脂质运载蛋白2（LCN2/NGAL）是一种多效性分泌糖蛋白，通过调控铁代谢、炎症反应及细胞死亡（铁死亡、凋亡）等机制，广泛参与眼科疾病的病理进程。生理状态下，LCN2在角膜上皮、视网膜神经节细胞层等部位低表达；病理条件下，其表达显著上调且功能呈现高度背景依赖性。在各类眼科疾病（如干眼症、角膜疾病、葡萄膜炎、青光眼、视网膜疾病等）中，既可表现为促炎促凋亡的致病因子，亦能发挥抗炎保护作用。靶向调控LCN2表达或其下游通路可能为眼科疾病治疗提供新策略。
Lipocalin-2 (LCN2/NGAL) is a multifunctional secretory glycoprotein that plays a critical role in the pathogenesis of ophthalmic diseases by regulating iron metabolism, inflammatory responses, and cell death pathways (ferroptosis, apoptosis). Under physiological conditions, LCN2 is expressed at low levels in tissues such as the corneal epithelium and retinal ganglion cell layer. However, its expression is significantly upregulated under pathological conditions, exhibiting highly context-dependent functionality. In major ophthalmic diseases—including dry eye disease, corneal disorders, uveitis, glaucoma, and retinal diseases—LCN2 can act either as a pro-inflammatory and pro-apoptotic pathogenic factor or as an anti-inflammatory protective agent. Targeted modulation of LCN2 expression or its downstream pathways may offer novel therapeutic strategies for ocular diseases.
本文应用接触式和非接触式角膜内皮照相机对 4 例虹膜角膜内皮综合征（包括 2 例 Chandler's 综合征、1 例 Cogan-Reese 综合征和 1 例进行性实质性虹膜萎缩）作角膜内皮细胞观察照相研究。可见病眼角膜内皮细胞均有相同的病理性形态学改变，结合临床表现和病理学检查所见，提示这几种不同表现的病变有可能是具有相同发病学基础的同一种疾病，亦支待这一类病变的基本病因是角膜内皮细胞的异常增殖所致，而且健眼角膜内皮细胞亦可见有改变，说明双眼可受影响。本文对内皮细胞密度的变化、角膜内皮细胞异常增殖和神经嵴细胞分化学说作了讨论。
Clinical contact and non-contact specular microscopic examination in 4 patients with iridocorneal endothelial syndrome (including 2 cases of Chandler's syndrome, 1 case of Cogan-Reese syndrome and l case of essential iris atrophy) showed that the affected eyes had the same morphological changes. From the clinical and pathologic examinations, it is shown that this spectrum of syndrome may be the different manifestations of the same pathogenic disease and the basic pathogenic event is abnormal proliferation of the corneal endothelium that could also be seen in the contralateral eye.
本文介绍用韩氏二重 15 色相测试的 Farn-sworth 色相配列法应用于色觉检查，此法比其他临床常用的色觉检查具有色觉障碍分型和定量分析的优点， 同时方法简便易懂。本文报告应用此法于先天性色盲和继发性色盲患者，其红色盲、绿色盲、红绿色盲、蓝色 盲、全色盲等及不同色觉异常程度的变异的实例。
The application of Farnsworth dichotomous test for color blindness using Hahn Double 15-Hue is introduced. The advantages of this method compared with other clinical color tests are that it is simple and can classify the types of color defect and analyse the defect quantitatively. This method applied to the patients with congenital and acquired color blindness, such as prota-, deutera-and tritanopia, protano-, deuteranomalopia, achromatopia and abnormal extent of color defect is reported.
帕金森病（Parkinson’s disease, PD）作为仅次于阿尔茨海默病的第二大神经退行性疾病，其眼部表现近年来逐渐成为跨学科研究热点。以往医生多关注运动迟缓、静止性震颤和肌强直等PD典型症状，但大量临床研究表明，眼睑异常、眼球运动障碍、视觉功能异常等眼部表现不仅普遍存在于PD患者中，更可能在典型运动症状出现前就已显现。长期以来，这些眼部症状因其他症状的掩盖往往被忽视，进一步降低了患者的生活质量。本综述系统梳理PD患者眼部表现的三大方面：首先，眼睑异常方面，PD患者瞬目频率降低，61.1%患者出现干眼症状，导致PD患者的生活质量进一步下降。其次，眼球运动障碍表现为特征性的阶梯式方波急跳、集合功能减退以及反向扫视错误率增加，其中反向扫视潜伏期延长对步态冻结的发生具有预测价值。最后，视觉功能障碍方面，PD患者可出现视敏度下降、色觉异常、对比敏感度受损和视幻觉。影像学检查观察到视网膜神经节细胞层变薄，伴随视网膜微血管密度降低，这些结构性改变与PD患者的视觉功能障碍有关，作为生物标志物具有独特潜力。神经内科-眼科联合诊疗模式不仅有助于PD的早期诊断和预后评估，更有助于临床医生全面理解PD的疾病机制和表现，为未来诊疗策略的优化提供客观依据。
Parkinson’s disease (PD), the second most common neurodegenerative disorder after Alzheimer’s disease, has increasingly garnered interdisciplinary research attention due to its ocular manifestations. While the classical triad of motor symptoms—bradykinesia, resting tremor, and rigidity—remains the diagnostic hallmark, accumulating clinical evidence indicates that ocular abnormalities, including eyelid dysfunction, oculomotor disturbances, and visual impairments, are not only prevalent in PD patients but may also precede the onset of typical motor symptoms. Historically overlooked due to masking by other clinical features, these ocular manifestations contribute to the deterioration of patients' quality of life. This review systematically examines PD-related ocular abnormalities across three key domains: First, eyelid dysfunction manifests as reduced blink frequency, with 61.1% of PD patients reporting dry eye symptoms, further exacerbating their life quality impairment. Second, oculomotor disturbances are characterized by staircase-pattern square-wave jerks, convergence insufficiency, and increased error rates in antisaccade tasks, with prolonged antisaccade latency serving as a predictive marker for freezing of gait. Third, visual dysfunction encompasses diminished visual acuity, dyschromatopsia, impaired contrast sensitivity, and visual hallucinations. Imaging studies reveal structural alterations such as retinal ganglion cell layer thinning and reduced retinal microvascular density, which correlate with visual deficits and hold promise as potential biomarkers. The establishment of a neuro-ophthalmological collaborative framework not only facilitates early PD diagnosis and prognostic assessment but also enhances clinicians' comprehensive understanding of disease mechanisms. Such an approach provides an objective foundation for optimizing future therapeutic strategies.
目的：探讨蛋白A免疫吸附联合糖皮质激素治疗对MOG抗体相关视神经炎（MOG antibody-associated optic neuritis， MOG-ON）患者的临床疗效及安全性。方法：回顾性分析2022年6月—2024年12月在广东三九脑科医院神经内科确诊并接受蛋白A免疫吸附联合糖皮质激素治疗的7例MOG-ON患者。所有患者均接受蛋白A免疫吸附治疗（隔天1次，共5次为1个疗程）并同期联合糖皮质激素治疗。评估治疗前及治疗后3个月、6个月的视力变化、扩展伤残状态量表（expanded disability status scale，EDSS）评分变化及MOG抗体滴度变化，并记录不良反应。结果：治疗后6个月，6/7患者视力较治疗前改善，其中4/7视力改善显著。左眼LogMAR视力值从治疗前的0.20(0.14，0.70)改善至0.10(0.10，0.42)，右眼LogMAR视力值从0.30(0.19，0.47)改善至0.18(0.10，0.21)，EDSS视力评分从2.86±1.68降至1.43±1.51（P < 0.05）。治疗前血清MOG抗体滴度几何平均数为1:52.0（几何标准差GSD = 3.7），治疗后3个月降至1:8.8（GSD = 1.9）（P = 0.027），治疗后6个月降至1:13.0（GSD = 4.1）（P = 0.027）。7例患者共接受35次免疫吸附治疗，未观察到严重不良反应，仅有轻微可控的不良事件。结论：蛋白A免疫吸附联合糖皮质激素治疗能够有效降低血液中MOG抗体水平，改善MOG-ON患者的视力。
Objective: To investigate the clinical efficacy and safety of protein A immunoadsorption combined with glucocorticoid therapy in patients with myelin oligodendrocyte glycoprotein antibody-associated optic neuritis（MOG-ON）. Methods: A retrospective analysis was conducted on 7 patients with MOG-ON who were diagnosed and treated with protein A immunoadsorption combined with glucocorticoid therapy at the Department of Neurology，Guangdong Sanjiu Brain Hospital from June 2022 to December 2024. All patients underwent protein A immunoadsorption therapy （once every other day, with 5 sessions constituting one course） in conjunction with concurrent steroid therapy. Visual acuity changes, EDSS score changes, and MOG antibody titer changes were assessed before treatment, as well as at 3 and 6 months after treatment. Additionally, adverse events were meticulously recorded. Results: At the 6 months post-treatment mark, 6 patients （85.7%） demonstrated an improvement in visual acuity compared to their baseline levels, with 4 patients （57.1%） achieving a significant improvement. The median LogMAR visual acuity values in the left eye improved from 0.20(0.14,0.70) to 0.10(0.10,0.42), and in the right eye, they improved from 0.30(0.19,0.47) to 0.18(0.10,0.21). MeanWhile, the EDSS visual score decreased from 2.86±1.68 to 1.43±1.51（P < 0.05）. The geometric mean serum MOG antibody titer declined from 1:52.0（GSD = 3.7） before treatment to 1:8.8（GSD = 1.9） at 3 months after treatment（P = 0.027）, and further decreased to 1:13.0（GSD = 4.1） at 6 months after treatment（P = 0.027）. A total of 35 immunoadsorption sessions were administered to the 7 patients, and no serious adverse reactions were observed; only minor and manageable adverse events occurred. Conclusion: Protein A immunoadsorption combined with glucocorticoid therapy can effectively lower serum MOG antibody levels and enhance visual outcomes in patients with MOG-ON.
目的：评估EYESi手术模拟器在眼科医师专科培训玻璃体手术中的教学效果。方法：招募中山大学中山眼科中心进行专科医师规范化培训的15名学员，开展眼底手术培训课程，随机分为A组、B组、C组，每组各5名学员。以培训开始前进行初次视网膜脱离手术作为基础分数，除玻璃体后脱离项目、视网膜前膜及内界膜项目等基础练习内容外，A组仅接受双手剪刀训练，B组仅接受激光训练，C组同时接受双手剪刀训练及激光训练。最后所有学员再进行视网膜脱离手术项目作为最终考核成绩。记录下学员的每次得分和操作时间。结果：培训后学员视网膜脱离手术得分较培训前提高（P<0.001）。C组与A组学员最终视网膜脱离手术得分高于B组学员（P<0.05）。有内眼手术经验的学员初次视网膜脱离手术得分高于无内眼手术经验的学员，且手术时长低于无内眼手术经验的学员（P<0.05）。结论：EYESi手术模拟器能有效提高眼科医师的手术操作信心及玻璃体视网膜手术操作技能，双手剪刀训练模块是玻璃体视网膜手术培训中的重要模块。
Objective: To assess the instructional efficacy of the EYESi surgical simulator in training ophthalmology residents on vitreoretinal surgical procedures. Methods: Fifteen ophthalmology residents participating in standardized specialist training program at Zhongshan Ophthalmic Center, Sun Yat-sen University, were randomly assigned to three groups (A, B, C; n=5 per group). All participants underwent an initial baseline assessment through simulated retinal detachment surgery. In addition to standard training modules covering posterior vitreous detachment, anterior retinal membrane peeling, and inner limiting membrane manipulation, Group A received supplementary bimanual scissors training, Group B underwent laser training, and Group C received both types of advanced training. The final assessments were carried out using the same retinal detachment simulation, with performance scores and operation times carefully recorded. Results: Post-training surveys revealed significant increases in both trainees’ self-confidence and their self-assessed surgical proficiency. Objective performance scores for retinal detachment surgery showed marked improvement after training (P < 0.001). Groups C and A achieved significantly higher final scores compared to Group B (P < 0.05). Participants with prior intraocular surgical experience scored higher and completed procedures more quickly in the baseline assessment than those without such experience (P < 0.05). Conclusions: The EYESi simulator proves to be an effective tool for enhancing surgical skills and boosting operational confidence in vitreoretinal surgery training. In particular, bimanual instrumentation training offers significant educational value in the development of advanced microsurgical techniques.
目的：设计一套瞳孔动、静态信息提取方案，尝试初步建立正常人群瞳孔动、静态信息数据库。方法：于2023年1月—7月，从中山大学眼科中心眼科门诊招募无眼部疾病、全身疾病的参与者。使用工业级红外相机搭配850 nm红外光源录制参与者瞳孔区域20 s视频，提取瞳孔横径数据并输出为txt文件。使用R语言分析数据，构建瞳孔舒缩过程中的波峰、波谷拟合线，并估算瞳孔舒缩频率。结果：共收集32位参与者的瞳孔动态数据，右眼数据纳入主要结果的分析。参与者年龄范围为7~61岁，男性占50%，等效球镜度范围为-5.630~+5.00 D。测量过程中的瞳孔横径平均值与年龄呈负相关，与等效球镜度、性别无关。在20 s的记录中，瞳孔舒缩次数为(15±7)次。基于波峰与波谷拟合线的趋势，瞳孔舒缩动态分为3种类型：舒缩扩张型、舒缩稳定型和舒缩缩小型。舒缩稳定型进一步分为稳定扩张型、稳定恒定型和稳定缩小型3个亚型，其中25人为舒缩缩小型。双眼的过滤后波峰、波谷拟合线的斜率和截距与过滤前比较差异无统计学意义(P>0.05)。结论：低成本、简易的设备配以算法可以便捷、快速地提取瞳孔动、静态信息。
Objective: To design a method for extracting dynamic and static information of the pupil and to establish a database of pupil dynamic and static information in a healthy population. Methods: From January to July 2023, subjects without any ocular or systemic diseases were recruited from the ophthalmology outpatient department. An industrial-grade infrared camera, paired with an 850nm infrared light source, was used to record 20-second videos of the pupil area of each subject. Horizontal pupil diameter data was extracted and saved as txt files. The data was analyzed using R software to construct fitted lines of peaks and troughs during the pupil constriction and dilation process, and the frequency of pupil contraction and dilation was estimated. Results: Pupil dynamic data was collected from 32 subjects with an age range of 7 to 61 years, of whom 50% were male. The spherical equivalent range was from +5.00 D to -5.625 D. The average number of pupil contractions and dilations within the 20-second recordings was (15 ± 7) cycles. Based on the trend of fitted lines for peaks and troughs, pupil dynamic types were categorized into three types: dilation type, stable type, and contraction type. The stable type was further divided into stable dilation, stable constant, and stable contraction subtypes. 25 subjects exhibiting the constriction type. A paired t-test showed no significant difference in the slope and intercept of the fitted lines for peaks and troughs between both eyes. Conclusion: Low-cost and simple equipment combined with algorithms can efficiently and quickly extract dynamic and static pupil information.
迟发性眼前节毒性综合征（toxic anterior segment syndrome，TASS）是 TASS 的一种特殊类型，两者既有共同点又有区别，随着人们认识的深入，越来越多的迟发性 TASS 被报道。迟发性 TASS 较典型性 TASS 少见，流行病学特征因人工晶体不同而有差异。几乎所有可引起典型性 TASS 的因素都可以引起迟发性 TASS，此外铝元素在迟发性 TASS 的发生中可能有关键作用。迟发性 TASS 临床表现与典型性 TASS 类似，累及后段更为常见，激素治疗有效。
Late-onset toxic anterior segment syndrome (TASS) is a special type of TASS, which has both similarities and differences. With the deepening understanding, more and more late-onset TASS is reported. Late-onset TASS is less common than typical TASS, and the epidemiological characteristics are vary with intraocular lenses. Almost all the factors that can cause typical TASS can cause late-onset TASS, in addition, aluminum element may play a key role in the occurrence of delayed TASS. The clinical manifestations of late-onset TASS are similar to those of typical TASS, with the involvement of the posterior segment more common and hormone therapy effective.
干眼是指以泪膜稳态失衡为主要特征并伴有眼部不适症状的多因素眼表疾病。目前干眼的主要治疗手段包括药物治疗（人工泪液替代疗法、抗炎治疗、免疫抑制治疗）和必要时的手术干预治疗。地夸磷索四钠属于 P2Y2 受体激动剂，是一种治疗干眼的新型药物。它通过刺激位于眼表组织的 P2Y2 受体，促进泪液、黏液、脂质分泌，增强泪膜稳定性，从而改善干眼的症状和体征。
Dry eye refers to a series of chronic and progressive ocular surface diseases characterized by imbalanced tear film accompanied with ocular discomfort symptoms. The available methods mainly include pharmacotherapy (artificial tears replacement, anti-inflammatory, immunosuppressive therapy) and ophthalmic surgery. P2Y2 receptor agonist is a novel pharmaceutical agent for dry eye treatment, which could stimulate tear fluid secretion and mucin secretion through binding with P2Y2 receptors on the ocular surface, so that improve tear film stability and alleviate symptoms of dry eye. 3% diquafosol ophthalmic solution is the only P2Y2 receptor agonist available for dry eye.
