眶尖部肿瘤为眼科罕见疾病，但因其所处位置特殊，对机体，特别是视神经功能危害极大，错误的诊断、不规范合理的治疗不仅不能解决问题，甚至会对机体造成严重的不可挽回的损害。目前针对眶尖部肿瘤的诊断、治疗多建立在医生的主观认知与经验的基础上，尚未达成共识。本文通过分析眶尖部肿瘤的临床特点，结合以往漏诊、误诊、误治的临床案例，阐述眶尖肿瘤正确诊断的关键要点；同时，结合不同临床案例，客观分析治疗方案，尤其是手术方式、路径，为眶尖部肿瘤的合理化治疗提供依据，以期规范眶尖部肿瘤的诊断和治疗，提高治疗成功率。

Although orbital apical tumor is a rare ophthalmic disease, its special location can cause great harm to the body, especially to the function of the optic nerve. Misdiagnosis and improper treatment are not only unable to solve the problem, but also irretrievably harmful to the body. At present, there is no consensus on the diagnosis and treatment of orbital apical tumors, which are mostly based on subjective cognition and experience of doctors. In this paper, the clinical characters of orbital apical tumors were analyzed through the past clinical cases of misdiagnosis and mistreatment, and the key points of proper diagnosis of orbital apical tumors were expounded. Meanwhile, by combining with different clinical cases, the treatment plans, especially the surgical approaches, were analysed to provide a basis for the appropriate treatment of orbital apical tumors, in order to standardize the diagnosis and treatment of orbital apex tumor, and improve the success rate of treatment.

Abstract: Submacular haemorrhage (SMH) is a sight threatening complication that can occur in exudative age related macular degeneration (AMD), but has been described to occur more frequently in eyes with polypoidal choroidal vasculopathy (PCV). Left untreated, SMH carries a grave visual prognosis. Thus, expedient diagnosis and effective management of this complication is of paramount importance. The treatment strategies for SMH include (I) displacement of blood from the fovea, usually by injection of an expansile gas; (II) pharmacologic clot lysis such as with recombinant tissue plasminogen activator (rtPA); and (III) treatment of the underlying choroidal neovascularization (CNV) or PCV, such as with anti-vascular endothelial growth factor (anti-VEGF) agents. These three strategies have been employed in isolation or in combination, some concurrently and others in stages. rtPA has demonstrable effect on the liquefaction of submacular clots but there are remaining uncertainties with regards to the dose, safety and the timing of initial and repeat treatments. Potential side effects of rtPA include retinal pigment epithelial toxicity, increased risk of breakthrough vitreous haemorrhage and systemic toxicity. In cases presenting early, pneumatic displacement alone with anti-VEGF may be sufficient. Anti-VEGF monotherapy is a viable treatment option particularly in patients with thinner SMH and those who are unable to posture post pneumatic displacement.

Abstract: Submacular haemorrhage (SMH) is a sight threatening complication that can occur in exudative age related macular degeneration (AMD), but has been described to occur more frequently in eyes with polypoidal choroidal vasculopathy (PCV). Left untreated, SMH carries a grave visual prognosis. Thus, expedient diagnosis and effective management of this complication is of paramount importance. The treatment strategies for SMH include (I) displacement of blood from the fovea, usually by injection of an expansile gas; (II) pharmacologic clot lysis such as with recombinant tissue plasminogen activator (rtPA); and (III) treatment of the underlying choroidal neovascularization (CNV) or PCV, such as with anti-vascular endothelial growth factor (anti-VEGF) agents. These three strategies have been employed in isolation or in combination, some concurrently and others in stages. rtPA has demonstrable effect on the liquefaction of submacular clots but there are remaining uncertainties with regards to the dose, safety and the timing of initial and repeat treatments. Potential side effects of rtPA include retinal pigment epithelial toxicity, increased risk of breakthrough vitreous haemorrhage and systemic toxicity. In cases presenting early, pneumatic displacement alone with anti-VEGF may be sufficient. Anti-VEGF monotherapy is a viable treatment option particularly in patients with thinner SMH and those who are unable to posture post pneumatic displacement.

Abstract: Dry eye disease is the most prevalent ocular surface disease in eye clinics. The deficiency of tears is regarded as one of the main pathogenic factors for this disease. Due to the fact that the components of tears are still far beyond our knowledge, the restoration of physiological tears remains the optimum choice for dry eye patients. However, the traditional way to stimulate tear production by systemic administration of muscarinic agonists usually encounters severe side effects. Recently, Nakamachi and colleagues reported that PACAP, a native neurotransmitter present in tear fluid, could stimulate main lacrimal gland secretion and relieve dry eye-like symptoms in PACAP knockout mice. The finding of PACAP and its underlying mechanisms suggest a new modality for dry eye treatment via targeted topical tear stimulations.

Abstract: Dry eye disease is the most prevalent ocular surface disease in eye clinics. The deficiency of tears is regarded as one of the main pathogenic factors for this disease. Due to the fact that the components of tears are still far beyond our knowledge, the restoration of physiological tears remains the optimum choice for dry eye patients. However, the traditional way to stimulate tear production by systemic administration of muscarinic agonists usually encounters severe side effects. Recently, Nakamachi and colleagues reported that PACAP, a native neurotransmitter present in tear fluid, could stimulate main lacrimal gland secretion and relieve dry eye-like symptoms in PACAP knockout mice. The finding of PACAP and its underlying mechanisms suggest a new modality for dry eye treatment via targeted topical tear stimulations.

鼻内镜外科技术延伸到鼻眼相关疾病的诊断和治疗已经有二十余年的历史。随着鼻眼相关解剖研究、影像诊断技术和手术器械的进步和手术临床经验的积累，大量临床和基础研究不断涌现，逐渐形成了相对成熟的内镜鼻眼相关外科理论与实践体系。本文概述了内镜鼻眼相关外科的发展现状，对几种主要手术提供经验总结并提出展望。

Nasal endoscopic surgery technology has gradually developed and involved into the diagnosis and treatment of nose-eye related disease for more than 20 years. With the improvement of anatomical studies on nose-eye, imaging diagnostic technology and surgical instruments, the accumulation of surgical clinical experience, as well as the increasing emergence of a large number of clinical and basic studies on endoscopic rhino-orbital related surgery, a well-established theoretical and practical system of endoscopic nose-eye surgery has gradually been formed. This article summarized the development of endoscopic rhino-orbital surgery, and the advantages and limitations of several major surgical methods. Also, the further research was prospected.

    霍纳综合征是一种由眼交感神经传出通路中任意部分中断所造成的临床综合征，常以上睑下垂、瞳孔缩小等眼部特征为主要临床表现，往往提示头、颈或胸部严重疾病或术后并发症的发生。现报告1例49岁的男性患者，曾在武汉市中心医院耳鼻喉科行右侧咽旁间隙肿物切除术，术后第1天出现右眼上睑下垂，瞳孔缩小，伴同侧面部无汗。术后随访半年，上述症状未见明显改善。右侧咽旁间隙肿物的病理结果证实为交感干神经鞘瘤，该病例临床较为罕见。

Horner syndrome is caused by damage of the oculosympathetic pathway. It is a common disorder characterized by ocular signs such as ptosis and miosis, and these signs usually indicate the occurrence of severe head, neck and chest diseases or surgical complications. We report a case of 49-year-old male patient who underwent parapharyngeal space tumor resection in the Department of otolaryngology. On postoperative day one, the patient presented right eyelid drooping, the right pupil constricted, and the absence of sweating on the right side of the face.  After six months of follow-up, the above signs still presented and showed no significant change. T??he pathological assessment of the resected parapharyngeal space tumor demonstrated that it is the sympathetic trunk schwannoma, which is relatively rare in clinical practice.

永存胚胎血管(persistent fetal vasculature，PFV)，也称永存原始玻璃体增生症( persistent hyperplastic primary vitreous，PHPV)，是一种先天性眼病，多发现于婴幼儿时期。因大多数患儿单眼发病、症状隐匿，且易被误诊为单纯的先天性白内障，常常延误手术治疗的最佳时机。因此，正确的诊断和适宜治疗方式的选择对于患儿视功能的预后尤为重要。本文报道了1例6岁6个月的男性患儿，诊断为混合型PFV，眼部特征表现为先天性白内障和黄斑区结构错位。

Persistent fetal vasculature (PFV), also known as persistent hyperplastic primary vitreous (PHPV), is a congenital ocular anomaly, which is common in infants and young children. Due to most children have unilateral occurrence, insidious symptoms and are easily misdiagnosed as simple congenital cataract, the optimum time for treatment is often delayed. Therefore, correct diagnosis and appropriate treatment are particularly significant for the prognosis of PFV children’s visual function. A male child aged 6 years and 6 months with a diagnosis of combined PFV is reported, whose ocular features were congenital cataract and structural dislocation of macula.

目的：探究短期周边遮盖对成年视皮层双眼优势平衡的作用。方法：对12名正常成年人的各眼 (24只眼)分别进行单眼短期周边遮盖。遮盖方式为单眼佩戴90 min的环形、半透明的塑料遮盖板，遮盖板仅能透光，中央留有1 0°~15°视野范围的圆孔，从而实现周边遮盖。受试者在周边遮盖前、遮盖后的0~3、3~6、6~9、9~12、12~15、30、60和90 min均完成双眼竞争任务 (binocular rivalry task)。记录并分析各时间段中各眼的占优时间、双眼竞争在眼别间切换周期数和各眼占优概率随时间改变的特点等。每位受试者左右眼测试间隔1周进行。结果：在遮盖前，12名正常成年受试者被遮盖眼的占优时间与非遮盖眼的差异无统计学意义(92.78±6.33 s vs 87.22±6.23 s，P>0.05)，提示眼优势平衡。遮盖去除后的0~3 min，被遮盖眼占优比例显著增加至 0.721±0.11(P<0.001)，该效应在遮盖去除后的3~30 min均存在(P<0.05)，直至60 min(P=0.445)双眼基本恢复优势平衡。双眼优势转换周期在周边遮盖前后差异无统计学意义(P=0.064)。主导眼在去除周边遮盖后的0~3 min遮盖眼占优时间比例相对基线的改变幅度与遮盖非主导眼的差异无统 计学意义(P=0.835)。结论：短期的周边遮盖可改变成年双眼优势平衡，有望应用于视觉关键期后的弱视治疗中。视觉关键期后双眼视功能仍保留有一定的可塑性。

Objective: To study the effect of short-term peripheral patching on binocular dominance in adult visual cortex. Methods: Monocular short-term peripheral patching was performed on each eye (24 eyes) of 12 normal adults. The patching was achieved by monocularly wearing a ring-shaped, translucent and plastic patch for 90 minutes. The patch could only transmit light, but not pattern, and there was a circular hole with a visual field of 10°–15°, so as to achieve peripheral patching. Participants completed the binocular rivalry task at baseline and 0–3, 3–6, 6–9, 9–12, 12–15, 30, 60 and 90 min after peripheral patching. The dominance duration of each eye and the number of dominance switches between eyes were recorded. The probability of perceiving stimulus of each eye was calculated in each time period. Each participant’s both left and right eyes performed peripheral patching one week apart. Results: Before patching, the dominance duration of the patched eye was not significantly different from the non-patched eye (92.78±6.33 s vs 87.22±6.23 s, P>0.05), which suggests that the eye dominance was balanced. At 0–3 min after the removal of the patch, the dominance duration of the patched eye was increased significantly (P<0.001), and this effect existed until 30 min after the removal of the patch (P<0.05). The dominance duration of the patched eye at post-60 min was not significantly different from the baseline (P=0.445). There was no significant difference in the dominance switches among baseline and each period after patching (P=0.064). After the removal of patch on the dominant eye, the amplitude of change in the dominance duration of the patched eye at 0–3 min was not significantly different from that after the removal of patch on the non-dominant eyes (P=0.835). Conclusion: Short-term peripheral patching can also change the binocular dominance in adults, and it has the potential to be applied in treatment of adult amblyopia. After the critical period for visual development, binocular vision function still retains plasticity.