当下，我国眼科的发展存在失衡现象，大城市与农村及偏远地区在眼科相关诊疗设施水平、诊疗技术等方面存在巨大差异，仍需探寻新的智能诊疗模式以解决失衡问题。由于眼球是唯一可以直接观察人体血管和神经的器官，眼部可反映其他脏器的健康状态，部分眼科检查的医学图像可对眼部疾病做出诊断等特点，眼科开展人工智能(artificial intelligence，AI)具有独到的优势。此外，人工智能可在一定程度上提高跨时间空间传递信息的精准度及效率。人工智能在眼科及远程信息传递的优势为解决眼科发展失衡状况提供了助力。本文从眼科人工智能在眼科远程医疗相关应用的角度，主要分析并总结当下我国人工智能在眼科相关疾病远程医疗中的发展程度、所具优势以及存在问题，并讨论眼科人工智能在远程医疗的应用展望。

At present, there is an imbalance in the development of ophthalmology in China. There are huge differences in the level of ophthalmology related facilities, diagnosis and treatment technologies between big cities and rural, remote areas. New intelligent diagnosis and treatment models are still needed to solve the imbalance. Since the eye is the only organ that can directly observe the blood vessels and nerves of the human body, the eye can reflect the health status of other organs and diagnosis of eye diseases based on medical images of some ophthalmic examinations can be made as well as other characteristics. Therefore, the development of artificial intelligence in ophthalmology has unique advantages. In addition, artificial intelligence can improve the accuracy and efficiency of information transmission across time and space to a certain extent. The advantages of artificial intelligence in ophthalmology and telematics are helping to solve the imbalance in ophthalmology development. From the perspective of the application of ophthalmic artificial intelligence in telemedicine, this paper mainly analyzes and summarizes the development degree, advantages and existing problems of artificial intelligence in the telemedicine of ophthalmic diseases in China, and discusses the prospect of the application of ophthalmic artificial intelligence in telemedicine.

帕金森病(Parkinson’s disease，PD)是老年人常见的神经系统退行性疾病，眼部及视觉功能障碍是PD常见的非运动症状之一，进一步影响其生活质量。已有研究表明PD患者视网膜内存在多巴胺浓度的减少以及α突触核蛋白的沉积。目前，PD仍缺乏有效的早期诊断及病情评估工具，光学相干断层扫描及光学相干断层扫描血管成像技术可以显示视网膜各层微细结构及微血管的异常，应用该技术研究者发现PD患者视乳头旁视网膜神经纤维层及黄斑区视网膜的厚度均存在不同程度的变薄，视网膜浅层及深层毛细血管丛的毛细血管密度和复杂性下降。进一步研究者应用该技术在PD临床应用中进行了探索，并发现其可用于检测早期PD中发生的病理变化，反映疾病的病程及严重程度，并且在鉴别诊断中起到一定的作用。总而言之，视网膜相关检测可能成为评估PD患者脑病理严重程度的指标，并且帮助疾病诊断和监测疾病的进展，不过这仍需要大样本、多中心的重复研究以提供更多理论依据。

Parkinson’s disease is a common neurodegenerative disease in the elderly, and ocular and visual dysfunction is one of the common non-motor symptoms of PD, further affecting PD patients’quality of life. Reduced dopamine concentrations and deposition of α-synuclein in the retina of PD patients have been shown in studies. At present, there is still a lack of effective tools for early diagnosis and assessment of PD. Optical coherence tomography and optical coherence tomography angiography can reveal abnormalities in the microstructure and microvasculature of the retinal layers, and researchers applying these techniques have found that the thickness of the parapapillary retinal nerve fiber layer and the retina in the macula in PD patients have had varying degrees of thinning, and the density and complexity of capillaries in the superficial and deep capillary plexus of the retina have been reduced. Further, investigators have explored the clinical application of these techniques in PD and have found that they can be used to detect pathological changes occurring in early PD, reflect the course and severity of the disease, and play a role in differential diagnosis. In conclusion, retinal-correlated testing may be an indicator to assess the severity of brain pathology in PD patients and to aid in disease diagnosis and monitoring the progression of PD, although large sample, multicenter replication studies are still needed to provide more reliable results.

目的：评估基于微信平台的延续护理对超脉冲CO₂激光治疗眼睑肿物患者心理状态、满意度及并发症的影响。方法：采用回顾性历史对照研究设计，纳入2018年6月—2023年6月于中山大学中山眼科中心接受超脉冲CO₂激光治疗的眼睑肿物患者100例，根据患者是否接受延续护理分为接受延续护理组50例和未接受延续护理组50例。采用焦虑自评量表（Self-Rating Anxiety Scale, SAS）和抑郁自评量表（Self-Rating Depression Scale, SDS）评估护理干预前后患者心理状态，评估两组患者的心理状态、护理满意度及并发症发生率。结果：接受延续护理组男性12例（24.0%），女性38例（76.0%），平均年龄为（37.9±20.0）岁；未接受延续护理组男性19例（38.0%），女性31例（62.0%），平均年龄为（36.9±20.4）岁。两组患者在年龄、性别及肿物特征等方面与基线资料比较差异均无统计学意义（P>0.05）。心理状态评分中，接受延续护理组SAS和SDS评分平均下降（23.38±4.94）分和（21.98±5.38）分，而未接受延续护理组平均上升（15.58±5.16）分和（3.78±5.45）分，SAS评分两组间差异为38.96（95%CI：41.14~36.78）分，SDS两组间差异为25.76（95%CI：27.58~23.94）分，差异均有统计学意义（P<0.001；P=0.025）。未接受延续护理组在担忧创面愈合过程、担忧瘢痕形成、担忧影响外观等的发生率均高于接受延续护理组（P<0.001）。接受延续护理组总满意度为100.0%，高于未接受延续护理组88.0%（P=0.006）。两组治疗有效率均为100%，治愈率分别为92%和90%，差异无统计学意义（P=0.749）。接受延续护理组并发症总发生率为34.0%，低于未接受延续护理组的48.0%（P=0.043）。结论：基于微信平台的延续护理有助于改善超脉冲CO₂激光治疗眼睑肿物患者的焦虑抑郁情绪，降低并发症发生率，提高患者满意度，促进医患和谐。

Objective: To evaluate the effects of WeChat-based continuity of care on psychological status, treatment outcomes, and complications in patients with eyelid tumors treated with ultrapulse CO₂ laser. Methods: A retrospective historical control study was conducted, including 100 patients with eyelid tumors who underwent ultrapulse CO₂ laser treatment at Zhongshan Ophthalmic Center, Sun Yat-sen University from June 2018 to June 2023. Patients were divided into continuity of care group (n=50) and non-continuity of care group (n=50) based on whether they received continuity of care. The Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) were used to assess patients' psychological status before and after nursing intervention. Psychological status, nursing satisfaction, and complications were compared between the two groups. Results: The continuity of care group included 12 males (24.0%) and 38 females (76.0%) with a mean age of (37.9±20.0) years; the non-continuity of care group included 19 males (38.0%) and 31 females (62.0%) with a mean age of (36.9±20.4) years. No significant differences were found in baseline characteristics including age, gender, and tumor features between the two groups (P>0.05). For psychological status scores, the continuity of care group showed mean decreases in SAS and SDS scores of (23.38±4.94) points and (21.98±5.38) points respectively, while the non-continuity of care group showed mean increases of (15.58±5.16) points and (3.78±5.45) points respectively. The between-group differences were 38.96 points (95%CI: 36.78-41.14) for SAS scores and 25.76 points (95%CI: 23.94, 27.58) for SDS scores, both statistically significant (P<0.001; P=0.025). The non-continuity of care group had significantly higher rates of concerns about wound healing process, scar formation, and appearance impact compared to the continuity of care group (all P<0.001). The total satisfaction rate was 100.0% in the continuity of care group, significantly higher than 88.0% in the non-continuity of care group (P=0.006). Both groups achieved 100% treatment effectiveness, with cure rates of 92% and 90% respectively, showing no statistical difference (P=0.749). The total complication rate in the continuity of care group was 34.0%, significantly lower than 48.0% in the non-continuity of care group (P=0.043). Conclusions: WeChat platform-based continuity of care can significantly improve anxiety and depression in patients with eyelid tumors treated with ultrapulse CO₂ laser, reduce complication rates, enhance patient satisfaction, and promote harmonious doctor-patient relationships, demonstrating important clinical application value.

抗菌药物临床应用的分级管理是抗菌药物管理的核心策略。眼局部应用抗菌药物是感染性眼病最常用的治疗方式，但目前尚未有针对眼局部应用的抗菌药物分级管理规定。为规范眼局部抗菌药物的管理，进一步落实抗菌药物临床应用分级管理制度，促进抗菌药物临床合理使用，有效遏制细菌耐药，保障医疗质量和医疗安全，广东省药学会眼科药学专家委员会组织相关专家以各省抗菌药物分级管理规定为基础，经过认真讨论建立本共识，将眼科应用的眼局部抗菌药物进行分级管理，供相关医疗机构参考。

The graded management of antibacterial drugs is a core strategy within the framework of Antibacterial stewardship. The topical ocular application of antibacterial drugs represents the most prevalent treatment approach for infectious eye diseases. However, at present, there are no specific regulations governing the graded management of antibacterial drugs administered via topical ocular routes. To standardize the management of topical ocular antibacterial drugs, further enforce the graded management system for the clinical use of antibacterial drugs, encourage the rational clinical application of these drugs, effectively curb bacterial resistance, and ensure both medical quality and safety, the Ophthalmology Pharmacy Expert Committee of the Guangdong Provincial Pharmacists Association Pharmaceutical Association organized relevant experts to establish this consensus based on existing provincial regulations for the graded management of antibacterial drugs after rigorous discussions. This consensus sets forth a standard graded management framework for topical ocular antibacterial drugs in ophthalmology.

角膜基质透镜是带有一定屈光度的角膜组织，为利用激光或板层刀等在角膜基质层内雕刻出一个精确对焦点的光学透镜。随着角膜屈光手术的不断发展，术中产生了大量的角膜基质透镜, 越来越多的学者也将目光聚焦于此。我国角膜供体来源匮乏与手术量需求严重不匹配, 眼库严重缺乏供体角膜，而对角膜组织的需求却越来越大。角膜穿孔作为角膜疾病的终末阶段，严重威胁患者的视力,甚至要面临摘除眼球的风险, 是对患者身体与心理的双重打击。绝大多数的角膜穿孔需要紧急手术处理, 对于一些常规治疗无效或角膜病变更严重的，角膜移植术可能是唯一有效的手段。对原本废弃的透镜重新利用, 将其用于治疗角膜溃疡、修补角膜穿孔以及辅助治疗各类角膜疾病的危重阶段, 均观察到其取得了良好的效果, 这在一定程度上缓解了临床上角膜供体缺乏的现状。本文报道了2例由角膜白斑引起的角膜穿孔患者使用异体角膜基质透镜移植治疗的病例, 术后2例患者病情均得到稳定。同时探讨了角膜基质透镜移植的局限性, 本文并未观察到角膜透镜移植对于感染性、免疫性等其他原因造成的角膜穿孔的疗效, 因此在行角膜移植之前，要正确认识及处理原发病，尽量避免并发症和排斥反应的发生。

Corneal stromal lenses are corneal tissues with specific refractive power, created by precisely sculpting an optical lens within the corneal stromal layer using lasers or microkeratomes. With the ongoing development of corneal refractive surgery, a large amount of corneal stromal lenses are generated during procedures, drawing increasing attention from researchers. In China, there exists a severe mismatch between the scarcity of corneal donors and the high demand for surgical procedures. This has led to a critical shortage of donor corneas in eye banks, while the need for corneal tissue keeps rising. Corneal perforation, which is the end-stage of various corneal diseases, poses a significant threat to patients' vision and may even result in enucleation, causing considerable physical and psychological distress. Most cases of corneal perforation require urgent surgical intervention. For patients with severe conditions or those for whom conventional treatments are ineffective, corneal transplantation may be the only viable option. Reusing stromal lenses that were previously discarded to treat corneal ulcers, repair corneal perforations, and assist in managing critical stages of various corneal diseases has shown promising results. This, to some extent, helps alleviate the clinical shortage of donor corneas. This article presents two cases of corneal perforation caused by corneal leukoma, both of which were successfully treated with allogeneic corneal stromal lens transplantation. Both patients achieved stable conditions after the operation. Additionally, this paper discusses the limitations of corneal stromal lens transplantation. The efficacy of corneal lens transplantation for perforations caused by infectious or immunological etiologies was not observed in this study. Therefore, it is essential to accurately diagnose and manage the underlying disease before transplantation and to minimize the occurrence of complications and rejection reactions.

近视已成为全球性流行病，预计到2050年全球将有近半数人群发生近视，已成为全球性重大功能卫生问题。近视不仅影响视力，还增加黄斑病变、青光眼等致盲性疾病的风险。近视的发病机制尚未完全明确，但与环境、遗传因素及昼夜节律紊乱密切相关。昼夜节律通过调节光照、多巴胺代谢和视网膜信号传导等机制影响近视的发生和发展。光照是调节昼夜节律的关键，户外活动时的高光照强度能有效刺激多巴胺分泌，抑制眼轴增长，减少近视发生，而异常光照模式（如夜间光暴露）则会干扰此过程。其次，睡眠不足与儿童近视患病率呈负相关，眼部关键参数（如眼轴长度、玻璃体腔深度等）均呈现显著的昼夜节律性波动。多巴胺作为视网膜中的重要神经递质，受生物钟基因调控，具有抑制眼轴生长的作用。视网膜中的生物钟基因和光敏色素也参与调节眼球生长，自主神经系统则通过调节脉络膜厚度与血流灌注参与眼球生长调控。动物实验和临床研究表明，昼夜节律紊乱会导致眼轴增长和近视进展。未来研究应进一步探讨昼夜节律与近视的因果关系、多巴胺代谢的调控机制以及生物钟基因的功能，以制定有效的近视防控策略。

Myopia has become a global epidemic,with projections indicating that nearly half of the world’s population will be affected by myopia by 2050, positioning it has a significant global functional health concern.Beyond merely impairing vision, myopia also heightens the risk of blinding diseases such as macular degeneration and glaucoma. Although the pathogenesis of myopia is not yet fully elucidated, it is strongly associated with environmental factors, genetic predispositions, and circadian rhythm disruptions. The circadian rhythm plays a pivotal role in the onset and progression of myopia by governing mechanism such as light exposure, dopamine metabolism, and retinal signaling. Light serves as a crucial regulator of the circadian rhythm. Specifically, high light intensity during outdoor activities can effectively stimulate dopamine secretion, thereby inhibiting axial elongation and reducing the incidence of myopia. Conversely, abnormal light patterns, such as exposure to light at night, can disrupt this regulatory process. Moreover, insufficient sleep has been found to be negatively correlated with the incidence of myopia in children. Additionally, key ocular parameters, including axial length and vitreous cavity depth, exhibit pronounced diurnal rhythmic fluctuations. Dopamine,  an important neurotransmitter in the retina, is regulated by circadian clock genes and functions to inhibit axial elongation. Both the circadian clock genes and photosensitive pigments within the retina are involved in regulating eye growth. Meanwhile, the autonomic nervous system contributes to this regulation by modulating choroidal thickness and blood flow perfusion. Animal experiments and clinical studies have consistently demonstrated that disrupted circadian rhythms can lead to axial elongation and the progression of myopia. Future research should delve deeper into the causal relationship between circadian rhythm and myopia, the regulatory mechanisms underlying dopamine metabolism, and the functions of circadian clock genes. Such investigation will pave the way for the development of effective strategies for myopia prevention and control.

散光是儿童视力发育的重要威胁之一，很多情况下其发生与眼表疾病的进展密切相关。非先天性眼表疾病如睑缘炎相关性角结膜病变、春季角结膜炎、干眼、感染性角膜炎和眼外伤等可通过慢性炎症介导的眼表微环境失衡、角膜瘢痕产生、泪膜稳定性破坏及角膜生物力学结构异常重塑等途径，导致角膜表面不规则性的产生和角膜曲率的改变。先天性眼表疾病如圆锥角膜、睑内翻和眼表肿瘤等则可通过遗传或发育异常改变眼睑结构、改变角膜曲率的对称性和机械压迫角膜产生散光，例如遗传疾病圆锥角膜的进行性角膜变薄与发生春季角结膜炎时眼表微环境的炎症性改变可协同作用加剧散光进展。针对不同病因，局部糖皮质激素滴眼液、免疫抑制剂环孢素滴眼液等药物使用和手术治疗均可改善患儿本身的病情和散光情况，只是不同疾病的治疗和散光矫正方案不尽相同。现有研究虽指出了部分儿童眼表疾病与散光的关联，但对于儿童的特异性机制部分如发育过程中免疫系统的变化、角膜可塑性差异及各种因素交互作用效应尚未完全解析。

Astigmatism is a significant threat to children's visual development and is often closely linked to the progression of ocular surface diseases. Non-congenital conditions, such as blepharitis-associated keratoconjunctivitis, vernal keratoconjunctivitis, dry eye, infectious keratitis, and ocular trauma, can induce irregularities on the corneal surface and changes in corneal curvature. This occurs through mechanisms like the ocular surface microenvironment imbalance mediated by chronic inflammation, corneal scarring, tear film instability, and abnormal corneal biomechanical remodeling. Congenital disorders, including keratoconus, entropion, and ocular surface tumors, can also lead to astigmatism. These conditions do so by causing genetic or developmental abnormalities that alter the eyelid structure, disrupt corneal symmetry, or exert mechanical pressure. Notably, there can be synergistic effects between progressive corneal thinning seen in hereditary keratoconus and the inflammatory microenvironment changes associated with vernal keratoconjunctivitis. Therapeutic interventions, such as topical corticosteroids, cyclosporine eye drops, and surgical procedures, can improve both the primary conditions and the astigmatism. However, treatment strategies vary depending on the different etiologies. Current research has established associations between pediatric ocular surface diseases and astigmatism. Nevertheless, the specific developmental mechanisms, including the  maturation of the immune system, differences in corneal plasticity, and the interactive effects of multiple factors, remain incompletely understood.

蠕形螨是人类皮肤上最常见的寄生虫，在眼部主要寄居于毛囊、睑板腺及皮脂腺，可引起眼干、眼痒、异物感明显等眼部症状。目前已证实有2种寄生于人类的蠕形螨：毛囊蠕形螨和皮脂蠕形螨，二者均可诱发各类眼表疾病，如睑缘炎、睑板腺疾病、角膜病、翼状胬肉以及眼红斑痤疮等，但是由于疾病症状相似、检查遗漏以及认知不到位等主客观因素，该病易被误诊、漏诊。蠕形螨具有高度的年龄依赖性，并且可以在无症状的成年人中发现，因此蠕形螨的致病性一直存在争议，现有研究表明，蠕形螨可以通过直接损伤、诱发超敏反应和作为载体携带细菌等方式致病。蠕形螨的感染可以通过有效的手段进行检测，确诊后可通过热敷、眼睑清洁、局部或全身使用除螨药物进行治疗。了解蠕形螨在眼部疾病中的重要性对于准确诊断和适当的管理策略至关重要，近年来对于蠕形螨的研究越来越多，有必要对蠕形螨感染相关眼表疾病的诊断及治疗技术进行更新，因此本文综述了蠕形螨的病原学、流行病学、致病机制、检出方法，探讨了蠕形螨感染与各类眼表疾病之间的联系以及治疗方法，以期为蠕形螨感染相关眼表疾病的研究提供参考。

Demodex mites are the most common parasites found on human skin. They primarily reside in hair follicles, meibomian glands, and sebaceous glands of the eyes, and can trigger eye-related symptoms such as dry eyes, itchy eyes, and a pronounced foreign-body sensation. At present, it has been established that two types of Demodex mites parasitic in humans: Demodex follicle mite and Demodex sebum mite. Both types can induce various ocular surface diseases, including blepharitis, meibomian gland dysfunction, corneal disease, pterygium and ocular rosacea. However, due to subjective and objective factors, such as similar disease symptoms, omission of examination and a lack of awareness, these diseases are easy to misdiagnosis and underdiagnosis. Demodex mites exhibit a highly degree of age-dependence and can be detected in asymptomatic adults. Consequently, the pathogenicity of Demodex mites has been a subject of debate. Existing studies have shown that Demodex mites can cause diseases through direct injury, by inducing hypersensitivity reactions, and by acting as carriers for bacteria. Effective means are available for detecting Demodex mite infections. Treatment options include warm compresses, eyelid cleaning, and the use of topical or systemic anti-mite drugs. Understanding the significance of Demodex mites in ocular diseases is crucial for accurate diagnosis and the formulation of appropriate management strategies. In recent years, there has been a growing body of research on Demodex mite. It is necessary to update the diagnositic and therapeutic techniques  for ocular surface diseases associated with Demodex mite infection. Therefore, this paper reviews the etiology, epidemiology, pathogenic mechanism, and detection methods of Demodex mite. It also discusses the relationship between Demodex mite infection and various ocular surface diseases, as well as the corresponding treatment methods, with the aim of providing a reference for the research on ocular surface diseases related to Demodex mite infections. 

斜视作为眼科的常见疾病之一，多发生于儿童群体。传统的诊疗手段高度依赖医生的个人经验，效率欠佳，患者依从性差，极易延误病情，严重影响患儿视功能及身心发育。近年来，人工智能(artificial intelligence, AI)与虚拟现实(virtual reality, VR)技术作为数字智能技术中的前沿科技手段，已广泛应用于眼科疾病的筛查、诊断和治疗环节，并正推动斜视诊疗体系向智能化转型。AI技术凭借强大的图像识别与分析能力可自动检测斜视类型和角度，更全面地评估病情。同时，通过分析大量数据预测手术参数，辅助制定个性化的手术方案，并且评估手术效果，大幅提升了斜视诊疗的精准度和效率；而VR技术则通过眼动追踪和动态场景模拟，实现更全面的眼位测量和动态分析。在手术中为医生提供清晰全面的眼部视图，借助模拟试验提升操作精准度，降低手术风险。借助沉浸式的视觉训练有效优化了斜视的康复效果。本文系统地回顾了数字智能技术在斜视诊疗方面的创新应用实例，深入探讨了AI和VR在斜视诊疗中独特的技术优势以及显著的临床价值。AI与VR技术的协同创新，为斜视诊疗模式带来了智能化的变革，在未来，有望为眼科医疗领域的发展注入新的动力，推动整个行业迈向新的高度。

Strabismus is a prevalent ophthalmic disorder predominantly affects children. For a long time, its diagnosis and treatment have heavily relied on traditional methods, which are highly dependent on clinical expertise. This reliance often leads to inefficiency, poor patient compliance, and delayed treatment. These issues can severely impair visual function and hinder psychosocial development. Recently, there have been significant advancements in artificial intelligence (AI) and virtual reality (VR), both of which are cutting-edge digital technologies. These innovations have brought about a revolution in the screening, diagnosis, and treatment of ophthalmic diseases, driving the intelligent transformation of strabismus management. AI demonstrates remarkable capabilities in the automated detection of strabismus types and deviation angles. It achieves this through robust image recognition and analysis techniques, enabling a comprehensive evaluation of the disease. By analyzing vast amounts of data, AI can predict surgical parameters, assists in personalized surgical planning, and objectively assesses postoperative outcomes. This significantly enhances diagnostic accuracy and therapeutic efficiency. At the same time, VR technology enables holistic ocular alignment measurements and dynamic analysis via eye-tracking and simulated dynamic environments. During surgical procedures, VR offers surgeons an enhanced visualization of ocular structures and improves operational accuracy through simulated trials. As a result, it helps reduce surgical risks. After surgery, immersive VR-based visual training programs can optimize rehabilitation outcomes. This review systematically examines innovative applications of AI and VR in strabismus care, highlighting their unique technical advantages and clinical value. The synergistic integration of AI and VR has catalyzed an intelligent paradigm shift in strabismus management. This shift promises to inject new momentum into ophthalmic medicine and propel the field towards unprecedented advancements.

目的: 分析甲醇中毒性视神经病变的临床特征、影像学动态演变及治疗反应，探讨中毒程度、治疗时机与视功能预后的相关性，为优化临床诊疗路径提供循证依据。方法: 采用病例系列研究与文献回顾方法，回顾性纳入2017—2024年在中山大学中山眼科中心确诊的9例(18只眼)甲醇中毒性视神经病变患者，收集其临床资料包括瞳孔变化、眼底照相、光学相干断层成像(optical coherence tomography; OCT)、视野、视觉诱发电位(visual evoked potential; VEP)等，结合文献整合病例数据。纳入标准包括明确甲醇暴露史、急性视力下降伴视盘水肿或视网膜神经纤维层(retinal nerve fiber layer; RNFL)增厚、血/尿甲醇或甲酸浓度升高。排除既往视力不佳或视网膜病变者。通过多模态影像学评估视神经损伤特征，分析治疗反应及预后相关因素。结果: 9例(18只眼)患者年龄为23~51岁(男性7例，女性2例)，中毒后就诊时间为3 d~3个月。最佳矫正视力为无光感(11眼)至1.0，66.7%(12/18眼)出现瞳孔变化，眼底表现为视盘水肿，VEP提示振幅下降伴视野缺损，OCT显示急性期视盘区域RNFL增厚，慢性期进行性萎缩、杯盘比显著增大。经治疗后，12只眼视力提高(随访2个月，4只眼中毒后视力为1.0，未纳入其中)，持续随访(4个月~3年)的患者中，多数患者急性期干预后进入视力平台期，但少数患者仍存在迟发性神经退行风险。因此，部分患者通过早期干预联合全身激素冲击、血液透析、营养神经等治疗可能有助于改善视功能，而部分延迟治疗患者可出现不可逆视力丧失。瞳孔对光反射保留者预后更佳。结论: 甲醇中毒性视神经病变的预后与中毒程度、干预时机及瞳孔反射状态密切相关。早期给予激素冲击联合营养神经治疗可能改善部分患者的预后，但中毒时间长者易遗留不可逆视神经损伤，个性化分期治疗及长期视功能监测对保护残余视力至关重要。

Objective: To analyze the clinical characteristics, dynamic imaging changes, and treatment responses of methanol-induced toxic neuropathy. Additionally, it sought to explore the correlation between poisoning severity, intervention timing, and visual functional outcomes, so as to evidence-based insights for optimizing clinical diagnosis and treatment strategies. Methods: A case-series study combined with a literature review was conducted. Nine patients (18 eyes) diagnosed with methanol-induced toxic neuropathy at Zhongshan Ophthalmic Center, Sun Yat-sen University from 2017 to 2024, were retrospectively included. Clinical data, including pupillary changes, fundus photography, optical coherence tomography (OCT), visual field tests, and visual evoked potentials (VEP), were collected and integrated with findings from the literature. The inclusion criteria were a confirmed history of methanol exposure, acute vision loss accompanied by optic disc edema or retinal nerve fiber layer (RNFL) thickening, and elevated blood/urine methanol or formic acid levels. Patients with pre-existing poor vision or retinal diseases were excluded. Multimodal imaging was employed to evaluate the characteristics of optic nerve injury, and treatment responses and prognostic factors were analyzed. Results: The nine patients (18 eyes) ranged in age from 23–51 years (7 males, 2 females), with the time from poisoning to consultation spanning from 3 days to 3 months. The best-corrected visual acuity (BCVA) ranged from no light perception (NLP, 11 eyes) to 1.0. Pupillary abnormalities were observed in 66.7% (12/18 eyes) of the cases. Fundus examination showed optic disc edema, while VEP revealed reduced amplitude and visual field defects. OCT demonstrated RNFL thickening in the acute phase and progressive atrophy with an increased cup-to-disc ratio (C/D) in the chronic phase. After treatment, 12 eyes showed visual improvement (followed at 2 months; 4 eyes with post-poisoning BCVA of 1.0 were excluded from this analysis). Among patients with extended follow-up (4 months to 3 years), most reached a visual acuity plateau after acute-phase intervention, although a minority remained at risk of delayed neurodegenerative decline. Early intervention with systemic high-dose steroid therapy, hemodialysis, and neuroprotective treatment might improve visual function in some patients, whereas delayed treatment often led to irreversible vision loss. Patients with preserved pupillary light reflexes had more favorable prognoses. Conclusions: The prognosis of methanol-induced optic neuropathy is closely related to poisoning severity, intervention timing, and pupillary reflex status. Early high-dose steroid therapy combined with neuroprotective treatment may enhance outcomes in some patients; however, prolonged poisoning typically results in irreversible neurovisual damage. Personalized staged treatment and long-term visual function monitoring are essential for preserving residual vision.