糖尿病性黄斑水肿(diabetic macular edema, DME)是糖尿病最常见和最严重的并发症之一，也是中青年劳动人群常见的致盲原因。DME病理生理机制复杂，是多种因素相互作用的结果，控制这些危险因素是降低发病率的关键。DME是全身病相关性眼病，其发生与发展受众多危险因素的影响，但此前文献对其总结不足，本文从全身因素及眼部因素两个方面就DME的危险因素进行综述。全身危险因素主要包括血糖控制欠佳、糖尿病病程长、高血压、血脂代谢紊乱、肥胖、肾功能异常、妊娠状态、降糖药物使用、贫血、阻塞性睡眠呼吸暂停低通气综合征、遗传因素、吸烟、饮酒、高血钙、低血镁等；而其眼部危险因素主要包括白内障、青光眼及玻璃体切割术、全视网膜激光光凝术、合并视网膜静脉阻塞和相关细胞因子等。深入认识和理解这些危险因素，有助于更好地预防和早期治疗DME，同时为治疗糖尿病视网膜病变过程中控制DME进展提供指引和参考。但是，其中一部分因素还存在一定争议，更多的DME危险因素仍有待进一步探索，期望在不久的将来，更多基础和前瞻性临床研究为DME危险因素及治疗提供高质量的证据。

Diabetic macular edema (DME) is one of the most common and severe complications of diabetes, and it is a leading cause of blindness in the working-age population. The pathophysiology of DME is complex, resulting from the interplay of various factors. Controlling these risk factors is crucial in reducing the incidence of DME. As a systemic diseaserelated ocular condition, the onset and progression of DME are influenced by numerous risk factors. However, previous literature has provided insufficient summaries of these factors. This review aims to summarize the risk factors for DME from both systemic and ocular perspectives. The systemic risk factors primarily include poor glycemic control, prolonged duration of diabetes, hypertension, dyslipidemia, obesity, renal dysfunction, pregnancy, the use of hypoglycemic medications, anemia, obstructive sleep apnea-hypopnea syndrome, genetic factors, smoking, alcohol consumption, hypercalcemia, and hypomagnesemia. On the other hand, ocular risk factors include cataracts, glaucoma and vitrectomy, panretinal photocoagulation, coexisting retinal vein occlusion, and related cytokines. A deeper understanding of these risk factors will aid in the better prevention and early treatment of DME, while also providing guidance and reference for controlling the progression of DME during the treatment of diabetic retinopathy. However, some of these factors remain controversial, and additional DME risk factors still need to be explored. It is hoped that, in the near future, more 

foundational and prospective clinical studies will provide high-quality evidence on DME risk factors and treatments.

目的：了解湿性老年性黄斑变性(age-related macular degeneration,AMD)患者自我感受负担(self-perceived burden,SPB)现状及其影响因素。方法：采用方便抽样法选取2021年1月至11月在中山大学中山眼科中心就诊的204例湿性AMD患者为研究对象，采用一般资料调查表、SPB量表、家庭支持自评量表、医学应对问卷对其进行测评。结果：患者SPB得分是(21.98±6.68)分，总体属于轻度SPB。湿性AMD患者的SPB水平与家庭支出(r=?0.326, P<0.001)和面对应对(r=?0.365, P<0.001)呈负相关，与回避(r=0.456, P<0.001)及屈服(r=0.310, P<0.001)应对方式呈正相关性。多重线性回归显示，独居、高龄、自费、双眼患病及采用回避应对的患者的SPB更高，而高文化水平、高家庭支持的患者SPB较轻。结论：湿性AMD患者有轻度SPB，但仍存在改善空间，医护工作者在工作中应重点关注高龄、文化程度低、家庭收入低、自费、独居、双眼患病及低视力的患者，及时进行心理疏导，减轻患者的SPB水平。

Objective: To understand the current status and influencing factors of self-preceived burden (SPB) in patients with wet age-related macular degeneration (AMD). Methods: 204 patiens with wet AMD who were treated in Zhongshan Ophthalmic Center, Sun Yat-sen University from January to November 2021 were enrolled as the study subjects with convenience sampling method. A general information questionnaire, SPB scale, family support self-assessment scale, and medical coping questionnaire were collected from the subjects for assessment. Results: The patient’s SPB score was 21.98±6.68, which is generally mild SPB. The SPB level of patients with wet AMD was negatively correlated with family support (r=-0.326, P<0.001) and coping (r=?0.365, P<0.001), and were positively correlated with avoidance (r= 0.456,P<0.001), and surrender (r=0.310, P<0.001) coping style. Multiple linear regression showed that the patients who lived alone, were elder and self-funded, had binoclur diseases and used avoidance coping, had higher SPB. While the patients with high education and family support had lower SPB. Conclusions: It is still needed to pay attention to the patients with AMD having mild SPB. Medical workers should focus on patients with elder age, low education level, low family income, self-funded, living alone, binocular disease and low vision in their work, and provide timely psychological counseling to reduce the SPB level of patients.

视网膜色素上皮脱离(pigment epithelial detachment, PED)是年龄相关性黄斑变性(age-related macular degeneration, AMD)的常见临床体征之一，也是反应患者视力预后的重要生物标志物。随着眼底影像技术的快速发展，PED分型依据从单一视角逐渐转变为多模式影像。眼底荧光素血管造影对PED分型进行了初探，吲哚菁绿血管造影的应用加强了对PED内血管成分的判断，光学相干断层扫描的问世使PED结构和内容物的可视化水平得到提高，多模式影像的应用则兼顾了对PED血管特性及内容物性质的判断，为进一步认识PED的发病机制和病程特征提供了重要支持，促进PED分型体系不断更新。PED现有分型种类繁多，概念之间存在交叉。文章通过回顾国内外关于AMD相关的PED研究现状，对分型系统、多模式影像特征及最新影像进展进行汇总，为PED的标准化诊疗和未来研究方向提供了系统参考，以期推动PED相关临床和研究的深入发展。

Pigment epithelial detachment (PED) is one of the common manifestations of age-related macular degeneration (AMD), posing a significant threat to the patients’ vision. With the rapid advancement of imaging technology, the visualization of PED structure and content has improved considerably. The diagnostic methods and classification systems of PED are also evolving, enabling researchers to further explore its pathogenesis and disease course. However, current PED classification systems are numerous, with overlapping concepts that may cause confusion. This article reviews existing relative literature on AMD-related PED, summarizing the classification systems, multimodal imaging features, and recent imaging advances. The objective of this article is to standardize the diagnosis and guide treatment of PED, to provide systematic reference to the future research, ultimately advancing both clinical and research efforts related to PED.

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.

年龄相关性黄斑变性(age-related macular degeneration, AMD)是老年人视力丧失的主要原因之一，其中新生血管性AMD (neovascular AMD, nAMD)以其进展迅速、严重损伤视力的特点，成为全球眼科研究的焦点。随着人口老龄化加剧，nAMD的疾病负担日益沉重，对其发病机制的深入研究和有效治疗策略的探 索迫在眉睫。近年来，高通量组学技术的蓬勃发展为解析nAMD复杂的分子病理机制提供了前所未有的机遇。基因组学、转录组学、蛋白质组学、代谢组学以及多组学整合分析，不仅有助于深入挖掘疾病相关的关键分子、通路和网络，也为发现新的生物标志物和潜在治疗靶点提供了新的视角。文章系统综述了近年来分子组学技术在nAMD研究中的最新进展，重点关注不同组学方法在各类生物样本研究中 的发现，分析多组学整合在揭示疾病机制和筛选生物标志物方面的优势，以期为该领域的未来研究提供参考。

Age-related macular degeneration (AMD) is one of the leading causes of vision loss in elderly population. Among its subtypes, neovascular AMD (nAMD) has become a global focus in ophthalmological research due to its rapid progression and severe vision impairment. With the acceleration of population aging, the disease burden of nAMD is increasingly heavy, making it urgent to conduct in-depth research on its pathogenesis and explore effective therapeutic strategies. In recent years, the rapid development of high-throughput omics technologies has provided unprecedented opportunities to decipher the complex molecular pathological mechanisms of nAMD. Genomics, transcriptomics, proteomics, metabolomics, and multi-omics integration analyses have not only helped to deeply explore disease-related key molecules, pathways, and networks but also provided new perspectives for discovering novel biomarkers and potential therapeutic targets. This review systematically summarizes the recent advances in molecular omics technologies in nAMD research, focusing on findings from different omics approaches across various biological samples, and analyzes the advantages of multi-omics integration in revealing disease mechanisms and screening biomarkers, aiming to provide references for future research in this field.

Background: The purpose is to investigate the relationship between full-thickness macular hole (MH) and retinal break (RB) and/or lattice degeneration.

Methods: Patients diagnosed as full-thickness MH and referred to Dr. Lin Lu from January 2009 to December 2013 were evaluated. All patients underwent general ophthalmologic examinations, fundus examination and optical coherence tomography (OCT). The RB and/or lattice degeneration were recorded.

Results: Totally 183 eyes of 167 patients were included. The sex ratio of men to women was 1:2.88. A total of 17 eyes were pseudophakic and 166 eyes were phakic. RB and/or lattice degeneration were found in 62 eyes (33.88%). The prevalence of RB and/or lattice degeneration was similar between men and women (P=0.344>0.05). There was no statistical diff erence between the pseudophakic eyes and phakic eyes (P=0.138>0.05). All of the RB and/or lattice degeneration were located near or anterior to the equator. The inferior quadrants and the vertical meridian were aff ected more often than the superior quadrants and the horizontal meridian.

Conclusions: We identified a high incidence of RB/lattice degeneration in cases of full-thickness MH. Carefully examination of the peripheral retina and prophylactic treatment of RB and/or lattice degeneration are critical.

Background: The purpose is to investigate the relationship between full-thickness macular hole (MH) and retinal break (RB) and/or lattice degeneration.

Methods: Patients diagnosed as full-thickness MH and referred to Dr. Lin Lu from January 2009 to December 2013 were evaluated. All patients underwent general ophthalmologic examinations, fundus examination and optical coherence tomography (OCT). The RB and/or lattice degeneration were recorded.

Results: Totally 183 eyes of 167 patients were included. The sex ratio of men to women was 1:2.88. A total of 17 eyes were pseudophakic and 166 eyes were phakic. RB and/or lattice degeneration were found in 62 eyes (33.88%). The prevalence of RB and/or lattice degeneration was similar between men and women (P=0.344>0.05). There was no statistical diff erence between the pseudophakic eyes and phakic eyes (P=0.138>0.05). All of the RB and/or lattice degeneration were located near or anterior to the equator. The inferior quadrants and the vertical meridian were aff ected more often than the superior quadrants and the horizontal meridian.

Conclusions: We identified a high incidence of RB/lattice degeneration in cases of full-thickness MH. Carefully examination of the peripheral retina and prophylactic treatment of RB and/or lattice degeneration are critical.

Diabetic macular edema (DME) is a major sight-threatening cause in diabetic patients. We review the long-term outcome of four approved pharmacotherapy for treating DME, including intravitreal injections of corticosteroids (dexamethasone implants and fl uocinolone acetonide inserts) and anti-vascular endothelial growth factor (VEGF) (ranibizumab and aflibercept). They all show superior ability to improve vision and reduce macular thickness, comparing with sham injections or macular focal/grid laser treatment. Anti-VEGF agents result in low incidence of severe ocular or systemic adverse effects, but glaucoma and cataract should be aware after intravitreal corticosteroids. Prompt treatment with these agents can lead to a better outcome.

Diabetic macular edema (DME) is a major sight-threatening cause in diabetic patients. We review the long-term outcome of four approved pharmacotherapy for treating DME, including intravitreal injections of corticosteroids (dexamethasone implants and fl uocinolone acetonide inserts) and anti-vascular endothelial growth factor (VEGF) (ranibizumab and aflibercept). They all show superior ability to improve vision and reduce macular thickness, comparing with sham injections or macular focal/grid laser treatment. Anti-VEGF agents result in low incidence of severe ocular or systemic adverse effects, but glaucoma and cataract should be aware after intravitreal corticosteroids. Prompt treatment with these agents can lead to a better outcome.

目的：观察睡眠呼吸暂停综合征（Sleep apnea syndrome, SAS）患者睡眠前后黄斑厚度的改变。

方法：选择 2003 年 8 月至 2007 年 1 月经确诊的在我院门诊和住院部治疗的 SAS 患者共 32 例（63 只眼），分别在上午 11:00 ～ 12:00（睡眠前）及患者晨起 20 ～ 30 分钟内（睡眠后）采用相干光断层扫描仪（Optical Coherence Tomography, OCT）进行黄斑中心凹厚度的测量。

结果：睡眠前黄斑中心小凹平均视网膜厚度为（123.00 ± 19.98）μm，睡眠后黄斑中心小凹平均视网膜厚度为（134.25 ± 19.92）μm。睡眠后黄斑中心凹厚度比睡眠前厚度增加（11.25 ± 9.04）μm，95% 可信区间为（8.98，13.53）μm，差异有统计学意义（t = 9.878，P < 0.05）。

结论：睡眠呼吸暂停综合征患者睡眠时的缺血缺氧可以导致黄斑视网膜的水肿增厚。

Purpose: To observe the changes of macular thickness in patients with sleep apnea syndrome (SAS) before and after sleep.

Methods: Thirty-two patients (63 eyes) diagnosed as SAS from August 2003 to January 2007 were enrolled. Macular thickness was measured using Optical Coherence Tomography (OCT) at 11:00 ~ 12:00 evening (before sleep) and 20 ~ 30 minutes after sleep, respectively.

Results: The mean macular thickness was (123.00 ± 19.98) μm and (134.25 ± 19.92) μm before and after sleep, respectively. The mean difference was (11.25 ± 9.04) μm before and after sleep (t = 9.878, P < 0.05), 95% CI (8.98, 13.53) μm.

Conclusions: The macular thickness of SAS is increased in SAS patients, which may be due to anoxia of SAS.