论著

新疆喀什地区英吉沙县儿童青少年弱视患病率和影响因素分析

Analysis of the prevalence and influencing factors of amblyopia among children and adolescents in Yingjisha County, Kashi, Xinjiang

:807-819
 
目的:了解新疆喀什地区英吉沙县7~16岁儿童青少年弱视患病情况及其相关因素,为制定科学有效的眼健康防控策略提供依据。方法:选取新疆喀什地区英吉沙县3 261名在校儿童青少年,对其进行裸眼视力、最佳矫正视力、屈光度、眼位和眼底情况等检查,并通过问卷调查收集其基本人口学信息、近视家族史、用眼情况和睡眠情况,采用Logistic回归分析7~16岁儿童青少年弱视患病的相关因素。结果:英吉沙县儿童青少年弱视的患病率为1.99%(95%·CI: 1.51~2.47)。弱视患病率在学生类型、性别、近视家族史、主观睡眠质量、每天写作业时间、每天睡眠时间等方面比较差异无统计学意义(P>0.05),在斜视、近视、远视、屈光参差、每天使用电子产品时间等方面比较差异有统计学意义(P<0.05)。多因素回归分析结果显示,斜视、远视、屈光参差及每天使用电子产品时间与弱视相关,对应的OR值相应为3.82(95%CI: 1.93~7.58,P<0.001)、10.88(95%CI: 4.85~24.40,P<0.001)、13.54(95%CI:6.84~26.78,P<0.001)和0.25(95%CI: 0.12~0.54, P<0.001),合并斜视、远视或屈光参差的儿童青少年患弱视的风险增加。每天使用电子产品时间>60 min的儿童青少年患弱视风险较使用时间≤60 min降低。弱视类型以屈光不正性弱视和屈光参差性弱视为主。结论:在新疆喀什地区英吉沙县7~16岁儿童青少年人群中,屈光不正和屈光参差是弱视患病的主要原因。斜视、远视、屈光参差、每天使用电子产品时间是弱视的影响因素。
Objective: To conduct a comprehensive investigation into the prevalence of amblyopia and its influencing factors among children and adolescents aged 7-16 in Yingjisha County, Kashi, Xinjiang. The ojective is to furnish a solid basis for formulating scientific and effective eye health prevention and control strategies. Methods: A total of 3,261 school-aged children and adolescents in Yingjisha County, Kashi, Xinjiang, were selected for this study. The examinations included uncorrected visual acuity, best-corrected visual acuity, refractive error, ocular alignment, and fundus condition. A questionnaire was used to collect demographic information, family history of myopia, daily eye-use habits, and sleep status. The data were analyzed using SPSS statistical software, and logistic regression was employed to explore factors associated with amblyopia in children and adolescents aged 7-16. Results: The study revealed that the prevalence of amblyopia among children and adolescents in Yingjisha County was 1.99% (95% CI: 1.51-2.47). There were no significant differences (P > 0.05) in the prevalence of amblyopia across student type, sex, family history of myopia, subjective sleep quality, daily homework duration, or daily sleep duration. However, significant differences (P < 0.05) were observed in cases involving strabismus, myopia, hyperopia, anisometropia, and daily screen time. Multivariate regression analysis indicated that strabismus (OR = 3.82, 95% CI: 1.93-7.58, P < 0.001), hyperopia (OR = 10.88, 95% CI: 4.85-24.40, P < 0.001), and anisometropia (OR = 13.54, 95% CI: 6.84–26.78, P < 0.001) were positively correlated with amblyopia. Conversely, children and adolescents who used electronic devices for >60 minutes per day had a lower risk of amblyopia (OR = 0.25, 95% CI: 0.12-0.54, P < 0.001) compared to those with ≤60 minutes or less of daily screen time. The most common type of amblyopia was mixed amblyopia (60.00%), followed by anisometropic amblyopia (23.08%), refractive amblyopia (12.31%), and strabismic amblyopia (4.62%). Among mixed amblyopia cases, the combination of refractive amblyopia and anisometropic amblyopia was the predominant pattern (64.10%). Conclusions: Refractive errors and anisometropia are the main causes of amblyopia. Strabismus, myopia, hyperopia, anisometropia and the duration of electronic device use are identified as influencing factors for amblyopia.
综述

眼睑基底细胞癌的诊疗新进展

Recent advances in the diagnosis and treatment of eyelid basal cell carcinoma

:753-762
 
眼睑基底细胞癌(basal cell carcinoma of eyelid, BCC)是眼附属器中最为常见的恶性肿瘤,近年来,其全球发病率呈持续上升趋势,且患者发病年龄有明显年轻化的倾向,这不仅增加了疾病的公共卫生负担,也对临床防治策略提出了更高要求。本文综述了眼睑BCC在诊疗领域的最新研究进展。在诊断方面,除传统组织病理学检查外,皮肤镜、反射共聚焦显微镜(reflectance confocal microscope, RCM)和光学相干断层扫描(optical coherence tomography, OCT)等新技术的应用不仅显著提升了诊断灵敏度与特异度,更在肿瘤亚型鉴别和边界描绘方面展现出独特优势。在分子机制研究方面,代谢组学揭示了眼睑BCC存在显著的代谢重编程,包括脂质代谢、烟酰胺腺嘌呤二核苷酸(nicotinamide adenine dinucleotide, NAD)代谢、多胺代谢以及葡萄糖代谢等多条代谢通路的异常活化。更为前沿的空间代谢组学技术则将代谢信息与组织空间位置相结合,进一步验证了磺酸、羟基吡啶硫酮等特异性代谢物在肿瘤发生发展中的潜在生物标志物价值。治疗方面,除了传统手术治疗之外,放射治疗的技术革新,以及针对Hedgehog信号通路的靶向药物及免疫抑制剂等免疫疗法的突破,为晚期/转移性患者带来了革命性的治疗转机。文章旨在为未来的眼睑BCC预防和治疗策略提供新的见解,并为临床医生提供新的诊疗思路。
Eyelid basal cell carcinoma (BCC), the most prevalent malignant tumor of the ocular adnexa, has seen a steady rise in global incidence, accompanied by a notable trend toward earlier onset. This trend not only exacerbates the public health burden but also imposes greater demands on clinical strategies for prevention and management. This article reviews the latest research progress in the diagnosis and treatment of eyelid BCC. In diagnostic practice, alongside conventional histopathological examination, the incorporation of novel technologies—such as dermoscopy, reflectance confocal microscopy (RCM), and optical coherence tomography (OCT)—has markedly enhanced diagnostic sensitivity and specificity, while offering distinct advantages in tumor subtype differentiation and margin assessment. Metabolomic analyses reveal pronounced metabolic reprogramming in eyelid BCC, with aberrant activation of lipid, NAD, polyamine, and glucose metabolism. Spatial metabolomics further supports the biomarker potential of metabolites such as taurine and pyrithione in tumor initiation and progression. Beyond conventional surgery, advances in radiotherapy, targeted Hedgehog pathway inhibitors, and immunotherapies have created new opportunities for advanced or metastatic eyelid BCC. This review highlights emerging strategies for prevention, diagnosis, and treatment, offering clinicians fresh perspectives for patient management.
综述

小牛血去蛋白提取物眼用制剂在眼表疾病应用中的回顾与展望

The review and prospect of the applications of deproteinized calf blood extract ophthalmic preparation in ocular surface disease

:574-584
 
眼表是统一整体,依靠泪液、细胞、神经及免疫等综合因素维持平衡,某个或多个因素的失衡会造成眼表出现一系列连锁反应,导致眼表疾病,影响个体生活质量。近年来,越来越多研究围绕细胞能量代谢与多种疾病的发生、发展和治疗进行,纠正细胞能量代谢的异常是治疗此类疾病的重要思路。小牛血去蛋白提取物从发现并应用至今已有60多年历史,具有良好的组织修复作用和安全性。作为经典的能量补充修复剂,小牛血去蛋白提取物眼用制剂以特定工艺去蛋白处理的小牛血液提取物作为其主要有效成分,具有多重作用机制,在不同严重程度的角膜损伤、干眼症、眼烧伤等多种眼表疾病的治疗方面展现出良好的效果。文章就小牛血去蛋白提取物眼用制剂的制备工艺、作用机制、安全性以及临床应用等进行综述,旨在系统梳理小牛血去蛋白提取物眼用制剂的临床应用价值,并为其在未来的实验研究以及在眼表疾病的进一步实践应用提供科学依据和参考价值。
The ocular surface is an integrated entity maintained in equilibrium by a complex interplay of factors, including tears, cellular components, neural mechanisms, and immunological processes. Disruption of one or multiple factors can precipitate a cascade of reactions on the ocular surface, leading to ocular surface diseases and consequently affecting an individual's quality of life. In recent years, more researches have focused on the relationship between cellular energy metabolism and the occurrence, development, as well as treatment of a wide range of diseases. To treat such diseases, correcting the abnormality of cellular energy metabolism is an important idea. Deproteinized calf blood extract ophthalmic preparation has been discovered and applied over sixty years, demonstrating excellent tissue repairment and safety. As a classic energy supplement, deproteinized calf blood extract ophthalmic preparation process with specific technique involving deproteinized calf blood extract as its main active ingredient and showing significant effects in the treatment of various ocular surface diseases such as corneal injuries, dry eye syndrome, and ocular burns. This article summarized the preparation process, mechanism of action, safety, and clinical applications of deproteinized calf blood extract ophthalmic preparation. It aims to systematically organize the clinical utility of deproteinized calf blood extract ophthalmic preparation and provide scientific evidence and reference value for future research and practical applications in the treatment of ocular surface diseases.
教学专栏

眼科住院医师规范化培训前医师职业认同感调查

A survey on professional identity of ophthalmology residents before standardized resident training

:394-401
 

目的:了解目前眼科住院医师规范化培训前职业认同感现状,并探讨相关影响因素。方法:于2024年7—8月,通过问卷调查法调查64名临床医学眼科住培医师,了解其住院医师规范化培训前的职业认同感现状和影响因素,同时探讨规范化培训对于其职业认同感的影响及作用,通过描述性分析、t检验、单因素方差分析、Pearson相关性分析、多元线性回归分析等方法对相关数据进行分析。结果:规范化培训前,职业认同感评分、职业认知、职业情感、职业承诺、职业行为、职业期望、职业价值观等评分分别为(143.16±12.25)(3.60 ± 0.94)(3.98 ± 0.71)(3.61 ± 1.01)(3.89 ± 0.653.84 ± 0.78)(3.71 ± 0.86)分。规范化培训后,眼科住培医师职业期望评分略有降低,与规范化培训前比较差异有统计学意义 (均P  < 0.01), 其他职业认同度部分条目评分在规范化培训前后比较差异无统计学意义(均P > 0.05)。女生对于眼科医学的职业情感(P = 0.01)及职业价值观高于男生(P = 0.03)。本科时担任学生干部的眼科住培医师职业情感高于非学生干部的学生(P < 0.01)。第一选择为眼科的眼科住培医师的医学职业期望(P  < 0.01)和职业价值观更高((P = 0.02)。而学历、临床医学志愿选择与职业认同感差异均统计学意义(均P > 0.05)。此外,规范化培训一定程度增强了眼科住培医师的显微操作能力和职业信心。结论:住院医师规范化培训前眼科住培医师的职业认同感较高,但仍有待进一步提高。眼科住培医师的职业认同感与职业看法、培训内容、教学资源等因素密切相关。

Objective: To investigate the current status of professional identity among ophthalmology residents before standardized resident training and to explore the influencing factors. Methods: A survey was conducted from July to August 2024 involving 64 clinical ophthalmology residents. The survey assessed their professional identity before standardized resident training and examined the impact and role of pre-residency training on their professional identity. Descriptive analysis, t-tests, univariate analysis, Pearson correlation analysis, and multiple linear regression were used to analyze the data. Results: Before pre-residency training, the scores for overall professional identity, professional cognition, professional emotion, professional commitment, professional behavior, professional expectations, and professional values were (143.16 ± 12.25), (3.60 ± 0.94), (3.98 ± 0.71), (3.61 ± 1.01), (3.89 ± 0.65), (3.84 ± 0.78), and (3.71 ± 0.86), respectively. However, after pre-residency training, the score for professional expectations among ophthalmology residents decreased slightly (P < 0.01), while no significant statistical differences were observed in other items related to professional identity (all P > 0.05). Female residents had higher scores in professional emotion (P = 0.01) and professional values (P = 0.03) than male residents. Ophthalmology residents who had served as student leaders during undergraduate studies had higher scores in professional emotion (P < 0.01). Residents who chose ophthalmology as their first preference had higher scores in professional expectations (P  < 0.01) and professional values (P = 0.02). However, no significant differences were found among educational levels, clinical medicine preferencesand professional identity. In addition, pre-residency training enhanced the residents micro-surgical skills and professional confidence. Conclusions: The professional identity of clinical ophthalmology medical students before standardized resident training is relatively high but still needs improvement. Professional identity is closely related to factors such as professional views, training content, and teaching resources.

综述

脉络膜在近视发展中的调控作用及其机制

The regulatory role and mechanism of choroid in the development of myopia

:657-665
 
近年来,随着现代社会生活节奏的加快以及电子产品的普及,近视逐渐呈现低龄化、高发病率的趋势,成为不容忽视的公共卫生问题。动物和人类研究均发现,在近视的发展过程中,脉络膜表现出变薄的现象,并伴有血流量减少,这些变化与近视度数增加和眼轴增长呈正相关。研究表明,脉络膜厚度的变化不仅发生在近视初期,而是在近视进展阶段持续发生。此外,脉络膜血流量的调节也与近视的发生和发展密切相关,可能通过神经机制及生长因子的作用影响眼球的生长。光学相干断层扫描血管成像(optical coherence tomography angiography, OCTA)技术在探索近视进程中的脉络膜变化和血管功能方面展现了巨大的潜力。它能够提供无创性的脉络膜结构和血流信息,对于理解脉络膜在近视调控中的作用至关重要。未来的研究应当结合先进的OCTA技术,进一步探讨脉络膜在不同阶段近视中的具体变化及其背后的机制,特别是脉络膜血流调节与眼球生长之间的关系。深化对脉络膜在近视调控中作用的理解,将有助于开发有效的预防和控制措施,为近视防控策略提供理论依据。
In recent years, with the acceleration of the pace of life in modern society and the popularization of electronic products, myopia has gradually affected younger individuals and has a higher incidence rate, becoming a public health problem that cannot be ignored. Both animal and human studies have found that during the development of myopia, the choroid exhibits thinning and is accompanied by reduced blood perfusion. These changes are positively correlated with increased myopia and axial growth. Studies have shown that changes in choroidal thickness not only occur in the early stages of myopia, but also continue to occur in the progression stage of myopia. In addition, the regulation of choroidal blood flow is also closely related to the occurrence and development of myopia, which may affect the growth of the eyeball through the action of neural mechanisms and growth factors. Optical coherence tomography angiography (OCTA) technology has shown great potential in exploring choroidal changes and vascular function in the progression of myopia. It can provide non-invasive information on choroidal structure and blood flow, which is crucial for understanding the role of the choroid in the regulation of myopia. Future research should combine advanced OCTA technology to further explore the specific changes in the choroid in different stages of myopia and the underlying mechanisms, especially the relationship between choroidal blood flow regulation and eyeball growth. A better understanding of the role of choroid in myopia regulation will aid in developing effective prevention and control measures, providing a solid theoretical foundation for myopia prevention strategies.
综述

眼组学在神经退行性疾病中的研究进展

Research progress of oculomics in neurodegenerative diseases

:578-585
 

神经退行性疾病会损害大脑和神经系统的结构和功能,导致认知和行为能力逐渐下降,因此,早期诊断神经系统疾病可以促进预防、监测和治疗,从而改善患者的预后。眼与脑在结构和胚胎学上的相似之处为评估中枢神经系统的神经和微血管变化提供了潜在可能。眼组学是眼科学、遗传学和生物信息学的交叉学科,目标是开发快速、无创、具有成本效益的生物标志物,用于全身性疾病的筛查、诊断和风险分层。随着诊断和眼科成像技术的进步,用于检测眼的结构、功能和视觉变化的各项技术得到了快速发展。眼部生物标志物成为评估神经退行性疾病进展有前景的工具。文章采用眼部影像学例如光学相干断层扫描(optical coherence tomography, OCT)和OCT 血管成像 (OCT angiography, OCTA)和电生理学例如视觉诱发电位(visual evoked cortical potentials, VEP)、视网膜电图(electroretinogram, ERG)等筛查方法检测眼部异常神经退行性疾病,总结了眼组学在神经退行性疾病的应用,包括阿尔茨海默病、帕金森病、额颞叶痴呆、肌萎缩侧索硬化症和亨廷顿病,旨在为神经退行性疾病的诊断和治疗提供新的思路。尽管并非所有生物标志物都是疾病特异性的,但未来大数据、人工智能和眼组学的融合,有可能进一步深入了解这些神经退行性疾病。

Neurodegenerative diseases can damage the structure and function of the brain and nervous system, leading to a gradual decline in cognitive and behavioral abilities. Therefore, early diagnosis of neurological diseases can promote prevention, monitoring, and treatment, thereby improving the prognosis of patients. The structural and embryological similarities between the eyes and the brain provide potential for evaluating neurological and microvascular changes in the central nervous system. oculomics is an interdisciplinary field that combines ophthalmology, genetics, and bioinformatics, with the goal of developing rapid, non-invasive, and cost-effective biomarkers for screening, diagnosis, and risk stratification of systemic diseases. With the advancement of diagnostic and ophthalmic imaging technologies, various techniques for detecting the structure, function, and visual changes of the eye have been rapidly developed. Eye biomarkers have become promising tools for assessing the progression of neurodegenerative diseases. The article uses screening methods such as eye imaging (such as OCT, OCTA) and electrophysiology (such as VEP, ERG) to detect abnormal neurodegenerative diseases in the eyes. It summarizes the application of oculomics in neurodegenerative diseases, including Alzheimer's disease, Parkinson's disease, frontotemporal dementia, amyotrophic lateral sclerosis, and Huntington's disease, aiming to provide new ideas for the diagnosis and treatment of neurodegenerative diseases. Although not all biomarkers are disease-specific, the integration of big data, artificial intelligence, and oculomics in the future may further deepen our understanding of these neurodegenerative diseases.
论著

基于钉钉平台的全面质量管理模式在眼科教学中的应用

Application of a total quality management model based on the DingTalk platform in ophthalmology education

:527-532
 
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(=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,=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 vs5(4,5)分,=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 (=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 =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, =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.
综述

红光疗法在眼科疾病中的应用研究进展

Research progress of red-light therapy in the treatment of ocular diseases

:471-480
 
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.
综述

儿童Ⅱ期人工晶状体植入术后青光眼相关不良事件影响因素与预测的研究进展

Research progress on associated factors and prediction of glaucoma-related adverse events following secondary intraocular lens implantation in pediatric eyes

:416-423
 
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.

综述

正常眼的脉络膜血管系统研究进展

Research progress on choroidal vascular system in healthy eyes

:365-373
 
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.
其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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