目的：分析天津市某眼科医院急诊病例疾病谱，为规范疾病诊断流程、合理分配急诊医疗资源提供循证依据。方法 回顾性分析2019年1月~2023年12月在天津市某眼科医院急诊科就诊患者的临床资料，包括一般人口学资料、就诊时间、季节分布及初步诊断等。结果：共纳入26 077例眼科急诊患者，男女比例为1.12∶1，年龄为（36.82±15.44）岁，就诊年龄大多分布在＜14岁（26.74%）及31~40岁（21.03%）；日就诊时间分布中：10:00~12:00（11.06%）、14:00~16:00（10.41%）及20:00~22:00（10.43%）就诊人数较多，05:00~07:00（4.83%）就诊人数较少；4月就诊人数最少（3.87%），8月就诊人数最多（11.61%），夏季就诊人数（31.74%）显著多于其他3个季节；眼科急诊患者最常见的10种初步诊断中结膜炎占比最多（39.58%），其次为干眼症（14.32%）；与2019年相比，2020年和2021年眼科急诊患者前10种初步诊断显著下降（均P<0.001，2020年95%CI为-0.98~-0.68、2021年95%CI为-0.54~-0.11）；与春季相比，其他季节眼科急诊患者前10种初步诊断显著下降（P均<0.001，夏季95%CI为-0.32~-0.08、秋季95%CI为-0.39~-0.14、冬季95%CI为-0.54~-0.30）。其中在结膜炎病例中，与春、夏季相比，冬季结膜炎病例分布呈显著下降趋势（P均<0.001，95%CI分别为-0.08~-0.03]、为-0.08~-0.04）；眼科急诊患者前10种初步诊断性别分布具有统计学意义（P＜0.001）；与14岁以下年龄段相比，其他年龄眼科急诊患者前10种初步诊断均呈下降趋势，（P均<0.001，14~20岁95%CI为-0.88~-0.43、21~30岁95%CI为-1.01~-0.65、31~40岁95%CI为-1.10~-0.82、41~50岁95%CI为-0.97~-0.66、51~60岁95%CI为-1.71~-1.38、61~70岁95%CI为-1.45~-1.08、71~80岁95%CI为-1.36~-0.80、>80岁95%CI为-1.44,-0.22）。结论：眼科急诊患者以儿童和中青年男性为主，14岁以下年龄段人群相比来说有较高风险；日就诊时间分布呈现出“三个高峰一个低谷”的显著特征，就诊高峰时段分别为10:00~12:00、14:00~16:00以及20:00~22:00，就诊低谷出现在05:00~07:00期间；眼科急诊中最常见的诊断主要是那些通常被认为是非紧急的诊断，即结膜炎和干眼症；结膜炎的发病呈现明显的季节性特征，春、夏季为高发期；与2019年相比，2020年和2021年眼科急诊就诊总量显著减少，其中以结膜炎和干眼症的就诊量减少尤为明显，2022年有一定程度的恢复。

Purpose：To analyze the disease spectrum of emergency cases at an ophthalmology hospital in Tianjin, offering evidence-based support for standardizing diagnostic procedures and rationing emergency medical resources. Methods: Reviewed clinical data of patients at the hospital's emergency department from January 2019 to December 2023, covering demographics, visit timings, seasonal distribution, and preliminary diagnoses. Results: A total of 26,077 ophthalmology emergency patients were included, with a male-to-female ratio of 1.12:1 and an average age of 36.82±15.44 years. Most patients were aged <14 years (26.74%) and 31~40 years (21.03%). Daily visits peaked at 10:00~12:00 (11.06%), 14:00~16:00 (10.41%), and 20:00~22:00 (10.43%), and were lowest at 05:00~07:00 (4.83%). April had the fewest visits (3.87%), August the most (11.61%), and summer accounted for the highest quarterly proportion (31.74%). The top 10 preliminary diagnoses were led by conjunctivitis (39.58%) and xerophthalmia (14.32%). Compared to 2019, the top 10 preliminary diagnoses dropped significantly in 2020 and 2021 (both P<0.001), 2020 95%CI[-0.98~-0.68]、2021 95%CI[-0.54~-0.11]. Similarly, these diagnoses were significantly lower in summer, autumn, and winter than in spring (all P<0.001), summer 95%CI[-0.32~-0.08]、autumn 95%CI[-0.39~-0.14]、winter 95%CI[-0.54~-0.30]. In conjunctivitis cases, winter incidence was significantly lower than in spring and summer (both P<0.001). Gender distribution in the top 10 diagnoses was statistically significant (P<0.001), 95%CI[-0.08~-0.03] and [-0.08~-0.04] . Compared to those aged <14, other age groups showed a downward trend in the top 10 preliminary diagnoses (all P<0.001), 14~20 95%CI[-0.88~-0.43]、21~30 95%CI[-1.01~-0.65]、31~40 95%CI[-1.10~-0.82]、41~50 95%CI[-0.97~-0.66]、51~60 95%CI[1.71~-1.38]、61~70 95%CI[-1.45~-1.08]、71~80 95%CI[-1.36~-0.80]、>80 95%CI[-1.44,-0.22].Conclusions: Ophthalmology emergency patients are mainly children and middle-aged men, with those <14 years old at higher risk. Visit times follow a "three-peak-one-valley" pattern. Most diagnoses are non-urgent conditions like conjunctivitis and xerophthalmia. Conjunctivitis shows marked seasonality, peaking in spring and summer. Total ophthalmology emergency visits declined in 2020 and 2021 versus 2019, particularly for conjunctivitis and xerophthalmia, partially recovering in 2022.

目的：回顾2型神经纤维瘤病(neurofibromatosis type 2, NF2)患者的眼部表现，分析NF2眼部病变的临床和影像学特征，以助该病的早期诊断。方法：收集来自深圳市眼科医院的1例和来自中山眼科中心的3例NF2患者完整的临床资料并进行总结分析。结果：这4例患者均因眼部异常首诊于眼科且符合曼彻斯特诊断标准。4例患者中，3例为NF2早发型(<20岁)，1例为晚发型(>20岁)，男女比例1∶1。3例患者因视力下降、1例患者因复视首诊于眼科。3例行眼底光学相干断层成像(optical coherence tomography, OCT)检查显示，视网膜错构瘤2例，视网膜前膜2例，视盘隆起2例，视网膜神经纤维层和节细胞层变薄1例。其他表现包括麻痹性斜视2例，复视1例，白内障1例，球后段视神经增粗1例，眼眶肿瘤1例。结论：NF2的眼部表现多种多样，可出现在神经症状和听力损失之前。详细的眼科检查及影像学检查对年轻患者的早期诊断非常有价值，有助于选择更好的治疗计划。

Objective: To review the ocular manifestations of patients with neurofibromatosis type 2 (NF2), and analyze the clinical and imaging features of the ocular lesions in NF2, so as to facilitate the early diagnosis of this disease. Methods: The complete medical records of 1 case from Shenzhen Eye Hospital and 3 cases of NF2 from Zhongshan Ophthalmic Center were collected. Results: All four patients were first diagnosed in ophthalmology due to eye symptoms and met the Manchester diagnostic criteria. Of the four patients, three were NF2 early hairstyles (<20 years old), one was late hairstyle (>20 years old), and the male-to-female ratio was 1:1. Three patients were first diagnosed in the ophthalmology department due to decreased visual acuity, and one patient was first diagnosed due to diplopia. Optical coherence tomography (OCT) examinations were performed on three patients, which showed that there were two cases of retinal hamartoma, two cases of epiretinal membrane, two cases of optic disc elevation, and one case of thinning of the retinal nerve fiber layer and ganglion cell layer. Other manifestations included two cases of paralytic strabismus, one case of diplopia, one case of cataract, one case of thickening of the retrobulbar optic nerve, and one case of orbital tumor. Conclusions: The ocular manifestations of NF2 are diverse and can precede neurological symptoms and hearing loss. Detailed ophthalmic examinations and imaging studies are highly valuable for early diagnosis in young patients, aiding in the selection of a better treatment plan.

       小泪囊型慢性泪囊炎是泪道阻塞性疾病中的特殊亚型，目前尚无针对小泪囊的确切定义，传统内镜下泪囊鼻腔吻合术(endoscopic dacryocystorhinostomy, En-DCR)治疗小泪囊型慢性泪囊炎因泪囊体积小手术操作难度大、术后吻合口易闭锁和成功率低而被视为相对禁忌。本研究通过CT泪囊造影(CT dacryocystography, CT-DCG)三维精准测量、定义小泪囊(水平径≤3 mm、前后径≤3 mm、垂直径≤6 mm)，提出开放泪总管平面技术以扩大泪囊鼻腔吻合口，同时联合双管人工泪管植入术的En-DCR治疗方案，术后予以肾上腺皮质激素(激素)喷鼻剂辅助，显著提升手术疗效。

      研究纳入61例小泪囊型泪囊炎患者，术后9个月随访显示，解剖成功率达80. 33%(49/61)，功能成功率为75.41%(46/61)。术中开放泪总管平面技术有效扩大手术窗口；短期双管人工泪管植入(术后3个月取出)联合激素喷鼻剂使用可降低吻合口闭锁风险同时未增加肉芽增生和感染风险。与传统治疗相比，该方案突破小泪囊手术禁忌，为患者提供更优选择。

       小泪囊型慢性泪囊炎是泪道阻塞性疾病中的特殊亚型，目前尚无针对小泪囊的确切定义，传统内镜下泪囊鼻腔吻合术(endoscopic dacryocystorhinostomy, En-DCR)治疗小泪囊型慢性泪囊炎因泪囊体积小手术操作难度大、术后吻合口易闭锁和成功率低而被视为相对禁忌。本研究通过CT泪囊造影(CT dacryocystography, CT-DCG)三维精准测量、定义小泪囊(水平径≤3 mm、前后径≤3 mm、垂直径≤6 mm)，提出开放泪总管平面技术以扩大泪囊鼻腔吻合口，同时联合双管人工泪管植入术的En-DCR治疗方案，术后予以肾上腺皮质激素(激素)喷鼻剂辅助，显著提升手术疗效。

      研究纳入61例小泪囊型泪囊炎患者，术后9个月随访显示，解剖成功率达80. 33%(49/61)，功能成功率为75.41%(46/61)。术中开放泪总管平面技术有效扩大手术窗口；短期双管人工泪管植入(术后3个月取出)联合激素喷鼻剂使用可降低吻合口闭锁风险同时未增加肉芽增生和感染风险。与传统治疗相比，该方案突破小泪囊手术禁忌，为患者提供更优选择。

双眼视，即双眼同时工作、协调和整合视觉信息的能力，能够产生单一、立体和深度感的视觉体验，近年来在认知心理学和神经科学研究中逐渐受到越来越多的重视，尤其是在探讨其与执行能力之间复杂关联的方面。执行能力作为一项至关重要的认知功能，涉及多个方面，包括注意力、工作记忆、决策和问题解决等，这些因素共同影响着个体在日常生活和工作中的表现和效率。当前的研究表明，双眼视不仅在视觉信息的处理上发挥着关键作用，还对个体的执行能力产生了显著的影响。双眼视异常群体（如斜视、弱视患者）在执行功能测试中普遍表现出反应抑制延迟、工作记忆容量降低等特征。然而，现有文献中关于双眼视与执行能力之间关系的研究，特别是基于神经机制及其临床影响的系统性分析仍显得相对不足。为此，本文通过对现有研究的综述，深入探讨双眼视在执行能力中的作用，详细分析其背后的神经机制，并讨论这些发现对临床实践可能产生的影响。此外，文章还提出了未来研究的方向，以期更全面地理解双眼视与执行能力之间复杂的交互关系，从而为相关领域的研究提供新的视角和思路，推动这一领域的进一步发展。

Binocular vision, the ability of both eyes to work simultaneously, coordinate, and integrate visual information, can produce a unified, three-dimensional, and depth-perceptive visual experience. In recent years, it has garnered increasing attention in cognitive psychology and neuroscience research, particularly in exploring its complex relationship with executive functions. Executive functions, as a crucial cognitive capability, encompass various aspects, including attention, working memory, decision-making, and problem-solving, all of which collectively influence an individual's performance and efficiency in daily life and work. Current research indicates that binocular vision plays a key role not only in processing visual information but also has a significant impact on an individual's executive functions. Groups with binocular vision abnormalities (such as strabismus and amblyopia patients) generally exhibit characteristics like delayed response inhibition and reduced working memory capacity in executive function tests. However, existing literature on the relationship between binocular vision and executive functions, especially systematic analyses based on neural mechanisms and their clinical implications, remains relatively insufficient. Therefore, this article reviews existing research to delve into the role of binocular vision in executive functions, analyzes the underlying neural mechanisms in detail, and discusses the potential clinical implications of these findings. Additionally, the article proposes future research directions to comprehensively understand the complex interplay between binocular vision and executive functions, aiming to provide new perspectives and ideas for research in related fields and promote further development in this area.

真菌性角膜炎是我国常见的致盲性眼病，其中排前3位的致病病原菌分别为曲霉菌、镰刀菌以及念珠菌。念珠菌作为一种条件致病真菌，在宿主免疫功能低下或眼表微环境失衡时易引发机会性感染，其发病率因免疫抑制药物的滥用以及隐形眼镜佩戴的增加等因素逐年上升。在机会感染后，由于念珠菌本身以及生物膜形成的特殊作用，常导致其对现用系统性抗真菌药物，如伏立康唑、两性霉素B、伊曲康唑及氟康唑等耐药性增加。近年来，关于纳米材料介导的药物传递系统作用于治疗念珠菌角膜炎的研究日益增多，新型纳米材料通过作为抗真菌药物的载体，增加药物溶解度，延长眼表停留时间，加强生物膜、角膜穿透性，提高了抗真菌药物对念珠菌的抗菌作用，为解决念珠菌感染耐药性难题提供了新思路。文章综述了纳米聚合物、纳米颗粒、纳米凝胶、脂质体载体、纳米立方体、纳米微针和纳米胶束等新型纳米材料作为治疗念珠菌角膜炎的新型给药载体的研究现状与进展，突破传统疗法的局限，为改善目前临床存在抗真菌治疗药物有限的问题提供新的可行思路。

Fungal keratitis is a prevalent blinding ocular disease in China, with Aspergillus, Fusarium, and Candida ranking as the top three pathogenic fungi. As an opportunistic pathogenic fungus, Candida readily causes opportunistic infections when host immunity is compromised or the ocular surface microenvironment is imbalanced. The incidence of Candida keratitis has been rising annually due to factors such as the misuse of immunosuppressive drugs and increased contact lens wear. Following infection, Candida itself and the formation of biofilms contribute to enhanced resistance against currently used systemic antifungal agents, including voriconazole, amphotericin B, itraconazole, and fluconazole, posing significant challenges to clinical treatment.Recently, research on nanomaterials-mediated drug delivery systems for treating Candida keratitis has burgeoned. Novel nanomaterials, serving as carriers for antifungal drugs, enhance therapeutic efficacy by improving drug solubility, prolonging ocular surface retention time, penetrating biofilms, and enhancing corneal permeability. These advancements offer new strategies to address drug resistance in Candida infections. This article reviews the research status and progress of emerging nanomaterials—such as nanopolymers, nanoparticles, nanogels, liposomal carriers, nanocubes, nanoneedles, and nanomicelles—as innovative drug delivery vectors for Candida keratitis. By overcoming the limitations of conventional therapies, these nanomaterials provide feasible solutions to the clinical challenges of limited antifungal options and drug resistance. The integration of nanotechnology holds promise for revolutionizing the treatment of Candida keratitis and advancing precision medicine for ocular surface fungal infections.

目的：探讨压核进钩劈核技术在白内障超声乳化摘除手术培训中的应用效果。方法：采用回顾性研究。选取2019年1月—2023年12月在广东省中医院珠海医院眼科学习超声乳化白内障吸除术的30名学员为研究对象，所有对象培训周期均为3个月，分为乳化劈核教学组和压核进钩劈核教学组，统计学员第一次完成劈核前的猪眼手术量、第一次完成全部手术步骤前的猪眼手术量、一次性完整完成二分核的次数，培训结束时对学员进行猪眼手术操作考核并记录评分，采用问卷调查对两种教学方式进行评价。结果：压核进钩劈核教学组第一次完成劈核前的平均猪眼手术量为36.69（19，50）个，低于乳化劈核教学组的49.86（29，66）个（U=-3.08，P<0.05）；压核进钩劈核教学组第一次完成全部手术步骤前的平均猪眼手术量为58.13（31，79）个，低于乳化劈核教学组73.14（50，90）个（U=-2.66，P<0.05）；压核进钩劈核教学组一次性完整完成二分核的次数为14.75（9，22）次，高于乳化劈核教学组6.79（3，14）（U=4.02，P<0.05）；压核进钩劈核教学组学员动物眼手术碎核步骤平均分为4.50（3，5），高于乳化劈核教学组的3.71（2，5）次（U=2.23，P<0.05）；完整手术考核总分平均分为29.00（23，33）分，高于乳化劈核教学组的23.07（19，28）分（U=3.98，P<0.05）。培训结束时，压核进钩劈核教学组学员评价教学效果调查问卷总评分平均为18.31（15，20）分，高于乳化劈核教学组15.07（12，18）（U=3.69，P<0.05）。结论：核进钩劈核技术有助于学员更快地掌握碎核技术，缩短白内障超声乳化摘除手术的学习曲线，增强学习白内障手术的信心，提高超声乳化白内障吸除术的教学效果和满意度。

Objective:To investigate the effect of the press-and-chop technique in cataract phacoemulsification training. Methods:From January 2019 to December 2023, 30 trainees who studied cataract phacoemulsification surgery in the ophthalmology department of Guangdong Hospital of Traditional Chinese Medicine,Zhuhai were selected as the research subjects. The training period for all subjects was 3 months, and they were divided into two groups: phaco-chop teaching group and press-and-chop teaching group. The quantity of porcine eye surgeries performed by each trainee before completing the first nuclear chopping, the quantity of porcine eye surgeries performed before completing all surgical steps for the first time, and the number of times of complete nuclear chopping in one attempt were recorded. At the end of the training, the trainees were assessed on their ability to perform porcine eye surgeries and their scores were recorded. A questionnaire survey was conducted to valuate the two teaching methods. Results:The average number of porcine eye surgeries performed by the press-and-chop teaching group before completing the first nuclear chopping was 36.69 (19,50), which was lower than the phaco chop teaching group's 49.86 (29,66);The average number of porcine eye surgeries performed by the press-and-chop teaching group before before the first completion of all surgical steps was 58.13 (31, 79), which was lower than the phaco chop teaching group's 73.14 (50, 90).The average number of complete nuclear chopping in one attempt in the press-and-chop teaching group was 14.75 (9,22), which was higher than the phaco chop teaching group's 6.79 (3,14);The average score of the chopping step of porcine eye surgery for the press-and-chop teaching group was 4.50 (3,5), which was higher than the phaco chop teaching group's 3.71 (2,5);The average score for the press-and-chop teaching group of the complete surgery examination was 29.00 (23, 33), which was higher than the phaco chop teaching group's 23.07 (19, 28).At the end of the training, the average score of the survey questionnaire on the evaluation of teaching effectiveness by the press-and-chop teaching group was 18.31 (15, 20), which was higher than that of the phaco chop, which was 15.07 (12, 18). Conclusions:The press-and-chop technique helps trainees to master the chopping technique faster, shorten the learning curve of cataract phacoemulsification surgery, enhance confidence in learning cataract surgery, and improve the teaching effectiveness and satisfaction of cataract phacoemulsification surgery．

目的：利用美国食品药品监督管理局公共数据开放项目（OpenFDA）检索并分析盐酸环喷托酯滴眼液药品不良反应（adverse drug reactions，ADRs）的报告情况，为临床安全用药提供参考。 方法： 以“盐酸环喷托酯滴眼液”作为检索词，在OpenFDA数据库中检索2004年1月1日至2024年8月1日期间盐酸环喷托酯滴眼液相关ADRs的所有信息，对检索到的数据进行分析。 结果：共检索到盐酸环喷托酯滴眼液相关ADRs 1185例。1185例患者中，剔除性别不详后，女性和男性分别为516例和483例（43.54% vs 40.76%）；剔除年龄不详后，ADRs发生率较高的是65~<80岁患者（221例，18.65%）、50~<65岁患者（176例，14.85%）、3~<13岁患者（140例，11.81%）。盐酸环喷托酯滴眼液发生率较高的ADRs为眼器官疾病（767例，64.73%）、神经系统疾病（254例，21.43%）及胃肠系统疾病（228例，19.24%）。 结论：盐酸环喷托酯滴眼液可发生眼局部和全身ADRs，临床在使用时应详细询问患者疾病史和用药史，加强用药监护，提高患者用药的安全性。

Objective: To retrieve and analyze adverse drug reactions (ADRs) of cyclopentolate hydrochloride eye drops on the US Food and drug Administration Public Data Open Project (OpenFDA), so as to provide reference for clinical rational drug use. Methods: Using "Cyclopentolate hydrochloride eye drops" as the search term, retrieve all information related to ADRs of cyclopentolate hydrochloride eye drops from the OpenFDA database from January 1, 2004 to August 1, 2024, and analyze the retrieved data  Results: A total of 1 185 cases of ADRs associated with cyclopentolate hydrochloride eye drops were found. Among the 1185 patients, 516 were female and 483 were male ( 43.54 % vs 40.76 % ) after excluding the unknown gender. After excluding patients with unknown age, the incidence of ADRs was higher in patients aged 65~ < 80 years old ( 221 cases, 18.65 % ), 50~< 65 years old ( 176 cases, 14.85 % ), and 3~ < 13 years old ( 140 cases, 11.81 % ). The ADRs with high incidence of cyclopentolate hydrochloride eye drops were ocular organ diseases ( 767 cases, 64.73 % ), nervous system diseases ( 254 cases, 21.43 % ) and gastrointestinal system diseases ( 228 cases, 19.24 % ). Conclusions: Cyclopentolate hydrochloride eye drops can cause local and systemic adverse reactions. In clinical use, the patient 's disease history and medication history should be asked in detail, and medication monitoring should be strengthened to improve the safety of patient medication.

目的：评估内界膜翻瓣术联合空气填充在黄斑裂孔手术应用中的有效性。方法：回顾性分析中山眼科中心2016—2019年入院，因黄斑裂孔行内界膜翻瓣术联合空气填充术治疗的患者71例71眼，术后俯卧位1~3 d且随访达6个月以上。通过OCT判断患者黄斑裂孔闭合率，比较患者术前及术后最佳矫正视力(best corrected visual acuity, BCVA)，通过MAIA微视野计检查评估术前与术后黄斑平均光敏度、黄斑完整指数、固视稳定性P1及P2等指标。结果：在总的71只眼中，有91.5%达到了黄斑裂孔的完全闭合。患者术前及术后BCVA提升（P＜0.001），黄斑平均光敏度增加（P＜0.000 1）、黄斑完整指数降低（P＜0.000 1）、固视稳定性P1（P＜0.000 1）及P2（P＜0.001）均提升。结论：内界膜翻瓣术联合空气填充是治疗黄斑裂孔有效的手术方式，空气填充可有效地辅助黄斑裂孔愈合，可作为优先考虑的术中填充物，减轻患者因长时间保持面向下体位带来的痛苦。微视野计参数可用作评估黄斑结构及功能恢复的良好指标。

Objective: To assess the efficacy of the inverted internal limiting membrane (ILM) flap technique with air tamponade for macular holes (MHs). Methods: A retrospective analysis was conducted on 71 patients (71 eyes) who underwent inverted ILM flap surgery combined with air tamponade for macular holes at Zhongshan Ophthalmic Center from 2016 to 2019. Patients were positioned face down for 1-3 days postoperatively and followed up for more than 6 months. OCT was used to determine the closure rate of macular holes, and the best corrected visual acuity (BCVA) before and after surgery was compared. The MAIA microperimeter was used to assess the average macular sensitivity, macular integrity index, and fixation stability P1 and P2 before and after surgery. Results: Of the total 71 eyes, 91.5% achieved complete MH closure. The best corrected visual acuity (BCVA) significantly improved before and after surgery (P < 0.001), average macular sensitivity significantly increased (P < 0.000 1), macular integrity index significantly decreased (P < 0.000 1), and fixation stability P1 (P < 0.000 1) and P2 (P < 0.001) both significantly improved. Conclusions: Inverted ILM flap technique combined with air tamponade provides an effective approach for the management of MHs. The air tamponade should be considered as the preferred in MH surgeries, reducing the discomfort caused by prolonged face-down positioning. Parameters in microperimetry can serve as good indicators for assessing the recovery of macular structure and function.

音乐作为一种非侵入性的感官刺激，凭借其独特的治疗价值在医疗领域的应用日益广泛。文章综述了音乐在眼底诊疗领域的应用现状及研究进展。大量临床研究表明，音乐干预可以显著降低患者在眼科诊疗过程中的焦虑水平，改善医疗体验。在玻璃体腔注射、早产儿视网膜病变筛查、视野检查等不同临床场景中，音乐的应用均显示出积极效果。此外，在眼科模拟手术操作研究中，背景音乐的存在不仅没有对医生的手术操作造成干扰，反而可能通过调节术者的心理状态，优化手术环境。虽然音乐干预效果存在个体差异，不同患者对音乐类型、节奏和音量的偏好各异，但总体而言，作为一种安全、经济且易于实施的辅助手段，音乐疗法在眼底临床实践中展现出良好的应用前景。目前已有初步研究表明，音乐在糖尿病视网膜病变合并抑郁症的大鼠实验模型中可减少细胞凋亡并改善抑郁。未来需要开展更多严谨的随机对照试验，建立标准化的音乐干预方案，以充分发挥音乐在眼科诊疗中的积极作用。同时，也应该重视个体化治疗原则，根据患者的个人喜好和具体临床情况，制定合适的音乐干预策略。

Music, as a non-invasive sensory stimulus, has been increasingly applied in medical fields due to its unique therapeutic value. This article reviews the current applications and research progress of music in fundus examination and treatment. Extensive clinical studies have demonstrated that music intervention can significantly reduce patients' anxiety levels during ophthalmic procedures and improve their medical experience. Positive effects have been observed across various clinical scenarios, including intravitreal injections, retinopathy of prematurity screening, and visual field examinations. Furthermore, studies on simulated ophthalmic surgical procedures have shown that background music not only does not interfere with surgeons' operational performance but may actually optimize the surgical environment by regulating the operator's psychological state. Although the effectiveness of music intervention varies among individuals, with patients showing different preferences for music types, rhythms, and volumes, music therapy generally demonstrates promising potential in fundus clinical practice as a safe, economical, and easily implemented auxiliary measure. Preliminary studies have demonstrated that music can reduce cell apoptosis and improve depression in rat models of diabetic retinopathy complicated with depression. Looking forward, more rigorous randomized controlled trials are needed to establish standardized music intervention protocols to maximize the positive effects of music in ophthalmic treatment. Meanwhile, emphasis should be placed on the principle of individualized treatment, developing appropriate music intervention strategies based on patients' personal preferences and specific clinical conditions.

目的：利用超高效液相色谱串联四极杆-静电场轨道阱高分辨质谱(ultra-high per formance liquid chromatography tandem quadrupole-electrostatic field orbitrap high resolution mass spectrometer, UHPLC- HRMS)代谢组学技术结合机器学习识别与糖尿病视网膜病变(diabetic retinopathy, DR)进展过程中的房水代谢差异，以寻找DR进展相关生物标志物。方法：本研究共纳入78例2型糖尿病(type 2 diabetes mellitus, T2DM)患者以及30名年龄性别匹配健康对照人群。使用UHPLC- HRMS检测所有患者及对照人群房水中的代谢物丰度，结合机器学习筛选T2DM和DR进展相关代谢物标志物并建立预测模型。结果：在校正混杂因素后，与健康人群对比1, 5-脱水山梨醇、硫酸十四烷基酯和N,N,N-三甲基-5-氨基戊酸在T2DM患者中表现出显著差异(均P < 0.05)；而N-乙酰色氨酸、亚油酰胺、油酰胺、棕榈酰胺、戊酸(游离脂肪酸(5:0)和琥珀酸与DR进展显著相关(均P < 0.001)。代谢通路分析表明，“缬氨酸、亮氨酸和异亮氨酸的生物合成”“精氨酸的生物合成”和“半胱氨酸及蛋氨酸代谢”是T2DM差异代谢途径。基于生物标志物的随机森林预测模型显示，差异代谢产物对T2DM和DR进展的预测准确率分别为81.3%和74%。结论：代谢组学结合机器学习方法有效揭示了T2DM及与DR进展相关的代谢特征，亚油酰胺和油酰胺有望成为DR进展的生物标志物，为DR的诊断和个体化治疗提供了新的可能性。

Objective: To identify aqueous humor metabolic profiles associated with the progression of type 2 diabetes mellitus (T2DM) and diabetic retinopathy (DR), aiming to discover potential biomarkers for DR progression. Ultra-high performance liquid chromatography tandem quadrupole-electrostatic field orbitrap high-resolution mass spectrometry (UHPLC-HRMS) will be utilized in conjunction with machine learning (ML) for comprehensive analysis. Methods: A total of 78 patients with T2DM and 30 age- and gender-matched healthy controls were included. UHPLC-HRMS was used to identify metabolites in the aqueous humor of all participants. ML was employed to screen for metabolites associated with T2DM and DR progression, and predictive models were established. Results: After adjusting for covariates, 1,5-anhydroglucitol, tetradecyl sulfate, and n,n,n-trimethyl-5-aminovaleric acid identified as significant indicators for T2DM compared to controls (all P < 0.05). N-acetyltryptophan, linoleamide, oleamide, palmitic amide, valeric acid(FFA(5:0), and succinic acid emerged as predictors for DR progression (all P < 0.001). Metabolic pathway analysis revealed that "valine, leucine and isoleucine biosynthesis", "arginine biosynthesis," and "cysteine and methionine metabolism" were the most enriched pathways for T2DM. Predictive models achieved R² values of 81.3%, and 74% for T2DM and DR progression, respectively. Conclusions: Metabolomic combined with ML effectively uncovered metabolic characteristics associated with T2DM and DR progression. Linoleamide and oleamide represent promising potential biomarkers for DR progression, offering new opportunities for diagnosis and personalized treatment of DR.