随着科学技术的提高、手术方式的改进，角膜屈光手术成为治疗近视的主要方式。角膜屈光手术后角膜形态及生物力学的变化对于尽早发现术后相关并发症及术后长期稳定性具有重要意义，不同的术式及术后不同的恢复阶段角膜表面非球面参数及生物力学指标的变化存在一定差异，明确其变化的原因及机制可对临床研究提供一定的参考。
With the improvement of science and technology and the improvement of surgical methods, corneal refractive surgery has become the main way to treat myopia. The changes of corneal morphology and biomechanics after corneal refractive surgery are of great significance for early detection of postoperative complications and also affect the long-term stability after corneal refractive surgery. There are some differences in the changes of aspheric parameters and biomechanical properties in different surgical procedures and different postoperative recovery stages. Clarifying the reasons and mechanisms of these changes can provide some reference for clinical research.
纳入126名中山大学临床医学五年制4年级学生，对其接受为期1周的直接检眼镜见习教学后，进行问卷调查，了解学生对直接检眼镜学教学的看法以及学习过程中的操作难点。结果显示大部分学生认为直接检眼镜对临床工作有重要作用。但学生普遍反映学习过程难度大，师生视野无法共享，进而阻碍了师生直接的教学沟通。多数学生愿意接受更进一步的直接检眼镜教学。
A total of 126 senior of 5-year clinical medicine students in Sun Yat-sen University were recruited. After 1-week internship and direct ophthalmoscope training, a questionnaire survey was conducted to scrutinize students’ feedback about the training methods and learning difficulties during the internship. The results showed that most students thought that the direct ophthalmoscope played an important role in clinical work. However, students generally felt complicated and hard during the learning process due to the communication obstacle between teachers and students caused by the unavailability of vision sharing. In spite of this, most students are still willing to accept further direct ophthalmoscopy training.
患者因“左眼视物模糊2 0余年”就诊，2 0余年前曾行左眼小梁切除术，视力：右眼(oculus dexter，OD)无光感(no light perception，NLP)，左眼(oculus sinister，OS)光感(light perception，LP)光定位准确，右眼巩膜葡萄肿(鼻上)，前房浅约1/4 CT，瞳孔固定散大，晶状体脱位于玻璃体腔，左眼结膜上方滤过泡扁平，前房浅，约1/4 CT，虹膜层状分离漂浮于前房，上方虹膜切口引流通畅，C/D：0.4。眼压(intraocular pressure，IOP)示：右眼13.0 mmHg，左眼16.0 mmHg。超声生物显微(ultrasound biomicroscopy，UBM)示：右眼各象限前房角狭窄，晶体脱位；左眼前房浅，颞侧前房角狭窄，其余象限关闭，虹膜层状分离。B超示：右眼晶体脱离。诊断：左眼虹膜劈裂；右眼晶体脱位。
The patient was treated with ‘left eye blurred vision for more than 20 years’. The patient underwent left trabeculectomy more than 20 years ago. Visual acuity oculus dexter (OD): no light perception (NLP), oculus sinister (OS): light perception (LP), and light positioning was accurate, right eye scleral staphyloma (nose), the anterior chamber was approximately 1/4 CT, the pupil was fixed and scattered, the lens was displaced into the vitreous cavity, and the left eye conjunctiva was filtered. The blister was flat, the anterior chamber was shallow, about 1/4 CT, and the iris layer was separated and floated in the anterior chamber. The upper iris incision led to smooth flow, C/D: 0.4. Intraocular pressure (IOP): R 13.0 mmHg, L 16.0 mmHg. Ultrasound biomicroscopy (UBM): in the right eye, anterior chamber angle was narrow in each quadrant, dislocation of the lens; anterior chamber of the left eye was shallow, anterior chamber angle of the temporal stenosis was narrow, the remaining quadrants were closed, iris lamellar separated. B-ultrasound: the right eye lens was displaced into the vitreous cavity. Diagnosis: left eye Iridoshcisis; right eye lens dislocation.
临床上内源性真菌性眼内炎比较少见，其早期临床表现因类似于葡萄膜炎等常见眼病常常被误诊。武汉爱尔眼科医院汉口医院收治了1例49岁女性患者，首诊为葡萄膜炎，后前房穿刺送检确诊为内源性念珠菌性眼内炎。
Endogenous fungal endophthalmitis is easy to be misdiagnosed because it is quite rare and early clinical features resembling uveitis. A 48-year-old female patient was admitted to Wuhan Aier Eye Hospital Hankou Hospital, her first diagnosis was uveitis, and the posterior anterior chamber puncture was confirmed as endogenous Candida endophthalmitis.
目的：观察后房型有晶体眼人工晶体(implantable collamer lens，ICL)V4c植入术后2年的有效性、安全性和稳定性，评估ICL V4c矫正屈光不正的中远期临床疗效。方法：回顾性病例研究。收集在河北省沧州市中心医院眼一科行ICL V4c手术治疗的屈光不正患者，观察并记录术前至术后2年的裸眼视力、最佳矫正视力、屈光状态、对比敏感度、高阶像差、眼压、人工晶体拱高、角膜内皮细胞计数、不良反应、主观视觉质量等临床资料，进行统计学分析。结果：完成随访的96例术眼，术后2年的平均裸眼视力(LogMAR)为0.021±0.065，平均最佳矫正视力(LogMAR)为0.002±0.041，优于术前最佳矫正视力，有效性指数为1.05，安全性指数为1.09，等效球镜数值稳定，对比敏感度提升，高阶像差有所增加，但主观视觉质量良好，眼压基本稳定，内皮细胞丢失率为1.6%，平均拱高为(549.6±50.0) μm，随访期间未发现眼内感染、继发性青光眼、晶状体混浊、黄斑水肿、视网膜脱离等并发症。结论：ICL V4c植入术矫正屈光不正具有良好的中远期临床效果。
Abstract Objective: To assess the medium-long term efficacy, safety and stability of a newly developed posterior chamber phakic intraocular lens (model V4c Visian Implantable Collamer Lens) to correct refractive errors. Methods: Retrospective case series. This study evaluated eyes that had implantation of ICL V4c to correct ametropia for at least two years. Uncorrected and corrected distance visual acuities, refraction, contrast sensitivity, high-order aberration, quality of life, intraocular pressure, endothelial cell density, pIOL vault, and adverse events were evaluated to assess the efficacy, safety and stability of V4c. Results: The study comprised 96 eyes of 50 patients. At 2 years postoperatively, the mean uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were 0.021±0.065 logMAR and 0.002±0.041 logMAR, which were better than preoperative CDVA. The efficacy and safety indices were 1.05 and 1.09, respectively. The spherical equivalent was stable withimproved contrast sensitivity and increased high-order aberrations, but the subjective visual quality was well. The IOP remained stable over time. The mean vault was (549.6±50.0) μm and the mean endothelial cell loss was 1.6%. No eye developed intraocular infection, secondary glaucoma, lens opacity, macular edema or retinal detachment. Conclusion: The good medium-long term outcomes support the use of ICL V4c for the correction of myopia.
幽门螺杆菌(Helicobacter pylori，H P)感染是中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy，CSC)的一个危险因素，但是在HP感染和CSC相关性的研究仍存在争议，目前有两种观点：一是认为HP感染可能是CSC的一个危险因素，二是认为两者之间并没有相关性。本文将就对HP感染是否为CSC危险因素文献进行综述，同时探讨其发病机制。
Helicobacter pylori (HP) infection is a risk factor for central serous chorioretinopathy (CSC). But the existing studies tend to support two distinctively different trends regarding the link between HP infection and CSC. The first group tend to support that: HP infection may be a risk of CSC, and the second tend to claim to no correlation between the two. This paper will review the literature on whether HP infection is a risk factor for CSC and discuss its pathogenesis.
糖尿病视网膜病变(diabetic retinopathy，DR)在糖尿病肾病(diabetic nephropathy，DN)人群，特别是终末期糖尿病肾病(end stage diabetic nephropathy，ESRD)患者中的发病率和严重程度明显高于糖尿病人群。其中ESRD的一项重要治疗手段——血液透析(Hemodialysis，HD)可能会增加机体氧化应激反应、出血风险以及视神经的缺血缺氧，加重DR的发生发展；但另一方面也可通过清除尿毒症毒素、控制血压以及清除多余体液等途径改善糖尿病和DN对眼部的损伤。
The incidence and severity of diabetic retinopathy (DR) in patients with diabetic nephropathy (DN), especially those with end-stage renal disease (ESRD), were higher than those with diabetes. Hemodialysis (HD), an important treatment of ESRD, may aggravate DR by increasing the oxidative stress, fundus hemorrhage and hypoxia of the optic nerve. On the other hand, HD can improve the ocular damage caused by diabetes mellitus and DN by removing uremia toxin, controlling blood pressure and removing excess body fluid.
随着亚太眼科学会(Asia-Pacific Academy of Ophthalmology，APAO)永久会址和秘书处落户在中山大学中山眼科中心珠江新城院区眼科学国家重点实验室大楼(中国广州)，在大数据时代背景下，建设先进的亚太级眼科学科学数据中心已成为亚太眼科创新战略发展的需要。通过建设科学数据中心，一方面缓解眼科学国家重点实验室项目科研数据增长压力，一方面为眼科大数据与人工智能等新兴科研项目开展提供保障平台，为亚太眼科学科建设打下坚实的数据基础。科学数据中心设计建设遵照国家《科学数据管理办法》实施，以加强和规范科学数据管理，保障科学数据安全，提高开放共享水平，更好支撑国家科技创新、经济社会发展和符合国家信息安全建设方针。
As the Asia-Pacific Academy of Ophthalmology (APAO) secretariat permanently located in the building of State Key Laboratory of Ophthalmology (Guangzhou, China). In big data time, it’s a problem for the development of the Asia-pacific ophthalmology innovation strategy to construct the Asia-pacific science data center of ophthalmology. Through the construction of science data center, alleviate the pressure of the state key laboratory of ophthalmology data growth, for big data and new research fields such as artificial intelligence to provide guarantee, provided a basis for the Asia-pacific eye subject construction. Science data center construction in accordance with national “scientific data management method”, to strengthen and standardize the scientific data management, to ensure the safety of scientific data, improve the level of open sharing, better support scientific and technological innovation, economic and social development and national security as a policy.
目的：以光学相干断层扫描血管成像(optical coherence tomography angiography，OCTA)观察视网膜分支静脉阻塞(branch retinal vein occlusion，BRVO)抗血管内皮生长因子(vascular endothelial growth factor，VEGF)治疗前后的变化。方法：回顾性收集从2017年1月至2018年1 2月在汕头国际眼科中心的确诊为BRVO合并黄斑水肿的患者共3 1例3 2眼。患眼行玻璃体腔注射抗VEGF药物治疗，记录治疗前和治疗后1个月的最佳矫正视力(best corrected visual acuity，BCVA)，OCTA检查视网膜黄斑中心凹厚度(foveal macular thickness，FMT)、黄斑区血流密度。比较治疗前后各指标的变化。结果：治疗后BCVA较治疗前显著提高，差异有统计学意义(P<0.001)；FMT[(242.13±86.02) μm]较治疗前[(521.44±190.27) μm]明显下降，差异有统计学 意义(P<0.001)；中心凹浅层血流密度[(18.44±4.98)%]及中心凹旁浅层血流密度[(44.83±3.19)%]均较治疗前[(25.46±9.21)%，(46.06±5.25)%]相比明显下降，差异有统计学意义(P <0.001)。结论：玻璃体腔注射抗VEGF治疗BRVO合并黄斑水肿效果显著；OCTA能有效评价抗VEGF治疗BRVO合并黄斑水肿的临床疗效。
Objective: To evaluate the efficacy in patients with macular edema due to branch retinal vein occlusion (BRVO) treated with intravitreal anti-VEGF drug. Methods: In this retrospective study, 32 eyes of 31 patients with BRVO combined with macular edema at Joint Shantou international eye center of Shantou University and TheChinese University of Hong Kong during January 2017 to December 2018 were enrolled in this study. All the affected eyes received intravitreal anti-VEGF drug injections. BCVA (best corrective visual acuity) and optical coherence tomography angiography (OCTA) were performed before and one month after intravitreal anti-VEGF drug injections. Foveal macular thickness (FMT), macular blood flow density was measured in all eyes and compared. Results: The BCVA before therapy was (0.77±0.46) LogMAR and increased to (0.46±0.30) LogMAR in one month after therapy, which showed a statistical difference (P<0.001). The FMT, foveal superficial vascular plexus flow density and para foveal superficial vascular plexus flow density before therapy were (521.44±190.27) μm, (21.85±6.17)% and (46.29±2.70)%, respectively. The FMT, foveal superficial vascular plexus flow density and para foveal superficial vascular plexus flow density decreased to (242.13±86.02) μm, (18.40±5.18)% and (44.75±3.40)%, respectively. There was significant statistical difference for them (P<0.001). Conclusion: Intravitreal injection of anti-VEGF is effective in the treatment of BRVO combined with macular edema. OCTA can effectively evaluate the clinical efficacy of anti-VEGF in the treatment of BRVO combined with macular edema.
目的：观察健康中老年人群中心凹视觉敏感度阈值(foveal threshold，FT)及光相干断层扫描血管成像(optical coherence tomography angiography，OCTA)的双眼对称性。方法：横断面观察性研究。纳入33例66眼，测量并比较眼灌注压(ocular perfusion pressure，OPP)，FT，黄斑区3 mm × 3 mm范围内中心凹无血管区面积(non-flow area，NFA)，浅层视网膜血管密度(superior vessel density，SVD)和深层视网膜血管密度(deep vessel density，DVD)的双眼对称性；分析各指标双眼差值、均值及其比值与年龄、性别的相关性。结果：配对样本t检验结果显示除FT(t=?2.118，P=0.042)外，左右眼OPP，NFA，SVD和DVD差异均无统计学意义(P>0.05)；Pearson相关性分析和同类相关系数(intra-class correlation coefficient，ICC)检验结果显示5项指标左右眼测量值相关强度由强到弱为OPP>FT>NFA>DVD>SVD；Bland-Altman分析结果提示5项指标双眼间一致性良好。5项指标的双眼对称性不随性别、年龄改变。结论：健康中老年人群FT、黄斑区NFA，SVD及DVD的测量值具有双眼对称性。
Objective: To observe the interocular symmetry of foveal threshold (FT) and optical coherence tomography angiography (OCTA) parameters in healthy middle-aged and elderly subjects. Methods: Cross-sectional observational study. Sixty-six eyes from thirty-three subjects were enrolled to compare binocular ocular perfusion pressure (OPP), FT, non-flow area (NFA), superior vessel density (SVD) and deep vessel density (DVD) in a 3 mm × 3 mm OCTA scan of macula. The interocular symmetry of all the parameters was analyzed; the correlations of the differences (△), mean value (m) and the ratio of all the parameters with age and gender were analyzed. Results: There was no significant interocular difference revealed by paired-samples t-tests in all the parameters (P>0.05) except FT (t=?2.118, P=0.042), while the rank of Pearson’s correlation index and intraclass correlation coefficient (ICC) from strong to weak was OPP > FT > NFA > DVD > SVD. The interocular symmetry of all the parameters was proved to be good with Bland-Altman plots, and it changed little with the variations of age and gender. Conclusion: Interocular symmetries of FT and OCTA parameters are observed in healthy middle-aged and elderly subjects.
