目的：依托最新的第5代移动通信技术(5th generation wireless systems，5G)，构建基于眼底图片的5G医疗眼科远程诊断平台，促进医疗资源上下贯通，提升基层服务能力及医疗服务体系整体效能。方法：基于5G时代医院的信息化发展战略，在海南省卫生健康委员会的资助与指导下，中山大学中山眼科中心海南眼科医院与中国联通通信集团海南有限公司等进行跨行业、多学科的技术力量研究开发，构建5G条件下的平台建设模块和技术路线，确定远程眼科诊断流程，并在海南省内多地区应用。结果：远程诊断平台运行良好。2020年12月至2021年11月，本研究共在海南省17个地区的186个卫生院中开展，共收集1561例患者眼底病图片数据，筛查阳性例数为185例，检出眼底病总阳性率为11.9%。其中有42例需要转诊治疗，转诊率为23%；143例不需要转诊治疗，非转诊率为77%。在1561例眼底图像中，采集异常的眼底图像有490例。排除490例异常眼底图像后，辅助诊断系统与人工诊断结果有1 002张眼底图像诊断相同，69张眼底图像诊断不同，其辅助诊断系统准确率为93.3%。结论：5G移动通信与远程医学影像结合，运用互联网科技催生新型医疗生产力，提高卫生经济的质量和效率，是医疗领域探索5G应用场景的一项应用典范。

Objective: Relying on the latest 5th generation wireless systems (5G), a remote primary ophthalmology care diagnosis platform based on fundus images was constructed in order to promote the connectivity of medical resources and improve the primary health service capabilities and the overall effectiveness of the medical service system. Methods: Based on the 5G informatization development strategy of hospitals, and under the funding and guidance of the Hainan Provincial Health Commission, the Hainan Eye Hospital of Zhongshan Ophthalmic Center and China Unicom Communications Group Hainan Co., Ltd. conducted a cross-industry, multi-disciplinary technical research. To build platform construction modules and technical routes under 5G networks, present the remote ophthalmological diagnosis process, and apply it in many regions in Hainan Province. Results: The performance of the remote diagnosis platform is well. From December 2020 to November 2021, this study was carried out in 186 health centers in 17 regions of Hainan Province. A total of 1 561 patients with fundus disease image data were collected. The number of positive screening fundus disease cases was 185. The total positive rate was 11.9%. Among them, 42 cases required referral for treatment, with a referral rate of 23%, and 143 cases did not require referral for treatment, with a non-referral rate of 77%. Among 1 561 cases of fundus images, 490 fundus images were excluded due to abnormal quality. Compared the results of the diagnosis platform system with manual diagnosis, 1 002 fundus images were identical, and 69 fundus images were different in diagnosis. The accuracy of the auxiliary diagnosis system was 93.3%. Conclusions: The collaboration of 5G mobile communication and telemedicine imaging, combined with internet technology to promote new medical productivity, improve quality and efficiency of the health economy. This study is an application model for exploring 5G application scenarios in the medical field.

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.

目的：调查八年制临床医学生对眼科学直播课堂的满意度及教学效果。方法：基于八年制临床医 学生的直播课堂教学体验视角，进行问卷调查、课堂测验及课程考试，问卷内容包括调查对象基 本情况、直播课堂教学评价及满意度3个部分。采用SPSS 20.0统计学软件进行数据分析。结果：共 92名学生完成了问卷调查，男37名，女55名，年龄为(22.9±0.71)岁。课堂内容、课堂资源、平台设 计、平台技术及学习交流5个纬度的得分为40.60±4.582、17.43±2.814、13.07±1.759、13.14±2.052、 20.82±2.685；其中，与线下课堂交流相似性、学习交流积极性2个子条目的得分最低，分别为 3.42±1.131、3.85±0.864，这二者具有相关性(r=0.276，P=0.008)。直播课堂满意度的总得分为 13.52±1.872，课堂内容对其有显著影响(P<0.001)，标准化回归系数为0.687。相较于课前测验，课 测验成绩(65.9±11.4分)的提升差异具有统计学意义(P=0.033)；但是与2013级相比，2015级学生的 课程考试成绩(72.6±7.0分)降低，差异有统计学意义(P=0.009)。结论：课堂内容对直播课堂教学满 意度具有重要影响，需要注意直播课堂与线下课堂交流方式的差异，改进学习交流的参与积极性， 以提升教学效果。

Objective: To investigate the satisfaction and teaching effect of 8-year program medical students in live-streamed classroom on ophthalmology. Methods Based on teaching experience of live-streamed classroofrom the perspective of the 8-year program medical students, a questionnaire survey, classroom tests and course examination were conducted. The content of the questionnaire includes 3 parts: the basic information of the respondents, evaluation of live-streamed classroom teaching and its satisfaction. The SPSS 20.0 statistical software was used for data analysis. Results: A total of 92 students completed the questionnaire survey, including 37 males and 55 females, aged (22.9±0.71) years. The sores of content, resource, platform design, platform technology and learning communication of live-streamed classroom were 40.60±4.582, 17.43±2.814, 13.07±1.759, 13.14±2.052 and 20.82±2.685, respectively. Among all items, the scores of the similarity of offline classroom communication styles and enthusiasm for communication were lowest, with the points of 3.42±1.131 and 3.85±0.864, respectively, and the correlation of the two items were statistically significant (correlation coefficient =0.276, P=0.008). The total score of the live-streamed classroom satisfaction was 13.52±1.872. The classroom content has a significant effect on the satisfaction of the live-streamed classroom (P<0.001), and the standardized regression coefficient is 0.687. Compared with the pre-class test, the post-class test score was 65.9±11.4, with a statistically significant improvement (P=0.033); however, compared with grade 2013, the course test score of the students of grade 2015 was 72.6±7.0, with a statistically significant reduction (P=0.009). Conclusion: The classroom content has an important impact on the satisfaction of live-streamed classroom teaching. It is necessary to pay attention to the communication difference between live -streamed classroom and offline classroom settings, and improve the enthusiasm for participation in the study communication, in order to improve the effectiveness of teaching. 

接触镜在全球的应用日益广泛，配适方法的不断进步是目前接触镜安全性、舒适性不断提高的原因之一。在接触镜适配过程中，越来越多的先进影像技术被运用于指导接触镜的配适，这些技术的出现简化了接触镜适配的过程，为临床医生进行简便、准确、个性化的接触镜适配提供了帮助，也为接触镜的个性化设计提供了参考数据。

Contact lens has been widely applied worldwide, and the advancement of fitting strategy is one of the reasons which improve the safety and comfort of contact lens fitting. During the contact lens fitting procedure, more and more ophthalmic imaging modalities have been applied to guide the contact lens fitting. These techniques simplify the contact lens fitting procedure, help optometrists accurately perform the customize contact lens fitting, and assist the personalized contact lens design technique.

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.

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.

目的：了解目前眼科住院医师规范化培训前职业认同感现状，并探讨相关影响因素。方法：于2024年7—8月，通过问卷调查法调查64名临床医学眼科住培医师，了解其住院医师规范化培训前的职业认同感现状和影响因素，同时探讨规范化培训对于其职业认同感的影响及作用，通过描述性分析、t检验、单因素方差分析、Pearson相关性分析、多元线性回归分析等方法对相关数据进行分析。结果：规范化培训前，职业认同感评分、职业认知、职业情感、职业承诺、职业行为、职业期望、职业价值观等评分分别为（143.16±12.25）（3.60 ± 0.94）（3.98 ± 0.71）（3.61 ± 1.01）（3.89 ± 0.65）（3.84 ± 0.78）（3.71 ± 0.86）分。规范化培训后，眼科住培医师职业期望评分略有降低，与规范化培训前比较差异有统计学意义 (均P  < 0.01), 其他职业认同度部分条目评分在规范化培训前后比较差异无统计学意义（均P > 0.05）。女生对于眼科医学的职业情感（P = 0.01）及职业价值观高于男生（P = 0.03）。本科时担任学生干部的眼科住培医师职业情感高于非学生干部的学生（P < 0.01）。第一选择为眼科的眼科住培医师的医学职业期望（P  < 0.01）和职业价值观更高（（P = 0.02）。而学历、临床医学志愿选择与职业认同感差异均统计学意义（均P > 0.05）。此外，规范化培训一定程度增强了眼科住培医师的显微操作能力和职业信心。结论：住院医师规范化培训前眼科住培医师的职业认同感较高，但仍有待进一步提高。眼科住培医师的职业认同感与职业看法、培训内容、教学资源等因素密切相关。

Objective: To investigate the current status of professional identity among ophthalmology residents before standardized resident training and to explore the influencing factors. Methods: A survey was conducted from July to August 2024 involving 64 clinical ophthalmology residents. The survey assessed their professional identity before standardized resident training and examined the impact and role of pre-residency training on their professional identity. Descriptive analysis, t-tests, univariate analysis, Pearson correlation analysis, and multiple linear regression were used to analyze the data. Results: Before pre-residency training, the scores for overall professional identity, professional cognition, professional emotion, professional commitment, professional behavior, professional expectations, and professional values were (143.16 ± 12.25), (3.60 ± 0.94), (3.98 ± 0.71), (3.61 ± 1.01), (3.89 ± 0.65), (3.84 ± 0.78), and (3.71 ± 0.86), respectively. However, after pre-residency training, the score for professional expectations among ophthalmology residents decreased slightly (P < 0.01), while no significant statistical differences were observed in other items related to professional identity (all P > 0.05). Female residents had higher scores in professional emotion (P = 0.01) and professional values (P = 0.03) than male residents. Ophthalmology residents who had served as student leaders during undergraduate studies had higher scores in professional emotion (P < 0.01). Residents who chose ophthalmology as their first preference had higher scores in professional expectations (P  < 0.01) and professional values (P = 0.02). However, no significant differences were found among educational levels, clinical medicine preferences, and professional identity. In addition, pre-residency training enhanced the residents micro-surgical skills and professional confidence. Conclusions: The professional identity of clinical ophthalmology medical students before standardized resident training is relatively high but still needs improvement. Professional identity is closely related to factors such as professional views, training content, and teaching resources.

近年来，随着现代社会生活节奏的加快以及电子产品的普及，近视逐渐呈现低龄化、高发病率的趋势，成为不容忽视的公共卫生问题。动物和人类研究均发现，在近视的发展过程中，脉络膜表现出变薄的现象，并伴有血流量减少，这些变化与近视度数增加和眼轴增长呈正相关。研究表明，脉络膜厚度的变化不仅发生在近视初期，而是在近视进展阶段持续发生。此外，脉络膜血流量的调节也与近视的发生和发展密切相关，可能通过神经机制及生长因子的作用影响眼球的生长。光学相干断层扫描血管成像(optical coherence tomography angiography, OCTA)技术在探索近视进程中的脉络膜变化和血管功能方面展现了巨大的潜力。它能够提供无创性的脉络膜结构和血流信息，对于理解脉络膜在近视调控中的作用至关重要。未来的研究应当结合先进的OCTA技术，进一步探讨脉络膜在不同阶段近视中的具体变化及其背后的机制，特别是脉络膜血流调节与眼球生长之间的关系。深化对脉络膜在近视调控中作用的理解，将有助于开发有效的预防和控制措施，为近视防控策略提供理论依据。

In recent years, with the acceleration of the pace of life in modern society and the popularization of electronic products, myopia has gradually affected younger individuals and has a higher incidence rate, becoming a public health problem that cannot be ignored. Both animal and human studies have found that during the development of myopia, the choroid exhibits thinning and is accompanied by reduced blood perfusion. These changes are positively correlated with increased myopia and axial growth. Studies have shown that changes in choroidal thickness not only occur in the early stages of myopia, but also continue to occur in the progression stage of myopia. In addition, the regulation of choroidal blood flow is also closely related to the occurrence and development of myopia, which may affect the growth of the eyeball through the action of neural mechanisms and growth factors. Optical coherence tomography angiography (OCTA) technology has shown great potential in exploring choroidal changes and vascular function in the progression of myopia. It can provide non-invasive information on choroidal structure and blood flow, which is crucial for understanding the role of the choroid in the regulation of myopia. Future research should combine advanced OCTA technology to further explore the specific changes in the choroid in different stages of myopia and the underlying mechanisms, especially the relationship between choroidal blood flow regulation and eyeball growth. A better understanding of the role of choroid in myopia regulation will aid in developing effective prevention and control measures, providing a solid theoretical foundation for myopia prevention strategies.

神经退行性疾病会损害大脑和神经系统的结构和功能，导致认知和行为能力逐渐下降，因此，早期诊断神经系统疾病可以促进预防、监测和治疗，从而改善患者的预后。眼与脑在结构和胚胎学上的相似之处为评估中枢神经系统的神经和微血管变化提供了潜在可能。眼组学是眼科学、遗传学和生物信息学的交叉学科，目标是开发快速、无创、具有成本效益的生物标志物，用于全身性疾病的筛查、诊断和风险分层。随着诊断和眼科成像技术的进步，用于检测眼的结构、功能和视觉变化的各项技术得到了快速发展。眼部生物标志物成为评估神经退行性疾病进展有前景的工具。文章采用眼部影像学例如光学相干断层扫描(optical coherence tomography, OCT)和OCT 血管成像 (OCT angiography, OCTA)和电生理学例如视觉诱发电位(visual evoked cortical potentials, VEP)、视网膜电图(electroretinogram, ERG)等筛查方法检测眼部异常神经退行性疾病，总结了眼组学在神经退行性疾病的应用，包括阿尔茨海默病、帕金森病、额颞叶痴呆、肌萎缩侧索硬化症和亨廷顿病，旨在为神经退行性疾病的诊断和治疗提供新的思路。尽管并非所有生物标志物都是疾病特异性的，但未来大数据、人工智能和眼组学的融合，有可能进一步深入了解这些神经退行性疾病。

Neurodegenerative diseases can damage the structure and function of the brain and nervous system, leading to a gradual decline in cognitive and behavioral abilities. Therefore, early diagnosis of neurological diseases can promote prevention, monitoring, and treatment, thereby improving the prognosis of patients. The structural and embryological similarities between the eyes and the brain provide potential for evaluating neurological and microvascular changes in the central nervous system. oculomics is an interdisciplinary field that combines ophthalmology, genetics, and bioinformatics, with the goal of developing rapid, non-invasive, and cost-effective biomarkers for screening, diagnosis, and risk stratification of systemic diseases. With the advancement of diagnostic and ophthalmic imaging technologies, various techniques for detecting the structure, function, and visual changes of the eye have been rapidly developed. Eye biomarkers have become promising tools for assessing the progression of neurodegenerative diseases. The article uses screening methods such as eye imaging (such as OCT, OCTA) and electrophysiology (such as VEP, ERG) to detect abnormal neurodegenerative diseases in the eyes. It summarizes the application of oculomics in neurodegenerative diseases, including Alzheimer's disease, Parkinson's disease, frontotemporal dementia, amyotrophic lateral sclerosis, and Huntington's disease, aiming to provide new ideas for the diagnosis and treatment of neurodegenerative diseases. Although not all biomarkers are disease-specific, the integration of big data, artificial intelligence, and oculomics in the future may further deepen our understanding of these neurodegenerative diseases.

目的：结合眼科住院医师规范化培训(住培)的特点，建立基于钉钉平台的全面质量管理模式(total quality management, TQM)，探索一种高效的顺应时代特征的眼科教学管理模式。方法：研究团队依托中山大学中山眼科中心，选取82名眼科四证合一的住培一年级的学生作为研究对象，并将其随机分为两组，试验组41人采用基于钉钉平台的TQM模式进行全过程教学管理，采用全员参与、全程跟踪、全面评价的管理模式以保障教学质量。对照组41人接受传统的教学管理模式。观察指标为两组间教学前后测试分数、教学后满意度调查的问卷得分等。结果：通过对两组学生进行课前课后的测试，TQM模式组相较于传统模式组在学习成绩有所提升，课前课后分数的差值分别为40(30,40)分和30(20,50)分，比较差异有统计学意义(P =0.031)。问卷调查结果显示，两组满意度总分比较差异无统计学意义[10(10,10) 分 vs. 10(9,10)分，P =0.207]，但在满意度分项内容掌握性上，TQM模式组分值高于传统模式组[5(5,5)分 vs. 5(4,5)分，P =0.046]。结论：基于钉钉平台的TQM模式在眼科教学中能够有效提高住培的教学质量与学生满意度，相比传统教学管理模式具有更大的教学优势，可为眼科住培提供了一种创新且实用的教学管理模式，对于培养适应时代需求的高水平眼科医师具有重要意义。

Objective: To combine the characteristics of standardized training for ophthalmic resident physicians, establishes a Total Quality Management (TQM) model based on the DingTalk platform, and explored an efficient ophthalmic teaching management model that adapts to the characteristics of the times. Methods: The research team, based at Zhongshan Ophthalmic Center, selected 82 first-year postgraduate students undergoing the national standardized training for resident doctors (STRD) as participants, randomly allocating them into two groups. The experimental group consisting of 41 trainees received TQM-modeled online learning via the DingTalk platform, adopting a management model of full participation, full process tracking, and comprehensive evaluation to ensure teaching quality. While the control group, also comprising 41 trainees, underwent traditional offline instruction. The TQM group engaged in live streaming lectures on the DingTalk platform, whereas the conventional group continued with face-to-face teaching in classroom. Data including pre- and post-teaching scores, as well as scores from satisfaction surveys are analyzed. Results: Comparing pre- and post-teaching scores, significant statistical differences were found between the TQM and traditional groups, with mean score improvements of 40(30,40) points and 30(20,50) points, respectively, indicating statistical significance (P =0.013). Furthermore, the questionnaire survey revealed that the TQM group scored higher than the traditional group in aspects such as course design, clinical relevance, content mastery, and instructor satisfaction. In addition, the questionnaire survey showed that there was no statistically significant difference in the total satisfaction score between the two groups (10(10,10) points vs. 10(9,10)points P =0.207), but in terms of mastery of satisfaction sub items, the TQM model group scored higher than the traditional model group (5(5,5) points vs. 5(4,5) points, P =0.046). Conclusions: The application of a TQM-based model on the DingTalk platform significantly enhances the teaching quality and student satisfaction in the residency training of ophthalmologists, demonstrating greater pedagogical advantages over traditional methods. This efficient ophthalmic teaching management model thus provides a promising solution for standardized residency training in ophthalmology, and holds considerable importance for nurturing highly competent ophthalmologists who can meet the demands of the current era.