综述

眼表菌群与眼表疾病关系的研究进展

Research progress in the correlation of ocular surface microflora and ocular surface disease

:408-415
 
眼表菌群是定植于眼表的各种微生物群落,以细菌为主。在正常情况下,眼表菌群与人体眼表组织的细胞和平共生,维持眼表的稳态,共同保证眼表的健康。但在环境改变或免疫力低下的情况下,眼表菌群会发生变化,与眼部疾病的产生与发展关系密切,对人类的健康造成巨大的危害。随着组学研究的不断发展,我们对眼表菌群有了新的认识,为眼表疾病的发病机制、治疗开辟了新的思路,同时也提出了新的挑战。本文对国内外眼表菌群与疾病关系进行综述,为眼表疾病的发生、发展以及治疗提供参考。
The microbiome of the ocular surface consists of various microbial communities that colonize on the eye surface, mainly bacteria. The stabilization of the microbiome and the other ocular surface components plays an important role in maintaining the homeostasis of the ocular surface. However, unpredictable changes of ocular surface microbiome are strongly associated with ocular surface diseases in the situation of environmental changes or destruction of immune system. With the innovation of inspection technology, the current gene sequencing technology is applied to detect the ocular surface microbiome and confirm that the eye microbiome is closely related to ocular surface diseases. This paper investigates the corelation of ocular surface microbiomes and diseases. Moreover, we provide areference for the occurrence and development of ocular surface diseases and their treatment.
综述

眼球运动检查在阿尔茨海默病诊断的研究进展

Research progress on eye movement examination in the diagnosis of Alzheimer’s disease

:66-73
 
阿尔茨海默病(Alzheimer’s disease,AD)是发生于老年期或老年前期的中枢神经系统退行性病变,以进行性认知功能障碍为特征。随着社会老龄化加剧,AD已成为全球公共卫生问题,亟需研发更敏感、便捷和经济的筛查技术进行早期防控。眼球运动与认知功能密切相关,且眼球运动检查有非侵入性、成本低、检查时间短等优点。研究眼球运动异常和认知功能障碍之间的相关性,有助于研发更简便易操作的认知功能障碍筛查工具。随着人工智能技术的发展,机器学习算法强大的特征提取和计算能力对处理眼球运动检查结果有显著优势。本文对既往AD患者与眼球运动异常之间的相关性研究进行综述,并对机器学习算法模型辅助下,基于眼球运动异常模式进行认知功能障碍早期筛查技术开发的研究前景予以展望。
Alzheimer’s disease (AD) is a degenerative disease of the central nervous system that occurs in old age or early old age. It is characterized by progressive cognitive dysfunction. With the world population aging, AD has become a global public health problem. The development of a more sensitive, convenient, and economic screening technology for AD is urgently needed. The eye movement function is closely related to cognitive function. Moreover, eye movement examination has advantages including non-invasiveness, low cost, and short examination time. Researches on the correlation between abnormal eye movement and cognitive dysfunction can help to develop a simple and easy-to-use screening tool for cognitive dysfunction. With the development of artificial intelligence technology, the dominant feature extraction and computing capabilities of machine learning algorithms have a significant advantage in processing eye movement inspection results. This article reviews the correlation between AD and eye movement abnormalities aiming to provide the research prospects of early screening technology development for cognitive dysfunction based on abnormal eye movement with the application of machine learning models.
综述

婴幼儿眼病的人工智能应用

Artificial intelligence application for infantile eye diseases

:214-221
 
近年来随着医疗领域数字化、信息化建设的加速推进,人工智能的应用越来越广泛,在眼科医学方面尤为突出。婴幼儿处于视觉系统发育的关键时期,此时发生的眼病往往会造成不可逆的视功能损伤,带来沉重的家庭和社会负担。然而,由于婴幼儿群体的特殊性以及小儿眼科医生的短缺,开展大规模小儿眼病筛查工作十分困难。最新研究表明:人工智能在先天性白内障、先天性青光眼、斜视、早产儿视网膜病变以及视功能评估等领域已经得到相关应用,在多种婴幼儿眼病的早期筛查、诊断分期、治疗建议等方面都有令人瞩目的表现,有效解决了许多临床难点与痛点。但目前婴幼儿眼科人工智能仍然不如成年人眼科发展充分,亟须进一步的探索和研发。
In recent years, with the acceleration of digitalization and informatization in medical field, artificial intelligence (AI) is more and more widely applied, especially in ophthalmology. Infants are in the critical period of visual development, during which eye diseases can lead to irreversible visual impairment and bring heavy burden to family and society. Due to the particularity of infants and the shortage of pediatric ophthalmologists, it is challenging to carry out large-scale screening for eye diseases of infants. According to the latest studies, AI has been studied and applied in the fields of congenital cataract, congenital glaucoma, strabismus, amblyopia, retinopathy of prematurity, and evaluation of visual function, and it has achieved remarkable performance in the early screening, diagnosis stage and treatment suggestions, solving many clinical difficulties and pain points effectively. However, AI for infantile ophthalmology is not as developed as for adult ophthalmology, so it needs further exploration and development.
综述

城市颗粒物与眼表疾病及其潜在致病机制

Urban particulate matter related ocular surface diseases and their potential pathogenic mechanism

:648-656
 
越来越多的证据表明,空气污染可严重损害人体健康,成为全球疾病负担的主要原因。并且污染空气中的主要成分空气颗粒物可渗透到肺部和心血管系统,引起缺血性心脏病、肺炎、慢性阻塞性肺疾病甚至肺癌,导致空气污染相关的发病率和死亡率升高。城市颗粒物作为城市居住人群面临的主要空气污染问题,被证实与多种炎症性眼表疾病密切相关,如过敏性结膜炎、角膜炎、干眼等。高浓度城市颗粒物暴露还会引起睑板腺病理性结构改变和功能异常,诱发炎性睑板腺功能障碍。文章综述了城市颗粒物相关的眼表疾病类型及其致病机制的最新研究,旨在阐明空气污染对于眼表组织的损害和相应的潜在治疗靶点,指导临床上环境相关眼病的诊断与治疗。
More and more evidence indicate that air pollution can seriously damage human health and become a major cause of the global disease burden. The main component of air pollution, particulate matter, can penetrate the lungs and cardiovascular system, causing ischemic heart disease, pneumonia, chronic obstructive pulmonary disease, and even lung cancer, leading to an increase in the incidence and mortality rates related to air pollution. Urban particulate matter, as the main air pollution problem faced by urban residents, has been shown to be closely related to various inflammatory eye diseases, such as allergic conjunctivitis, keratitis, and dry eye. Our research further confirms that exposure to high concentration of urban particulate matter can also cause pathological structural changes and functional abnormalities in the meibomian gland, leading to inflammatory meibomian gland dysfunction. This review comprehensively summarizes the latest research on the eye surface diseases related to urban particulate matter and their pathogenic mechanisms, aims to elucidate the damage of air pollution to eye surface tissues, identify potential therapeutic targets, and guide the diagnosis and treatment of environmentally related eye diseases in clinical practice.
综述

肥厚型脉络膜谱系疾病与脉络膜、涡静脉、巩膜改变的研究进展

Research progress of pachychoroid disease spectrum and changes in the choroid, vortex veins and sclera

:693-699
 
肥厚型脉络膜谱系疾病(pachychoroid disease spectrum,PCD)包括肥厚型脉络膜色素上皮病变(pachychoroid pigment epitheliopathy,PPE)、中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)、肥厚型脉络膜新生血管病变(pachychoroid neovasculopathy,PNV)、息肉样脉络膜血管病变(polypoidal choroidal vasculopathy,PCV)、局灶性脉络膜凹陷(focal choroidal excavation,FCE)和盘周肥厚型脉络膜综合征(peripapillary pachychoroid syndrome,PPS)。有学者将PCD看作脉络膜功能障碍引发的一系列连续疾病过程,但关于PCD的发病机制、形态改变尚未明确。该文对PCD的脉络膜、涡静脉及巩膜相关改变做一综述。

Pachychoroid disease spectrum include pachychoroid pigment epitheliopathy, central serous chorioretinopathy, pachychoroid neovasculopathy, polypoidal choroidal vasculopathy, focal choroidal excavation, and peripapillary pachychoroid syndrome. Currently, some scholars regard pachychoroid disease spectrum as a series of continuous disease processes caused by choroidal dysfunction, but the pathogenesis and morphological changes of pachychoroid disease spectrum are not yet clear. This paper reviews the changes of choroid, vortex veins and sclera in pachychoroid disease spectrum.

综述

慢性眼部移植物抗宿主病治疗的研究进展

Research progress in the treatment of chronic ocular graft-versus-host disease

:416-423
 
眼部移植物抗宿主病发生在超过一半的慢性移植物抗宿主病患者中,涉及眼表持续的炎症以及纤维化改变,最常见的表现为干燥性角膜结膜炎。严重的眼部移植物抗宿主病不但影响患者的工作和生活质量,同时也增加了其他眼部并发症的风险。慢性眼部移植物抗宿主病的治疗主要包括局部应用人工泪液、血清类制剂、抗炎药物等药物治疗,佩戴隐形眼镜、睑板腺按摩等物理治疗、封闭泪点、重建眼表等手术治疗。随着对眼部移植物抗宿主病发病机制的深入研究,许多新的治疗药物和治疗手段涌现临床。总结目前慢性眼部移植物抗宿主病在药物治疗、物理治疗、手术治疗方面的最新研究进展,将有助于为慢性眼部移植物抗宿主病的治疗带来更多选择和更新的研究思路。
More than half of the patients developed chronic graft-versus-host disease after accepting allogeneic hematopoietic stem cell transplantation suffer from ocular graft-versus-host disease. Ocular graft-versus-host disease involves persistent inflammation and fibrosis of the ocular surface and keratoconjunctivitis sicca is the most common symptom. Severe ocular graft-versus-host disease not only affects patients’ life quality, but also increases the risk of other ocular complications. The treatment of chronic ocular graft-versus-host disease mainly includes drug treatment, such as local application of artificial tears, serum eye drops and anti-inflammatory drugs; physical treatment, such as wearing contact lenses and meibomian gland massage; surgical treatment, such as punctal occlusion and reconstructing ocular surface. With the in-depth study of the pathogenesis of ocular graft-versus-host disease, many new therapeutic drugs and methods have emerged. Summarizing the latest research progress in drug, physical and surgical therapy of chronic ocular graft-versus-host disease will give us insights into treatment options and hot spot of research.
综述

慢性移植物抗宿主病相关性干眼的研究进展

Research progress on dry eye associated with chronic graft-versus-host disease

:36-44
 
慢性移植物抗宿主病(chronic graft-versus-host disease,cGVHD)是骨髓移植后最具有破坏性并发症之一。移植物抗宿主病(graft-versus-host disease,GVHD)发生在10%~80%的造血干细胞移植(hematopoietic stem cell transplantation)受者中,而眼睛是人身体最脆弱的器官之一,有40%~60%接受HSCT的患者发生眼部GVHD,它主要影响泪腺、睑板腺、角膜和结膜等。cGVHD相关性干眼(dry eye associated with chronic graft-versus-host disease,cGVHD-DE)是眼部GVHD最多见的表现形式。cGVHD-DE的长期治疗因涉及多学科、多重结合治疗,至今仍然具有挑战性,其除了全身免疫抑制和眼部润滑剂外,通常还使用局部类固醇、环孢霉素和他克莫司滴眼液。针对中度和重度cGVHD-DE的治疗干预包括使用自体血清滴眼液和佩戴巩膜镜等,新兴起的治疗方案包括重链透明质酸 (heavy chain-hvaluronan/穿透素(pentraxin 3)结膜下注射、间充质基质细胞静脉注射、抑制纤维化药物等。
Chronic graft-versus-host disease (cGVHD) is one of the most devastating complications following bone marrow transplantation. GVHD develops in 10–80% of patients after hematopoietic stem cell transplantation (HSCT). The eye is one of the most vulnerable organs of the human body. Ocular GVHD occurs in 40–60% of patients with GVHD undergoing HSCT, and it mostly affects the lacrimal glands, meibomian glands, cornea, and conjunctiva. The most common form of ocular GVHD is dry eye disease (DED). The long-term treatment of cGVHD-related dry eye syndrome remains challenging and involves a multidisciplinary approach. Besides systemic immunosuppression and ocular lubricants, topical steroids, topical cyclosporine, and topical tacrolimus are commonly prescribed. Newer therapeutic interventions for moderate and severe cGVHD-related DED include using serum eye drops and scleral contact lenses. Emerging treatment options include subconjunctival injection of heavy chain-hyaluronan (HC-HA)/ pentraxin 3 (PTX3), intravenous injection of mesenchymal stromal cells, antifibrotic drugs, etc. This article reviews the mechanisms, clinical findings, and treatment of cGVHD-related dry eye syndrome.
综述

眼部相关全身疾病的人工智能诊断

Artificial intelligence diagnosis of eye-related systemic diseases

:222-229
 
全身疾病通过一定途径累及眼球,产生眼部病变,这些眼部病变的严重程度与全身疾病的进展密切相关。人工智能(artificial intelligence,AI)通过识别眼部病变,可以实现对全身疾病的评估,从而实现全身疾病早期诊断。检测巩膜黄染程度可评估黄疸;检测眼球后动脉血流动力学可评估肝硬化;检测视盘水肿,黄斑变性可评估慢性肾病(chronic kidney disease,CKD)进展;检测眼底血管损伤可评估糖尿病、高血压、动脉粥样硬化。临床医生可以通过眼部影像评估全身疾病的风险,其准确度依赖于临床医生的经验水平,而AI识别眼部病变评估全身疾病的准确度可与临床医生相媲美,在联合多种检测指标后,AI模型的特异性与敏感度均可得到显著提升,因此,充分利用AI可实现全身疾病的早诊早治。
Systemic diseases affect eyeballs through certain ways, resulting in eye diseases; The severity of eye diseases is closely related to the progress of systemic diseases. By identifying eye diseases, artificial intelligence (AI) can assess systemic diseases, so as to make early diagnosis of systemic diseases. For example, detection of the degree of icteric sclera can be used to assess jaundice. Detection of the hemodynamics of posterior eyeball can be used to evaluate cirrhosis. Detection of optic disc edema and macular degeneration can be used to evaluate the progress of chronic kidney disease (CKD). Detection of ocular fundus vascular injury can be used to assess diabetes, hypertension and atherosclerosis. Clinicians can estimate the risk of systemic diseases through eye images, and its accuracy depends on the experience level of clinicians, while the accuracy of AI in identifying eye diseases and evaluating systemic diseases can be comparable to clinicians. After combining various detection indexes, the specificity and sensitivity of AI model can be significantly improved, so early diagnosis and early treatment of systemic diseases can be realized by making full use of AI.
综述

小牛血去蛋白提取物眼用制剂在眼表疾病应用中的回顾与展望

The review and prospect of the applications of deproteinized calf blood extract ophthalmic preparation in ocular surface disease

:574-584
 
眼表是统一整体,依靠泪液、细胞、神经及免疫等综合因素维持平衡,某个或多个因素的失衡会造成眼表出现一系列连锁反应,导致眼表疾病,影响个体生活质量。近年来,越来越多研究围绕细胞能量代谢与多种疾病的发生、发展和治疗进行,纠正细胞能量代谢的异常是治疗此类疾病的重要思路。小牛血去蛋白提取物从发现并应用至今已有60多年历史,具有良好的组织修复作用和安全性。作为经典的能量补充修复剂,小牛血去蛋白提取物眼用制剂以特定工艺去蛋白处理的小牛血液提取物作为其主要有效成分,具有多重作用机制,在不同严重程度的角膜损伤、干眼症、眼烧伤等多种眼表疾病的治疗方面展现出良好的效果。文章就小牛血去蛋白提取物眼用制剂的制备工艺、作用机制、安全性以及临床应用等进行综述,旨在系统梳理小牛血去蛋白提取物眼用制剂的临床应用价值,并为其在未来的实验研究以及在眼表疾病的进一步实践应用提供科学依据和参考价值。
The ocular surface is an integrated entity maintained in equilibrium by a complex interplay of factors, including tears, cellular components, neural mechanisms, and immunological processes. Disruption of one or multiple factors can precipitate a cascade of reactions on the ocular surface, leading to ocular surface diseases and consequently affecting an individual's quality of life. In recent years, more researches have focused on the relationship between cellular energy metabolism and the occurrence, development, as well as treatment of a wide range of diseases. To treat such diseases, correcting the abnormality of cellular energy metabolism is an important idea. Deproteinized calf blood extract ophthalmic preparation has been discovered and applied over sixty years, demonstrating excellent tissue repairment and safety. As a classic energy supplement, deproteinized calf blood extract ophthalmic preparation process with specific technique involving deproteinized calf blood extract as its main active ingredient and showing significant effects in the treatment of various ocular surface diseases such as corneal injuries, dry eye syndrome, and ocular burns. This article summarized the preparation process, mechanism of action, safety, and clinical applications of deproteinized calf blood extract ophthalmic preparation. It aims to systematically organize the clinical utility of deproteinized calf blood extract ophthalmic preparation and provide scientific evidence and reference value for future research and practical applications in the treatment of ocular surface diseases.
综述

红光疗法在眼科疾病中的应用研究进展

Research progress of red-light therapy in the treatment of ocular diseases

:471-480
 
红光是波长范围在620~760 nm的可见光,兼有良好的光化学和热作用,其穿透力较强,能够达到皮肤深层及组织内部,从而产生一系列的生物效应。在眼科领域,红光疗法最初主要应用于弱视和眼睑皮肤相关疾病的治疗,随着研究的进一步深入,红光逐渐被应用于控制近视进展和视网膜相关疾病。目前,重复低强度红光(repeat low-level red-light, RLRL)在近视进展的控制效果得到充分肯定,成为红光疗法在眼科应用最受关注的热点之一,其主要可能机制包括红光照射能激活线粒体中的细胞色素C氧化酶的活性,促进三磷酸腺苷(adenosine triphosphate, ATP) 生成,改善网膜缺氧状况;促进一氧化氮 (nitric oxide, NO)的合成和释放,引起脉络膜血管的扩张及血流量的增加;诱导巩膜细胞外基质的重塑,增加巩膜的强度。此外,红光疗法可抑制视网膜感光细胞调节通路中的氧化应激、炎症和细胞凋亡,减轻眼表炎症反应和疼痛,有助于周围神经损伤后修复等。文章针对红光疗法在近视、视网膜相关疾病、弱视及眼睑皮肤相关疾病的治疗机制、有效性及安全性进行综述,为红光疗法在眼科领域的应用提供重要的参考价值和依据。
Red light is visible light with a wavelength range of 620-760 nm, which has excellent photochemical and thermal effects. It can penetrate deeply into the skin and tissues with strong power, resulting in a series of biological effects. In the field of ophthalmology, red-light therapy was initially mainly used in the treatment of amblyopia and eyelid skin-related diseases, and with the further development of research, red light has been gradually used in the myopia control and the study of retina-related diseases. At present, the effect of repeated low-intensity red light (RLRL) on myopia progression has been fully recognized, and it has become one of the most concerned hotspots in the application of red-light therapy in ophthalmology. The main possible mechanisms include that red light therapy can activate the activity of cytochrome C oxidase in mitochondria, promote ATP production, and improve retinal hypoxia. It can also induce the synthesis and release of NO, cause the expansion of choroidal vessels with improvement of blood flow, and increase scleral strength by remodeling of scleral extracellular matrix. In addition, red- light therapy can reduce oxidative stress, inflammation and apoptosis in the regulatory pathways of photoreceptor cells, reduce eye inflammation and pain, and help repair peripheral nerves after injury. This article will review the mechanism, effectiveness and safety of red-light therapy in myopia, retinal diseases, amblyopia, and eyelid skin-related diseases, in order to provide important reference value and basis for the application of red-light therapy in ophthalmology.
其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
    浏览
  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
    浏览