目的：研究IgG4相关性眼病(IgG4-related ophthalmic disease, IgG4-ROD)患者的影像学特征与外周血免疫球蛋白G4(IgG4)水平之间的相关性，为评估IgG4相关性疾病全身性严重程度提供新思路。方法：收集2023年8月—2024年9月在吉林大学第二医院眼科医院经术后组织标本病理确诊的29例IgG4-ROD阳性患者。回顾性分析患者眼眶影像学特点与血清IgG4水平相关性，探讨影像学中特征性表现包括泪腺肿大、三叉神经分支增粗、眼外肌增粗、鼻黏膜类炎症改变、眼睑软组织肥厚，以及其他眶内软组织增生等特征性影像学改变出现比例，并按照累及组织结构情况分级评分，评估特征性影像学改变与血清IgG4水平之间的相关性。结果：29例病理确诊IgG4-ROD患者中，泪腺均受累，占比100%；眼外肌受累17例，占比58.62%；三叉神经分支受累5例(4例眶下神经受累，3例额神经病受累，2例眶下神经与额神经同时受累)，占比17.24%眼睑软组织肥厚24例，占比82.76%鼻黏膜出现类炎症反应15例，占比51.72%；合并眶内其他软组织增生性病变2例，占比6.90%。影像学中特征性受累组织结构分级评分与血清IgG4水平呈正相关(P < 0.05)。结论：IgG4-ROD影像学中特征性组织结构受累及范围与血清IgG4水平明显相关，可以辅助评估IgG4相关性疾病全身性严重程度。

Objective: To investigate the correlation between the imaging characteristics of patients with IgG4-related ophthalmic disease (IgG4-ROD) and the serum immunoglobulin G4 (IgG4) levels, providing new insights for assessing the systemic severity of IgG4-related diseases. Methods: This study collected postoperative tissue samples from 29 patients with histopathologically conffrmed IgG4-ROD at the Ophthalmology Department of Jilin University Second Hospital from August 2023 to September 2024. TTis study retrospectively analyzed the correlation between patients' orbital imaging features and serum IgG4 levels, and explored the proportion of characteristic imaging changes including enlargement of the lacrimal gland, thickening of the trigeminal nerve branches, thickening of the extraocular muscles, inffammatory like changes of the nasal mucous membranes, hypertrophy of the eyelid soft tissues, as well as hyperplasia of other intraorbital soft tissues in the imaging. A grading score for affected tissue structures was established to evaluate the correlation between characteristic imaging changes and serum IgG4 levels. Results: Among the 29 patients diagnosed with IgG4-ROD, lacrimal gland involvement was observed in all patients (100%). Extraocular muscle involvement was present in 17 patients (58.62%). Five patients had involvement of the trigeminal nerve branches (including 4 with infraorbital nerve involvement and 3 with frontal nerve involvement, with 2 patients having simultaneous involvement of both nerves), accounting for 17.24% of the cases. Eyelid soff tissue hypertrophy was observed in 24 patients (82.76%), and nasal mucosal inflammatory responses were noted in 15 patients (51.72%). Additionally, two patients (6.90%) presented with other proliferative lesions within the orbit. The correlation analysis between the grading scores for imaging features and serum IgG4 levels demonstrated a significant positive correlation. Conclusions: The extent of characteristic structural involvement observed in the imaging features of IgG4-ROD is significantly correlated with serum IgG4 levels. TTis correlation can assist in evaluating the systemic severity of IgG4-related diseases and provides clinical evidence supporting the need for comprehensive systemic evaluations, such as PET-CT, in patients whose initial presentation is IgG4-related ophthalmic disease.

目的：研究经鼻内镜低位泪囊鼻腔吻合术联合RT新型人工泪管置入手术的临床有效性和安全性。方法：采用前瞻性随机对照研究，将临床诊断为原发性鼻泪管阻塞继发的慢性泪囊炎患者随机分为两组。研究组(A组)43例(44眼)采用低位经鼻内镜泪囊鼻腔吻合联合新型RT人工泪管置入术。对照组(B组)39例(39眼)采用常规经鼻内镜泪囊鼻腔吻合联合双泪小管置入式人工泪管置入。术后3～6个月取出人工泪管，随访时间1～12个月，平均6个月。观察术中术后的并发症，评估其安全性。结果： A组治愈42眼(95.45%)，好转2眼(4.54%)；B组治愈38眼(97.43%)，好转1眼(2.56%)，两组比较差异无统计学意义(P＞0.05)。B组有12眼(30.77%)使用骨动力系统用于磨削骨质，A组未使用骨动力系统；A组手术时间为(31.88±1.64) min；B组手术时间为(48.54±4.40) min，两组比较差异有统计学意义(P <0.01)；B组术后人工泪管从内眦脱出2例，A组在人工泪管置入或取出时，均无管体被拉断裂的病例，无人工泪管从内眦侧脱出的病例。两组患者术后均无人工泪管导致的泪点撕裂，术后随访平均6个月，均无复发。结论：低位经鼻内镜泪囊鼻腔吻合术联合RT新型人工泪管置入可以作为一种新的治疗慢性泪囊炎手术有效、安全的方法。

Objective: To study the efficacy and safety of endonasal endoscopic lower position dacryocystorhinostomy(En-LPDCR) combined with new RT lacrimal stent intubation for treating chronic dacryocystitis. Methods: In A prospective randomized controlled study, patients with chronic dacryocystitis secondary to primary nasolacrimal duct obstruction who met the inclusion criteria were randomly divided into two groups. In study group (Group A), 43 cases (44 eyes) were treated with the En-LP-DCR combined with new RT lacrimal stent intubation. Control group (Group B), 39 cases (39 eyes): conventional endoscopic dacryocystorhinostomy combined with bicanalicular intubation. The stent was removed from 3 to 6 months after surgery and followed up 6 to 12 months. Results: There was no recurrence of chronic dacryocystitis in both groups. In group A, 42 eyes (95.45%) were cured and 2 eyes (4.54%) were improved. In group B, 38 eyes were cured (97.43%) and 1 eye was improved (2.56%), there was no significant difference between the two groups (P > 0.05). In group B, 12 eyes (30.77%) With the incorporation of powered instrumentation to make bony ostium with full exposure of the lacrimal sac., while group A did not use powered dynamic system. Operation time of group A was (31.88±1.64) min; The operation time of group B was (48.54±4.40) min. The difference between the two groups was significant (P < 0.01). In group B, the stent dislocated from the medial canthus in 2 cases, while in group A, there were no cases of the stent dislocated. No patient with dislocation, displacement of stent and punctum erosion founded in both groups, and no recurrence of chronic dacryocystitis was observed during the average follow-up of 6 months. Conclusion: Endonasal endoscopic lower position dacryocystorhinostomy combined with new RT lacrimal stent intubation is a new and effective method for the treatment of chronic dacryocystitis, with minimally surgical injury and faster postoperative recovery.

二氧化碳(carbon dioxide, CO₂)激光通过气体混合物激发产生红外光，组织水分高度吸收后引发汽化和局部热效应，能够精确封闭小血管和淋巴管。这些特性使得CO₂激光在组织切割过程中能够最大限度地减少出血，提高术中视野的清晰度，缩短手术时间，并减轻术后肿胀、瘀斑及疼痛。在眼整形外科，特别是处理眼周复杂病例方面，CO₂激光展现了显著的优势。文章对CO₂激光在眼整形外科中的应用进行综述，包括眼睑肿物切除、泪小管炎治疗、瘢痕治疗、皮肤松弛治疗以及眼袋去除等，旨在为临床医生和研究人员提供关于CO₂激光在眼整形外科中的全面参考，帮助其了解该项技术的优势、效果及术后并发症，以更有效地应用于实践并探索未来发展。

The carbon dioxide (CO₂) laser generates infrared light through the excitation of a gaseous mixture. When this infrared light is highly absorbed by tissue water, it triggers vaporization and localized thermal effects, enabling precise sealing of small blood vessels and lymphatic vessels. These properties allow the CO₂ laser to minimize bleeding during tissue dissection, enhance intraoperative visual field clarity, reduce operative time, and alleviate postoperative swelling, ecchymosis, and pain. The CO₂ laser has demonstrated significant advantages in oculoplastic surgery, particularly in the management of complex periorbital cases. This article reviews the applications of the CO₂ laser in oculoplastic surgery, including eyelid tumor excision, treatment of canaliculitis, scar management, skin laxity treatment, and removal of eye bags. It aims to provide clinicians and researchers with a comprehensive reference on the use of the CO₂ laser in oculoplastic surgery, helping them understand the advantages, effects, and postoperative complications of this technology, in order to more effectively apply it in practice and explore future developments.

目的：分析鼻内镜下泪囊鼻腔吻合术手术疗效的影响因素。方法：纳入2021年1月—2023年7月在成都中医药大学附属医院眼科行鼻内镜下泪囊鼻腔吻合术(endoscopic dacryocystorhinostomy, En-DCR)治疗的单眼慢性泪囊炎患者90例(90只眼)。所有患者均进行泪道CT造影检查及鼻内镜下泪囊鼻腔吻合术，术后随访6个月，评估手术疗效，分析手术疗效的影响因素。结果：本研究显示，慢性泪囊炎患者中女性占比为90%，平均年龄为(49.97±13.10)岁。单因素分析结果显示，术中是否置入引流管、下鼻甲肥厚与EnDCR手术疗效有关(P < 0.05)。Logistic多因素回归分析结果显示，下鼻甲肥厚为En-DCR手术疗效的危险因素(P < 0.05)。结论：慢性泪囊炎多发生于中老年女性。下鼻甲肥厚为En-DCR手术疗效的危险因素。

Objective: To analyze the influencing factors for effect of endoscopic dacryocystorhinostomy. Methods: A total of 90 patients (90 eyes) diagnosed with unilateral chronic dacryocystitis undergoing endoscopic dacryocystorhinostomy in the Department of ophthalmology, Hospital of Chengdu University of Traditional Chinese Medicine from January 2021 to July 2023 were included. All patients underwent lacrimal duct CT imaging and endoscopic dacryocystorhinostomy, and were followed up for 6 months to evaluate the efficacy of surgery. Results: This study showed that 90% of patients with chronic dacryocystitis were female, and the average age of patients was (49.97±13.096) years. The results of univariate analysis showed that there was a correlation between intraoperative drainage tube placement and inferior turbinate hypertrophy and the efficacy of En-DCR (P < 0.05). The results of Logistic regression analysis showed that inferior turbinate hypertrophy was a risk factor for the efficacy of En-DCR (P < 0.05). Conclusions: Dacryocystitis mostly occurs in middle-aged and elderly women. Inferior turbinate hypertrophy are the influencing factors of surgical effect. Chronic dacryocystitis mostly occurs in middle-aged and elderly women. Inferior turbinate hypertrophy is a risk factor affecting the curative effect of En-DCR surgery.

目的：比较中国南方地区与西北地区慢性泪囊炎患者的菌群分布，明确细菌谱的地理差异性，对不同地区抗生素使用因地制宜提供依据。方法：本研究为回顾性横断面研究。纳入2022年3月—2024年4月在中国西北地区三甲医院眼科诊断为慢性泪囊炎，拟行泪囊鼻腔吻合术的患者，并选取同时期在中国南方地区诊断为慢性泪囊炎的患者，所有患者在行经鼻镜泪囊鼻腔吻合术时切开泪囊取泪囊分泌物。两组标本均行一般细菌及真菌培养，比较两组细菌培养阳性率和构成比。结果：南方地区和西北地区泪囊分泌物细菌培养阳性率分别为26.0%和50.7%，差异有统计学意义(P < 0.001)。南方地区细菌分布中革兰阳性球菌、革兰阴性杆菌的构成比分别为 45.9%、37.6%，西北地区两种菌构成比为 71.4%、19.0%，差异有统计学意义(分别为P = 0.007，P = 0.003)。两地区检出率最高的菌均为凝固酶阴性葡萄球菌，链球菌属占比在两地区间比较差异有统计学意义(P = 0.004)。结论：中国南方地区比西北地区泪囊分泌物培养阳性率低，慢性泪囊炎细菌谱均以革兰阳性菌为主，南方地区革兰阴性菌占比较西北地区更高，链球菌属检出率较西北地区明显更低。这可能是不同地理环境、不同气候、不同生活习惯等共同因素的结果。

Objective: To compare the bacterial distribution of patients with chronic dacryocystitis from southern China and northwest China and to elucidate the geographical differences in the bacterial spectrum. Methods: This retrospective cross-sectional study included patients diagnosed with chronic dacryocystitis at the ophthalmology departments of tertiary hospitals in southern and northwest China between March 2022 and April 2024. Endoscopic dacryocystorhinostomy was performed on all patients to collect lacrimal sac secretions. The specimens were cultured for bacteria and fungi, and the positive rates and composition ratios of bacterial culture were compared between the two groups. Results: The positive rates of bacterial cultures from lacrimal sac secretions were 26.0% in southern China and 50.7% in northwest China (P < 0.001). The proportions of Gram-positive cocci and Gram-negative bacilli were 45.9% and 37.6%, respectively, in southern China, compared to 71.4% and 19.0%, respectively, in northwest China (P = 0.007 and P = 0.003, respectively). Coagulase-negative staphylococci were the most frequently detected bacteria in both regions. However, the proportion of Streptococcus species was significantly higher in northwest China compared to southern China (P = 0.004). Conclusions: The positive rate of lacrimal sac secretion cultures was lower in southern China compared to northwest China. The bacterial spectrum of chronic dacryocystitis in both regions was predominantly composed of Gram-positive bacteria. However, the proportion of Gram-negative bacteria was higher in southern China, while the detection rate of Streptococcus species was significantly higher in northwest China. These differences may be attributed to variations in climate, geographical features, and lifestyle habits.

血泪是指因各种原因导致眼部流出血性泪液的症状，其病因和临床表现复杂多样，往往涉及多学科多专业。不同病因引起的血泪，无论是临床表现，还是诊治方法均差异很大。为了向临床医生提供可参考的血泪临床诊疗流程，中国医师协会眼科医师分会泪器病专业委员会及中国中西医结合学会眼科专业委员会泪器病学组组织有关专家以临床实践经验为基础，经过认真讨论建立本共识，对血泪的病因、临床特征及诊疗流程提出指导性意见。

Bloody tears refers to the symptoms of blooding tears flowing from the eye due to various reasons. Its etiology and clinical manifestations are complex and diverse, often involving multiple disciplines and specialties. In order to provide clinicians with a reference for the clinical diagnosis and treatment process of bloody tears, Lacrimal Diseases Professional Committee of Ophthalmologist Branch of Chinese Medical Doctor Association and Lacrimal Diseases Group of Ophthalmic Professional Committee of Chinese Association of Integrated Medicine organized relevant experts to establish this consensus based on clinical practice after serious discussion, and put forward guiding opinions on the etiology, clinical characteristics, and diagnosis and treatment process of bloody tears.

      老年性黄斑变性(Age-related maeular degeneration，AMD)是老年人视力损伤和致盲的主要原因。视网膜的高耗氧性，高长链多不饱和脂肪酸含量，作为氧自由基的靶点和暴露于可见光的特性使其易产生氧化应激。大量研究均显示抗氧化营养素有助于老年性黄斑变性的防治，本文就其最新研究进展进行综述。

Age-related macular degeneration ( AMD)is the leading cause of irreversible visual impairent and blindness in elderly people. The retina seems particularly susceptible tooxidative stress because of its high concentration ofoxygen,polyunsaturated fatty acids, targets as oxygen free radical, and exposure to visible light.Multiple studies have suggested that antioxidative nutrients can play a role in slowing the onset or limiting the effects of AMD. The article has reviewed the latest research progress of antioxidative nutrients and age-related macular degeneration. 

目的：探讨上睑提肌缩短术和额肌肌瓣悬吊术后眼表改变和恢复的差异。

方法：对2007 年1 月至2007 年4 月在中山眼科中心住院的42例(62只眼)先天性上睑下垂患者，按手术方式和术后是否加用局部用药进行随机分组，观测各组术后2 d、5 d、7 d和2周患者泪液的分泌、泪膜破裂时间、结膜充血、角膜荧光染色、睑板腺功能、瞬目次数、上睑睫毛角度和眼睑闭合情况，并分析其观察结果的差异是否有统计学意义。

结果：3名患者(7.1 ％)因需要加用其它促角膜上皮生长的药物而退出本研究，其中1例(2.3 ％)因倒睫刺激角膜上皮水肿缺损需行手术调整，其余所有患者眼表检测项目的结果均显示不同程度地受到了手术影响，但是随着术后炎症的逐渐消退，这些受影响的眼表异常均会逐渐恢复正常。泪膜破裂时间、瞬目次数、眼睑闭合情况的影响在两种术式之间的差异有统计学意义，而在术后是否局部用药之间没有统计学差异；角膜荧光素染色在是否加用局部用药组之间有统计学差异，而不同术式之间没有统计学差异；泪液分泌量、结膜充血、睑板腺功能、睫毛角度则在所有组别之间均没有统计学差异。

结论：两种上睑下垂的矫正术均会引起患者眼表的改变，额肌肌瓣悬吊术对泪膜破裂时间、瞬目次数、眼睑闭合情况影响的程度较大，而局部用药只能改善角膜荧光素染色异常、对其它眼表因素影响不大。上睑睫毛角度异常是引起角膜损害最危险的因素。

Objective : To investigate the difference of ocular surface change and restoration after ex-ternal levator advancement and frontalis suspension.

Methods : Forty-two patients (62 eyes) with congenital ptosis hospitalized in ZhongshanOphthalmic Center from Jaruary to April in 2007 were randomly divided into four groups according to different surgery types and with or without post surgery ophthalmic medica-tion. Sehirmer test, tear film break-up time , conjunctiva congestion , cornea fluorescentpigmentation , tarsal gland function , winking frequency, angle of eyelash and eyelid clo-sure were all observed and statistically analyzed in all groups 2 days , 5 days , 7 days and 2 weeks after surgery.

Results : Except 3 patients needed advanced ophthalmic medicine, one of whom waswith corneal ulceration and needed another surgery, all the others were observed withocular surface items altered in varied degrees and gradually returned to normality as theinflammation caused by surgery recovered. Break-up time , winking frequency and eyelid closure were statistically diferent between the two types of surgery but not betweengroups with and without post surgery ophthalmic medication. Cornea fluorescent pigmen-tation was statistically different between groups with and without post surgery ophthalmicmedication but not between the two types of surgery. The other items did not have statis-tical difference in all groups.

Conclusion : The two types of surgery for ptosis correction could alter the ocular surface ,but frontalis suspension affect tear film break-up time , winking frequency and eyelid clo-sure much more than levator advancement. Ophthalmic medication after the surgerycould only ameliorate cornea fluorescent pigmentation but was not necessarily to restora-tion of normal ocular surface. Abnormality of eyelash angle was the most dangerous fac-tor to the corea injury.

       双眼自发晶状体悬韧带松弛，导致前房波动，进行性近视加重，继发闭角型青光眼的病例在临床比较少见。本病例报道了1例25岁女性双眼自发晶状体悬韧带松弛不伴有晶状体脱位及形态异常，出现双眼前房波动，近视加重，最终继发双眼闭角型青光眼。经过局部抗炎、散瞳处理和“PHACO+IOL(Phacoemulsification+intraocular lens)植入+前段玻璃体切除术”将IOL置于睫状沟后，患者眼压得到控制、视力基本矫正至正常。

Changeable anterior chamber depth due to spontaneous zonular laxity of thelens is a rare abnormality in clinic. Here is a 25 -year-old female with changeable anteri.or chamber depth due to bilateral spontaneous zonular laxity which also finally led toprogressive myopia and angle-closure glaucoma is deseribed. After using local anti-in-fammation and dilation of the pupil, and carrying out “ Phacoemulsification + anteriorvitrectomy" putted intraocular lens ( IOL) into the ravine of ciliary body , the womansintraocular pressure was controlled and visual acuity was corrected to 20/20. 

Diabetic retinopathy (DR), a major micro-vascular complication of diabetes, has emerged as a leading cause of visual impairment and blindness among adults worldwide. However, aside from pathological damage, the traditional laser and multi-needle operation treatments required for more advanced disease can cause further damage to the visual field and increase the operation risk. Therefore, the development of new therapeutic strategies for the prevention and treatment of DR is essential. Some emerging evidence now indicates that pigment epithelium-derived factor (PEDF),  a multifunctional protein, can target multiple pathways to exert neurotropic, neuroprotective, anti-angiogenic, anti-vasopermeability, anti-inflammation, anti-thrombogenic, and anti-oxidative effects against DR. This review addresses the functions of PEDF in different pathways that could lead to potential therapeutics for the treatment of DR.

Diabetic retinopathy (DR), a major micro-vascular complication of diabetes, has emerged as a leading cause of visual impairment and blindness among adults worldwide. However, aside from pathological damage, the traditional laser and multi-needle operation treatments required for more advanced disease can cause further damage to the visual field and increase the operation risk. Therefore, the development of new therapeutic strategies for the prevention and treatment of DR is essential. Some emerging evidence now indicates that pigment epithelium-derived factor (PEDF),  a multifunctional protein, can target multiple pathways to exert neurotropic, neuroprotective, anti-angiogenic, anti-vasopermeability, anti-inflammation, anti-thrombogenic, and anti-oxidative effects against DR. This review addresses the functions of PEDF in different pathways that could lead to potential therapeutics for the treatment of DR.