目的：利用信息化手段，优化眼遗传病患者的随访途径，降低病历资料缺失率，助力临床检验科室高效运营。方法：通过态势分析法搜集需求，基于微信公众号平台“中山大学眼科医院小儿遗传”，搭建眼遗传病信息管理系统。根据是否使用眼遗传病信息管理系统、是否受到人员流动限制，将2017年7月1日—2023年11月30日来院进行基因检测的患者分为四组：传统组、传统+人流限制组、微信组和微信+人流限制组，通过χ²检验对眼遗传病信息管理系统进行性能评价。结果：源软件架设在阿里云电子政务平台的眼遗传病信息管理系统，通过加密通讯与医院网络交互。系统主要分为基因检测业务、数据管理和系统管理三大模块。使用该系统的患者或亲属可以在任意时间和地点，自主上传病历资料、签署知情同意书、查询基因检测报告，如有需要还能进行一对一的沟通实现长期随访。在此过程中，患者的临床信息实现数字化。研究共纳入10 662例患者对该系统进行性能评价，使用眼遗传病信息管理系统后，患者病历资料缺失率显著降低，由12.2%(传统+人流限制组)降至2.7%(微信+人流限制组)；患者二次来访率由最高的70%(传统组)降至最低的11.7%(微信组)；两类比较差异有统计学意义(P<0.001)。结论：眼遗传病信息管理系统的使用显著降低患者病历资料缺失率和眼遗传病患者的二次来访率。

Objective: To optimize the follow-up approach for patients with ophthalmic genetic diseases through informational technology, reduce the loss rate of cases, and facilitate the efficient operation of the clinical laboratory. Methods: Using the SWOT analysis method to collect requirements, ‘Pediatric Genetics of Zhongshan Ophthalmic Center’, an ophthalmic genetics information management system for ophthalmic genetic diseases was established on the Wechat public platform. Based on whether the ophthalmic genetic disease information management system was used and there were personnel mobility restrictions, patients who underwent genetic testing in the hospital for genetic testing from July 1, 2017, to November 30, 2023, were divided into four groups: traditional group, traditional+ lockdown group, Wechat+ lockdown group, and Wechat group. Te chi-square test was used to evaluate the performance of the ophthalmic genetic information management system. Results:The ophthalmic genetic disease information management system, which is based on open-source sofware and hosted on the Alibaba Cloud e-government platform, interacts with the hospital network through encrypted communication. Te system was divided into three modules: gene detection business, data management, and system management. By the system, patients or relatives can upload medical records, sign informed consent, inquire about genetic test reports at any time and anywhere, and conduct one-on-one communication to achieve long-term follow-up if necessary. In this process, the patient's clinical information was digitized. A total of 10,662 patients were included in the study to evaluate the performance of the system. The loss rate of cases was decreased from 12.2%to 2.7%, and the rate of second visits was reduced from 70% to 11.7%, which were statistically different, respectively (P< 0.001). Conclusion: Te application of the ophthalmic genetic information management system has signifcantly reduced the loss rate of cases and the rate of second visits in patients with ophthalmic genetic diseases.

Aim: The objective of this study was to investigate the prognosis of massive vitreous hemorrhage(VH) secondary to polypoidal choroidal vasculopathy(PCV) after vitrectomy.  

Methods: Forty-nineeyes in 48 patients with PCV and breakthrough VH who underwent 23-gauge pars plana vitrectomy between January 2015 and December 2020 were enrolled. The main outcome parameters were best-corrected visual acuity, postoperative adverse events, and reoperation.

Results:The average follow-up time was 20.0±15.82 months. The average preoperative best-corrected visual acuity (BCVA) was 2.12±0.65 logarithm of the minimum angle of resolution (logMAR), the BCVA at six monthswas 1.65±0.64 logMAR, and the six-month follow-up BCVA was 1.67±0.76 logMAR. Compared to the average preoperative BCVA, the six-months and last follow-up BCVA after vitrectomy improved (P<0.05). The BCVAat the fnal follow-up was better than 1.3logMAR only in 14 eyes (28.6%). Postoperative complications were observed in 10 eyes (20.4%), including recurrent retinal detachment, recurrent vitreous hemorrhage, macular hole, hyphema and lens dislocation. Fourteen eyes(28.6%) underwent cataract surgery procedure an average of 10.16±5.14 months after vitrectomy. BCVAone week and three monthsafter cataract surgery improved compared toBCVAbefore cataract surgery (P<0.05). Hypertension was associated with BCVAsix months after vitrectomy (P=0.017). The BCVA at baseline and three months after PPV were worse in patients who underwent vitrectomy combined with silicone oil filling (P<0.05). Eyes with postoperative complications had worse BCVA at six months, 12 months, and at the final follow-up after PPV (P<0.05).The duration of VH is related to the BCVA12 months after PPV visual acuity after surgery. Patients who underwent vitrectomy within one month of the onset of vitreous hemorrhage had better BCVA 12 months after vitrectomy than those who underwent vitrectomy surgery one month later (P=0.015). 

Conclusions: Although the prognosis of vitrectomy varies greatly, cataract surgery could be considered to improve BCVAif polypoidal lesions are inactive six months after vitrectomy.

Aim: The objective of this study was to investigate the prognosis of massive vitreous hemorrhage(VH) secondary to polypoidal choroidal vasculopathy(PCV) after vitrectomy.

Methods: Forty-nineeyes in 48 patients with PCV and breakthrough VH who underwent 23-gauge pars plana vitrectomy between January 2015 and December 2020 were enrolled. The main outcome parameters were best-corrected visual acuity, postoperative adverse events, and reoperation.

Results:The average follow-up time was 20.0±15.82 months. The average preoperative best-corrected visual acuity (BCVA) was 2.12±0.65 logarithm of the minimum angle of resolution (logMAR), the BCVA at six monthswas 1.65±0.64 logMAR, and the six-month follow-up BCVA was 1.67±0.76 logMAR. Compared to the average preoperative BCVA, the six-months and last follow-up BCVA after vitrectomy improved (P<0.05). The BCVAat the fnal follow-up was better than 1.3logMAR only in 14 eyes (28.6%). Postoperative complications were observed in 10 eyes (20.4%), including recurrent retinal detachment, recurrent vitreous hemorrhage, macular hole, hyphema and lens dislocation. Fourteen eyes(28.6%) underwent cataract surgery procedure an average of 10.16±5.14 months after vitrectomy. BCVAone week and three monthsafter cataract surgery improved compared toBCVAbefore cataract surgery (P<0.05). Hypertension was associated with BCVAsix months after vitrectomy (P=0.017). The BCVA at baseline and three months after PPV were worse in patients who underwent vitrectomy combined with silicone oil filling (P<0.05). Eyes with postoperative complications had worse BCVA at six months, 12 months, and at the final follow-up after PPV (P<0.05).The duration of VH is related to the BCVA12 months after PPV visual acuity after surgery. Patients who underwent vitrectomy within one month of the onset of vitreous hemorrhage had better BCVA 12 months after vitrectomy than those who underwent vitrectomy surgery one month later (P=0.015). 

Conclusions: Although the prognosis of vitrectomy varies greatly, cataract surgery could be considered to improve BCVAif polypoidal lesions are inactive six months after vitrectomy.

Background: Diabetic retinopathy (DR) urgently needs novel and effective therapeutic targets. Integrated analyses of plasma proteomic and genetic markers can clarify the causal relevance of proteins and discover novel targets for diseases, but no systematic screening for DR has been performed.

Methods: Summary statistics of plasma protein quantitative trait loci (pQTL) were derived from two extensive genome-wide analysis study (GWAS) datasets and one systematic review, with over 100 thousand participants covering thousands of plasma proteins. DR data were sourced from the largest FinnGen study, comprising 10,413 DR cases and 308,633 European controls. Genetic instrumental variables were identified using multiple filters. In the two-sample MR analysis, Wald ratio and inverse variance-weighted (IVW) MR were utilized to investigate the

causality of plasma proteins with DR. Bidirectional MR, Bayesian Co-localization, and phenotype scanning were employed to test for potential reverse causality and confounding factors in the main MR analyses. By systemically searching druggable gene lists, the ChEMBL database, DrugBank, and Gene Ontology database, the druggability and relevant functional pathways of the identified proteins were systematically evaluated.

Results: Genetically predicted levels of 24 proteins were significantly associated with DR risk at a false discovery rate <0.05 including 11 with positive associations and 13 with negative associations. For each standard deviation increase in plasm protein levels, the odds ratios (ORs) for DR varied from 0.51 (95% CI: 0.36-0.73; P=2.22×10-5) for tubulin polymerization-promoting protein family member 3 (TPPP3) to 2.02 (95% CI: 1.44-2.83; P=5.01×10-5) for olfactomedin like 3 (OLFML3). Bidirectional MR indicated there was no reverse causality that interfered with the results of the main MR analyses. Four proteins exhibited strong co-localization evidence (PH4 ≥0.8): cytoplasmic tRNA synthetase (WARS), acrosin binding protein(ACRBP), and intercellular adhesion molecule 1 (ICAM1) were negatively associated with DR risk, while neurogenic locus notch homolog protein 2 (NOTCH2) showed a positive association. No confounding factors were detected between pQTLs and DR according to the phenotypic scan. Drugability assessments highlighted 6 proteins already in drug development endeavor and 18 novel drug targets, with metalloproteinase inhibitor 3 (TIMP) currently in phase I clinical trials for DR. GO analysis identified 18 of 24 plasma proteins enriching 22 pathways related to cell differentiation and proliferation regulation.

Conclusions:Twenty-four promising drug targets for DR were identified, including four plasma proteins with particular co-localization evidence. These findings offer new insights into DR's etiology and therapeutic targeting, exemplifying the value of genomic and proteomic data in drug target discovery.

Background: Diabetic retinopathy (DR) urgently needs novel and effective therapeutic targets. Integrated analyses of plasma proteomic and genetic markers can clarify the causal relevance of proteins and discover novel targets for diseases, but no systematic screening for DR has been performed.

Methods: Summary statistics of plasma protein quantitative trait loci (pQTL) were derived from two extensive genome-wide analysis study (GWAS) datasets and one systematic review, with over 100 thousand participants covering thousands of plasma proteins. DR data were sourced from the largest FinnGen study, comprising 10,413 DR cases and 308,633 European controls. Genetic instrumental variables were identified using multiple filters. In the two-sample MR analysis, Wald ratio and inverse variance-weighted (IVW) MR were utilized to investigate the

causality of plasma proteins with DR. Bidirectional MR, Bayesian Co-localization, and phenotype scanning were employed to test for potential reverse causality and confounding factors in the main MR analyses. By systemically searching druggable gene lists, the ChEMBL database, DrugBank, and Gene Ontology database, the druggability and relevant functional pathways of the identified proteins were systematically evaluated.

Results: Genetically predicted levels of 24 proteins were significantly associated with DR risk at a false discovery rate <0.05 including 11 with positive associations and 13 with negative associations. For each standard deviation increase in plasm protein levels, the odds ratios (ORs) for DR varied from 0.51 (95% CI: 0.36-0.73; P=2.22×10-5) for tubulin polymerization-promoting protein family member 3 (TPPP3) to 2.02 (95% CI: 1.44-2.83; P=5.01×10-5) for olfactomedin like 3 (OLFML3). Bidirectional MR indicated there was no reverse causality that interfered with the results of the main MR analyses. Four proteins exhibited strong co-localization evidence (PH4 ≥0.8): cytoplasmic tRNA synthetase (WARS), acrosin binding protein(ACRBP), and intercellular adhesion molecule 1 (ICAM1) were negatively associated with DR risk, while neurogenic locus notch homolog protein 2 (NOTCH2) showed a positive association. No confounding factors were detected between pQTLs and DR according to the phenotypic scan. Drugability assessments highlighted 6 proteins already in drug development endeavor and 18 novel drug targets, with metalloproteinase inhibitor 3 (TIMP) currently in phase I clinical trials for DR. GO analysis identified 18 of 24 plasma proteins enriching 22 pathways related to cell differentiation and proliferation regulation.

Conclusions:Twenty-four promising drug targets for DR were identified, including four plasma proteins with particular co-localization evidence. These findings offer new insights into DR's etiology and therapeutic targeting, exemplifying the value of genomic and proteomic data in drug target discovery.

Background: Research innovations inoculardisease screening, diagnosis, and management have been boosted by deep learning (DL) in the last decade. To assess historical research trends and current advances, we conducted an artifcial intelligence (AI)–human hybrid analysis of publications on DL in ophthalmology.

Methods: All DL-related articles in ophthalmology, which were published between 2012 and 2022 from Web of Science, were included. 500 high-impact articles annotated with key research information were used to fne-tune alarge language models (LLM) for reviewing medical literature and extracting information. After verifying the LLM's accuracy in extracting diseases and imaging modalities, we analyzed trend of DL in ophthalmology with 2 535 articles. 

Results: Researchers using LLM for literature analysis were 70% (p= 0.000 1) faster than those who did not, while achieving comparable accuracy (97% versus 98%, p = 0.768 1). The field of DL in ophthalmology has grown 116% annually, paralleling trends of the broader DL domain. The publications focused mainly on diabetic retinopathy (p = 0.000 3), glaucoma (p = 0.001 1), and age-related macular diseases (p = 0.000 1) using retinal fundus photographs (FP, p = 0.001 5) and optical coherence tomography (OCT, p = 0.000 1). DL studies utilizing multimodal images have been growing, with FP and OCT combined being the most frequent. Among the 500 high-impact articles, laboratory studies constituted the majority at 65.3%. Notably, a discernible decline in model accuracy was observed when categorizing by study design, notwithstanding its statistical insignificance. Furthermore, 43 publicly available ocular image datasets were summarized. 

Conclusion: This study has characterized the landscape of publications on DL in ophthalmology, by identifying the trends and breakthroughs among research topics and the fast-growing areas. This study provides an efcient framework for combined AI–human analysis to comprehensively assess the current status and future trends in the feld. 

Background: Research innovations inoculardisease screening, diagnosis, and management have been boosted by deep learning (DL) in the last decade. To assess historical research trends and current advances, we conducted an artifcial intelligence (AI)–human hybrid analysis of publications on DL in ophthalmology.

Methods: All DL-related articles in ophthalmology, which were published between 2012 and 2022 from Web of Science, were included. 500 high-impact articles annotated with key research information were used to fne-tune alarge language models (LLM) for reviewing medical literature and extracting information. After verifying the LLM's accuracy in extracting diseases and imaging modalities, we analyzed trend of DL in ophthalmology with 2 535 articles. 

Results: Researchers using LLM for literature analysis were 70% (p = 0.000 1) faster than those who did not, while achieving comparable accuracy (97% versus 98%, p = 0.768 1). The field of DL in ophthalmology has grown 116% annually, paralleling trends of the broader DL domain. The publications focused mainly on diabetic retinopathy (p = 0.000 3), glaucoma (p = 0.001 1), and age-related macular diseases (p = 0.000 1) using retinal fundus photographs (FP, p = 0.001 5) and optical coherence tomography (OCT, p = 0.000 1). DL studies utilizing multimodal images have been growing, with FP and OCT combined being the most frequent. Among the 500 high-impact articles, laboratory studies constituted the majority at 65.3%. Notably, a discernible decline in model accuracy was observed when categorizing by study design, notwithstanding its statistical insignificance. Furthermore, 43 publicly available ocular image datasets were summarized. 

Conclusion: This study has characterized the landscape of publications on DL in ophthalmology, by identifying the trends and breakthroughs among research topics and the fast-growing areas. This study provides an efcient framework for combined AI–human analysis to comprehensively assess the current status and future trends in the feld. 

哺乳动物雷帕霉素靶蛋白(mammalian target of rapamycin,mTOR)是一种蛋白激酶，在体内主要参与营养水平、生长代谢的调节。mTOR是癌症、衰老和其他代谢相关病理性疾病的重要靶点，参与了增殖、转分化、自噬等多种生物学过程。眼被认为是具有免疫特权的区域，由于血管系统会影响视力，眼的血管系统位于中心光路以外。眼的许多区域都有将免疫细胞运输至发育不良、受损或衰老有关的病变部位的机制。尽管免疫应答主要是为了修复或保护自身，但是免疫细胞可能会分泌一些细胞因子，导致炎症或纤维化，进而损害视力。研究证实，mTOR与翼状胬肉、年龄相关性黄斑变性(age-related macular degeneration,AMD)、青光眼、白内障、糖尿病视网膜病变(diabetic retinopathy,DR)、眼部肿瘤等多种眼病密切相关。目前，mTOR抑制剂通常被用作免疫抑制剂，用于癌症的治疗，但mTOR抑制剂用于眼部疾病的报道尚少。因此，该文就mTOR信号通路在相关眼科疾病中的作用、调控机制、药物治疗等方面进行简要综述，为相关眼科疾病的病理机制与治疗提供思路，以便后续开展更深入的研究。

Mammalian target protein of rapamycin (mTOR) is a protein kinase that primarily involves in the regulation of nutrient levels andgrowth metabolism in vivo. mTOR serves as a crucial target for cancer, aging, and other metabolic related pathological diseases, participating in various biological processes such as proliferation, transdifferentiation, and autophagy. Te eye is considered an area with immune privilege, as the vascular system afects vision and is located outside the central light path. Many areas of the eye have mechanisms for transporting immune cells to the afected areas related to developmental, damaged, or aging. Although the immune response is primarily aimed at reparing or protecting itself, immune cells may secrete some cytokines, leading to infammation or fbrosis, which in turn can damage vision. Results from studies have confirmed that mTOR is closely related to pterygium, age-related macular degeneration (AMD), glaucoma, cataract, diabetic retinopathy (DR), eye tumors and other eye diseases. Currently, mTOR inhibitors are widely used as immunosuppressants and approved for cancer treatment; however, there are few reports on the use of mTOR inhibitors for eye diseases. Therefore, in the article it provides a brief overview of the role, regulatory mechanisms, and drug treatment of the mTOR signaling pathway in related ophthalmic diseases, providing ideas for the pathological mechanisms and treatment of related ophthalmic diseases, in order to carry out more in-depth research in the future.

The whole lacrimal passage intubation is widely used in lacrimal surgery. However, one of the most typical complications is the prolapse of the silicone tube from the medial canthus. In case, the bicanalicular silicone tube after whole lacrimal duct intubation has completely prolapsed from the medial canthus before extubation, then cannot be found in the opening of the nasolacrimal duct, and it would be a challenge to reposition or removal. A novel approach to employ a modified suture-probe and silk thread traction technique has been developed, and it is not only safe and effective, but also cost-effective.

The whole lacrimal passage intubation is widely used in lacrimal surgery. However, one of the most typical complications is the prolapse of the silicone tube from the medial canthus. In case, the bicanalicular silicone tube after whole lacrimal duct intubation has completely prolapsed from the medial canthus before extubation, then cannot be found in the opening of the nasolacrimal duct, and it would be a challenge to reposition or removal. A novel approach to employ a modified suture-probe and silk thread traction technique has been developed, and it is not only safe and effective, but also cost-effective.

      精准的屈光规划——人工晶状体屈光力计算，是屈光性白内障手术的重要前提。人工晶状体计算公式使用患者术前的眼部生物学参数如眼轴长度、角膜曲率、前房深度、晶状体厚度等指标来预测患者在白内障术后的屈光状态。人工晶状体屈光力计算公式自1967年出现以来，不断发展革新，准确性得到了极大的提升。封面展示了几种基于不同原理而构建的计算公式：回归公式(以SRK公式为代表)、基于模型眼的会聚公式(以Holladay 1等为代表)、射线追踪公式(以Olsen为代表)与人工智能公式(以RBF为代表)。目前对于普通白内障患者，现有公式能够获得良好的预测准确性。然而，对于临床上很多特殊的患者(如眼球解剖参数异常、既往有其他眼病或眼部手术史)，如何准确预测术后的屈光状态仍存在较大的挑战。路途漫漫，学者们为提升人工晶状体屈光力计算准确性的努力却从未止步，力求为患者提供最佳的白内障手术效果。

      精准的屈光规划——人工晶状体屈光力计算，是屈光性白内障手术的重要前提。人工晶状体计算公式使用患者术前的眼部生物学参数如眼轴长度、角膜曲率、前房深度、晶状体厚度等指标来预测患者在白内障术后的屈光状态。人工晶状体屈光力计算公式自1967年出现以来，不断发展革新，准确性得到了极大的提升。封面展示了几种基于不同原理而构建的计算公式：回归公式(以SRK公式为代表)、基于模型眼的会聚公式(以Holladay 1等为代表)、射线追踪公式(以Olsen为代表)与人工智能公式(以RBF为代表)。目前对于普通白内障患者，现有公式能够获得良好的预测准确性。然而，对于临床上很多特殊的患者(如眼球解剖参数异常、既往有其他眼病或眼部手术史)，如何准确预测术后的屈光状态仍存在较大的挑战。路途漫漫，学者们为提升人工晶状体屈光力计算准确性的努力却从未止步，力求为患者提供最佳的白内障手术效果。

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.

随着角膜疾病治疗技术的不断进步，前弹力层移植技术(包括Inlay和Onlay技术)已成为晚期圆锥角膜治疗的重要手段，能有效改善患者的角膜地形图和视力结果，稳定角膜扩张，提高患者的生活质量。该文综述了前弹力层移植技术的理论基础、移植物的来源与制备技术、手术技术、临床疗效以及相关并发症，为晚期圆锥角膜的治疗提供了新的视角。研究表明，这种先进的移植技术相较于传统方法，在减少手术风险、简化手术流程以及加快术后恢复方面具有明显优势，特别是在降低异体移植物排斥反应及手术并发症的风险上，前弹力层移植表现出色。Onlay技术作为一种近期开发的新方法，其独特优势是无需剖离角膜，更好地保护角膜结构。此外这种技术的高度适应性和可逆性，为患者提供了更多的治疗选择和更好的视觉恢复。尽管如此，技术细节如移植物的尺寸和形状定制、手术深度的最优化等方面仍需进一步研究和优化，以提高整体治疗效果。

With the continuous advancement of corneal disease treatment technology, Bowman layer transplantation (including Inlay and Onlay technology) has become an important means for the treatment of advanced progressive keratoconus, which can effectively improve the corneal topography and visual acuity of patients, stabilize corneal dilation, and improve the quality of life of patients. Tis article reviews the theoretical basis of Bowman layer transplantation, the source and preparation of grafs, surgical techniques, clinical efcacy, and related complications, which provides a new perspective for the treatment of advanced keratoconus. It is stated in the research that this advanced transplantation technique has significant advantages over traditional methods in reducing surgical risks, simplifying the surgical procedures, and improving postoperative recovery. Especially in reducing the risk of allograft rejection and surgical complications, the bowman layer transplantation performs excellently. As a novel developed method, Onlay technology has the unique advantage of eliminating the need to dissect the cornea, which beter protects the corneal structure. In addition, due to the highly adaptable and reversible nature of this technique, it provides patients with more treatment options and beter visual recovery. However, in terms of technical details such as customizing the size and shape of the transplant, optimizing the surgical depth, etc., it is needed to conduct further research and optimization to improve the overall treatment efect.