive education training group received conductive education training, while the control group received routine rehabilitation training. Chinese version low vision quality of life questionnaire (CLVQOL) was used to assess the quality of life of low vision students at baseline and 3 months after training, and comparative analysis was conducted. Results: All 72 students with visual impairment completed CLVQOL surveys. At baseline, there was no significant difference in total CLVQOL scores between groups. After 3 months, overall CLVQOL scores increased in both groups, from baseline 59 (48.5, 80.5) to 105 (97.5, 119.5) in the conductive education group (Z=-4.781, P<0.001), and 69 (56, 85) to 106 (80, 112) in the control group (Z=-4.438, P<0.001). The total score of CLVQOL (P=0.021), reading and fine work subscale (P=0.004), and daily activities subscale (P<0.003) in the conductive education training group were higher than those in the control group. Conclusion: Conductive education training is an important method of low vision rehabilitation training, which can significantly improve the quality of life of patients.

目的：探究特发性黄斑前膜(idiopathic macular epiretinal membrane，IMEM)患者在光学相干断层扫描(optical coherence tomography，OCT)的形态学改变与视力的相关性。方法：回顾性研究。基于OCT图像4级分级方案，纳入3级及以下的特发性黄斑前膜患者35例共37只眼进行OCT扫描，并借助第三方软件分析并获取每只眼在黄斑中心凹直径分别为1、3、6 mm共3个同心圆区域内视网膜各层的平均厚度值，并按照是否存在内核层(inner nuclear layer，INL)囊样改变分为两组。通过建立最小分辨角对数(minimum resolution angle in logarithmic，logMAR)最佳矫正视力(best corrected vision acuity，BCVA)与视网膜各层厚度值的多元线性回归方程，以及比较有INL囊样改变及无INL囊样改变两组的视力，分析视力与视网膜各层厚度值及INL囊样改变的关系。结果：多元线性回归分析显示，在直径1 mm的区域内，logMAR BCVA与神经纤维层(retina nerve fiber layer，RNFL)、INL的厚度值均呈正相关(均P<0.05)，而在直径3 mm和6 mm的区域内，logMAR BCVA仅与INL的厚度值呈正相关(均P<0.05)。与无INL囊样改变组相比，有INL囊样改变组视力及INL厚度差异均有统计学意义(均P<0.05)。结论：特发性黄斑前膜患者当前的视力主要与RNFL和INL厚度值相关。发生在INL层的囊样改变可能很好的提示INL增厚，其与视力具有相关性，具有这种囊样改变的患者往往视力也较差。

Objective: To investigate the morphological changes detected by spectral domain optical coherence tomography (OCT) and their relevance to vision in patients with idiopathic macular epiretinal membranes (IMEM). Methods: This is a retrospective study. OCT recorded 37 eyes with stage 3 and below IMEM according to the 4-level grading system based on OCT images among 35 patients. We managed to obtain thickness of all retina layers in three concentric circular regions with a diameter of 1 mm, 3 mm and 6 mm across macular fovea with the help of a third-party software. Plus we divided all 37 eyes into two groups according to whether there were cystic changes in the inner nuclear layer (INL). Multiple linear regression analyses were performed between thickness of all retina layers and current minimum resolution angle in logarithmic (logMAR) best corrected visual acuity (BCVA). The difference of BCVA between groups with cystic changes and without was also compared. Thus, the relationships between visual acuity and thickness of retina layers, cystic changes in INL were analyzed. Results: Multiple linear regression analyses revealed that thickness of both retina nerve fiber layer (RNFL) and inner nuclear layer have positive correlation with logMAR BCVA in the region with a diameter of 1 mm (P<0.05), while in regions of a diameter of 3 mm and 6 mm, only INL thickness remained positively relevant (all P<0.05). There were significant differences in BCVA and thickness of INL between groups with INL cystic changes and without (all P<0.05). Conclusion: Current visual acuity among preoperative IMEM patients was mostly associated with thickness of RNFL and INL. Cystic change in INL layer may be a good indicator of INL thickening and was visually correlated. Those with this change tend to have worse vision.