目的：应用活体共聚焦显微镜（in vivo confocal microscopy，IVCM）观察视网膜激光光凝术对角膜上皮下神经的影响。方法：收集行视网膜激光光凝术的患者 36 例 46 眼，分为糖尿病性视网膜病变（diabetic retinopathy，DR）组（14 例 22 眼）与非DR组（22 例 24 眼），在治疗前及治疗后 1 周、1 个月应用IVCM采集两组角膜基底层下神经纤维图像，使用Image J和Neuron J软件计算其长度及密度。结果：DR组术前角膜神经纤维主干密度（corneal nerve fiber density，CNFD）、角膜神经纤维分支密度（corneal nerve branch density，CNBD）和角膜神经纤维长度（corneal nerve fiber length，CNFL）均低于非DR组，角膜神经弯曲度（corneal nerve fiber tortuosity，CNFT）高于非DR组。两组间角膜神经总分支节点密度（corneal total branch node，CTBN）无显著差异。DR组光凝术后CNFD，CNFL测量值持续降低，术前、术后 1 周、术后 1 个月 3 个观察时段两两之间的差异有统计学意义；光凝术后 1 个月CNFT与术前的差异有统计学意义。非DR组光凝术后CNFD，CNFL持续降低，术前、术后 1 周、术后1个月3个观察时段两两之间的差异有统计学意义；CNBD持续升高，术后 1 周、术后 1 个月测量值与术前的差异有统计学意义；CNFT持续升高，术后 1 周、术后 1 个月测量值与术前的差异均有统计学意义。结论：IVCM结合附属软件可量化评估角膜上皮下神经，糖尿病状态和视网膜激光光凝均可对角膜上皮下神经造成损伤。

Objective: To evaluate the effect of retinal photocoagulation on corneal sub-basal nerve using in vivo confocal microscopy （IVCM）. Methods: In this study, 46 eyes of 36 cases were enrolled. All patients were divided intotwo groups, 22 eyes in the diabetic retinopathy （DR） group and 24 eyes in the non-diabetic retinopathy （NDR） group. IVCM images were obtained to observe sub-basal nerve plexus before retinal photocoagulation and 1 week, 1 mouth after the treatment. Image J and Neuron J software were used for analysis. Results: In the DR group, before retinal photocoagulation, the corneal nerve fiber density （CNFD）, corneal nerve branch density （CNBD） and corneal nerve fiber length （CNFL） were lower than those in the NDR group while the corneal nerve fiber tortuosity （CNFT） was higher than that in the NDR group. There were no significant differences in corneal total branch node （CTBN） between two groups. The CNFD, CNFL were decreased constantly in the DR group. No statistical significance was observed in either CNBD or CTBN at any time point. After the treatment, the CNFT was enhanced; however, significant differences were noted between 1 week and 1 month. In the NDR group, CNFD, CNFL were declined continually to 1 month, whereas CNBD was increased. CTBN was slightly elevated at each time point without statistical significance. After treatment, CNFT was significantly increased, whereas no statistical significance was observed between 1 week and 1 month. Conclusion: IVCM combined with assistant software could be used to quantify corneal sub-basal nerve fiber. Retinal photocoagulation as well as diabetes mellitus can injure corneal sub-basal nerve fiber.

目的：比较粉尘螨滴剂与盐酸奥洛他定治疗过敏性结膜炎的效果。方法：选 取2015年1月至2017年1月期间东莞台心医院 80 例过敏性结膜炎患者，根据随机数字法分为对照组(盐酸奥洛他定)与观察组（粉尘螨滴剂），比较两组治疗前后症状及体征评分变化、临床疗效及治疗期间不良反应。结果：与对照组相比，观察组治疗后症状及体征评分均明显减少（P<0.05）；与对照组相比，观察组治疗的总有效率明显增高（P<0.05）；治疗期间两组患者均未出现严重不良反应（P>0.05）。结论：粉尘螨滴剂可明显改善过敏性结膜炎患者临床症状及体征，具有较好的临床疗效及治疗安全性。

Objective: To compare the clinical efficacy of dermatophagoides farina drops and olopatadine hydrochloride in the treatment for allergic conjunctivitis. Methods: A total of 80 patients with allergic conjunctivitis in our hospital from January 2015 to January 2017 were randomized into the control group （olopatadine hydrochloride） and the observation group （dermatophagoides farina drops） according to the random number method. The score changes of symptoms and signs on pre- and post-treatment, clinical efficacy and adverse reactions during the treatment period in the two groups were compared. Results: Compared with the control group, the scores of symptoms and signs on post-treatment were significantly decreased in the observation group （P<0.05）; compared with the control group, the total effective rate of treatment was obviously increased in the observation group （P<0.05）; there were no serious adverse reactions in two groups during the treatment period （P>0.05）. Conclusion: Thetreatment of dermatophagoides farina drops can significantly mitigate the clinical symptoms and signs in patients with allergic conjunctivitis, which yields higher clinical efficacy and treatment safety.

目的：评估光学相干断层扫描血管成像（optical coherence tomography angiography，OCTA）在糖尿病性黄斑水肿（diabetic macular edema，DME）患眼的黄斑区微血管改变及其与视功能的相关性。方法：采用横断面研究，纳入临床检查确诊的无糖尿病性黄斑水肿的糖尿病性视网膜病变（diabetic retinopathy，DR）患者23例24只眼（明确无DME组）及曾经罹患过黄斑水肿但经抗血管内皮生长因子（vascular endothelial growth factor，VEGF）治疗后水肿消退的DR患者 14 例 16 只眼（DME经抗VEGF水肿消退组）。受检者均行眼压（intraocular pressure，IOP）、收缩压/舒张压（systolic blood pressure/diastolic blood pressure，SBP/DBP）、黄斑中心凹敏感度（foveal sensitivity，FT）及OCTA技术测量黄斑区 3 mm×3 mm范围内中心凹无血管灌注区面积（foveal avascular zone，FAZ）、浅层毛细血管密度（superior vessel density，SVD）、深层毛细血管密度（deep vessel density，DVD）。采用Pearson分析FT与其年龄，眼灌注压（ocular perfusion pressure，OPP），平均动脉压（mean arterial pressure，MAP），FAZ，SVD，DVD之间的相关性。结果：两组受检眼性别、年龄、眼灌注压对比差异无统计学意义，FT，FAZ，SVD，DVD比较，差异亦无统计学意义（均P>0.05）。相关性检验结果显示：两组受检眼之间FT与SVD，DVD比较，差异无统计学意义（均P>0.05）；明确无DME组中，FT与FAZ之间呈中等程度负相关，差异有统计学意义（r=−0.554，P<0.01）；而DME经抗VEGF水肿消退组中，FT与FAZ比较，差异无统计学意义（P>0.05）。结论：与明确无DME组相比，DME经抗VEGF水肿消退组OCTA各参数差异无统计学意义，提示抗VEGF治疗DME具有安全性。此外，黄斑水肿对糖尿病性视网膜病变患者OCTA中FAZ与FT的相关性有影响。

Objective: To quantitatively evaluate the macular microvascular changes in optical coherence tomography （OCTA） in patients with diabetic macular edema （DME） and its relationship with visual function. Methods: Twenty-three patients （24 eyes） with diabetic retinopathy （DR） without diabetic macular edema and 14 patients with DR who had macular edema but regained edema after anti-VEGF treatment （the DME subsided group） into the study. All subjects underwent intraocular pressure （IOP）, systolic blood pressure/diastolic blood pressure （SBP/DBP）, foveal sensitivity （FT）, foveal avascular zone （FAZ）, superior vessel density（SVD）, and deep vessel density （DVD） in a 3 mm×3 mm OCTA scan of macular. Pearson was used to analyze the correlation between FT and age, ocular perfusion pressure （OPP）, mean arterial pressure （MAP）, FAZ, SVD, DVD. Results: There was no significant difference in sex, age and eye perfusion pressure between the two groups. There were no significant differences between FT, FAZ, SVD and DVD （all P>0.05）. Correlation test showed that there were no significant differences in FT, SVD and DVD between the two groups （all P>0.05）. In addition, there was a significant difference between FT and FAZ （P<0.01）. However, there was no significant difference between FT and FAZ in the DME subsided group （P>0.05）. Conclusion: There is no significant difference in OCTA parameters between two groups, indicating the safety of anti-vascular endothelial growth factor in treating DME. In addition, macular edema exerts an effect on the relationship between FAZ and FT by OCTA.

目的：分析有意愿接受准分子激光角膜屈光手术治疗近视的患者在术前检查后未行手术的原因。方法：选取 2015 年 1 月至 2017 年 6 月在安徽医科大学附属第一医院眼科激光中心检查的近视患者，分析其中未行激光手术的原因。结果：共 2875 例患者准备接受准分子激光角膜屈光手术，其中 821 例（28.6%）检查后未进行手术，男 462 例（56.3%），女 359 例（43.7%），年龄 18~51（23.69±5.85）岁。 821 例中社会心理因素影响484例（59.0%），角膜薄或角膜厚度不足 182 例（22.2%），超高度近视（>10.00 D)100例（12.2%），高眼压 19 例（2.3%），弱视 13 例（1.6%），角膜曲率异常11例（1.3%），眼底病变7例（0.9%），角膜变性3例（0.4%），其他 2 例（0.2%）。结论：近视治疗术前检查后未进行准分子激光角膜屈光手术的原因多种多样，其中社会心理因素及角膜厚度不足是最主要的原因。术前详细检查，严格掌握手术适应证和禁忌证以及充分医患沟通是手术安全的保障。

Objective: To analyze the reasons for not performing laser refractive keratomileusis surgery among refractive surgery candidates under regular preoperative examination. Methods: The patients with myopia examined in the Center of Ophthalmology in the First Affiliated Hospital of Anhui Medical University Laser between January 2015 and June 2017 were selected, the reasons for not performing laser refractive keraomileusis after regular preoperative examination were analyzed. Results: A total of 2 875 patients requested refractive surgery and 2 054 (71.4%) of them received refractive surgery. Among 821 (28.6%) patients who did not get laser refractive keratomileusis, 462 (56.3%) were male and 359 (43.7%) were female, aged 18–51 years (range, 23.69± 5.85 years). The most common reason for not offering refractive surgery were social psychological factors (59.0%), low central corneal thickness (22.2%), high myopia (12.2%), high intraocular pressure (2.3%), poor corrected visual acuity (1.6%), corneal topography anomaly (1.3%), retinal disease (0.9%), corneal (0.4%) and other diseases (0.2%).  Conclusion: Reasons for not performing refractive surgery are quite diverse. Social psychological factors and inadequate corneal thickness were the most common reasons in the present study. Careful preoperative examination, strictly mastering indications and contraindications and full doctor-patient communication should be done for the safety of surgery. 

暴发性脉络膜上腔出血（subchoroidal expulsive hemorrhage,SEH）是内眼手术中罕见且严重的并发症，广东省人民医院眼科收治 1 名因晶状体完全脱位继发青光眼的女性患者,73 岁，其手术过程中发生SEH，现报告如下.通过回顾病例，讨论及分析SEH的原因、危险因素及治疗。

Subchoroidal expulsive hemorrhage（SEH）is one of the rarest and worst complications of intraocular surgery. We treated one patient with secondary glaucoma due to complete dislocation of the lens, who developed SEH during the surgery. In this case report, the causes, risk factors and treatment of subchoroidal expulsive were discussed and analyzed by reviewing the case.

目的：探讨县级基层医院白内障患者术前焦虑情况，以便改善护理流程。方法：本研究为回顾性研究，收集河源光明眼科医院 2017 年 1 至 9 月 2 182 例行白内障复明手术患者的术前焦虑视觉模拟量表（The Anxiety Visual Analogue Scale，VAS-A）评分及阿姆斯特丹术前焦虑与信息需求表（Amsterdam Preoperative Anxiety and Information Scale，APAIS）评分，采用t检验和Spearman相关性检验进行术前焦虑情况分析。结果： 2 182 例白内障手术患者VAS-A焦虑评分为 4.74±1.93 ，APAIS焦虑评分为6.46±1.66 ，男性患者术前焦虑程度低于女性患者，患者术前焦虑程度与年龄呈低度负相关。结论：两种术前焦虑评分均能反映患者术前焦虑程度，可根据其对麻醉或手术信息需求度的不同选择相应的护理对策，以缓解患者术前焦虑，改善护理质量。

Objective: To investigate the preoperative anxiety in patients with cataract in a township hospital. Methods: A retrospective study was conducted on preoperative anxiety of 2 182 patients with cataract according to the Anxiety Visual Analogue Scale（VAS-A） and Amsterdam Preoperative Anxiety and Information Scale（APAIS）from Jan 1, 2017 to Sep 30, 2017 in Heyuan Guangming Eye Hospital. Student’s t-test and Spearman correlation were used to evaluate the preoperative anxiety. Results: The score of preoperative anxiety was 4.74±1.93 with the VAS-A and was 6.46±1.66 with the APAIS. The preoperative anxiety in male was lower than that in female, and the degree of the preoperative anxiety was negatively correlated with age. Conclusion:The preoperative anxiety of patients with cataract can be properly evaluated using either the VAS-A or the APAIS.The nursing care should be adjusted corresponding to patients’ different needs of the information about anesthesia and surgery in order to alleviate the preoperative anxiety and improve the nursing care.

目的：探讨大泡性角膜病变（ bullous keratopathy，BK）患者行飞秒激光辅助的角膜内皮移植术（endothelium keratoplasty，EK）的围手术期护理。方法：回顾性分析在南京总医院眼科行飞秒激光辅助角膜内皮移植的 BK20 例患者，分析并总结患者术前的心理疏导、术前准备、眼科检查、术中如何配合医生、术后特殊体位、高眼压的护理及如何正确用药和出院健康教育等。结果：患者得到及时、有效的护理，术后视力均有所提高，内皮贴伏好，无排斥反应及其他并发症的发生。结论：通过对患者围手术期的护理，可提高护理质量，缩短患者住院时间。

Objective: To observe the perioperative nursing of femtosecond laser-assisted corneal endothelial transplantation in the treatment of patients with bullous keratopathy. Methods: A retrospective analysis of 20 patients with bullous keratopathy with femtosecond laser-assisted corneal endothelial transplantation in our department. The preoperative psychological counseling, preoperative preparation, ocular examination, how to cooperate with the doctors in operation, nursing of special position, high intraocular pressure after surgery, how to use eye drops correctly and health education after discharge were summarized. Results: Nursing were performed to the patients timely and effectively. Postoperative visual acuity of all the patients were improved, the endothelial and corneal stroma bed are well combined and no graft rejection and other complications occurred in the patients postoperatively. Conclusion: We concluded that the quality of nursing was improved and the time of hospitalization was shortened after perioperative nursing. 

年龄相关性黄斑变性（age-related macular degeneration, AMD）是一种与氧化应激及多基因调控异常密切相关的视网膜黄斑区域进行性退化性疾病。由于黄斑区缺乏血管，因此对氧气的高度依赖使其特别容易受到氧化应激的影响。氧化应激反应影响视网膜色素上皮细胞（retinal pigment epithelium, RPE）功能，导致RPE细胞代谢异常、RPE细胞凋亡与损伤；影响脉络膜血管功能，表现为新生血管异常和血管内皮细胞功能障碍；过度激活补体系统，使炎症细胞浸润与炎症因子释放引发炎症；这三者构成了AMD的发病机制之一。文章列举了抗氧化酶基因家族（超氧化物歧化酶、过氧化氢酶、谷胱甘肽过氧化物酶）、炎症相关基因（补体系统相关基因和细胞因子相关基因）和其他相关基因（血管内皮生长因子、血红素加氧酶-1、载脂蛋白E、铁死亡相关基因、年龄相关性黄斑病变易感因子2基因）的异常表达与AMD产生的关联性，并阐述了基因编辑技术纠正氧化应激相关基因缺陷和基于氧化应激基因靶点的药物治疗手段，以期为AMD的防治提供思路。

Age-related macular degeneration (AMD) is a retinal degenerative disease closely associated with oxidative stress and dysregulation of polygenic mechanisms. Due to the absence of blood vessels in the macular region, its high dependence on oxygen renders it particularly susceptible to oxidative stress. Oxidative stress impairs the function of retinal pigment epithelium (RPE) cells, leading to metabolic dysregulation, apoptosis, and cellular damage. It also disrupts choroidal vascular function, characterized by abnormal neovascularization and endothelial dysfunction. Moreover, excessive activation of the complement system promotes inflammatory cell infiltration and the release of pro-inflammatory cytokines. Collectively, these processes constitute one of the key pathogenic mechanisms underlying AMD. This paper highlights the pathogenic associations between AMD progression and dysregulated expression in antioxidant enzyme genes (e.g., superoxide dismutase, catalase, glutathione peroxidase), inflammation-related genes (e.g., complement and cytokine-related genes), and other relevant genes (e.g., vascular endothelial growth factor, heme oxygenase-1, apolipoprotein E, ferroptosis-related genes, age-related maculopathy susceptibility 2 gene). Potential therapeutic strategies, including gene editing to correct oxidative stress-related genetic defects and pharmacological interventions targeting oxidative stress-associated genes, are also elaborated, aiming to provide new insights into AMD prevention and treatment.

目的：了解干眼患者相关知识、管理态度及防治行为的现状及影响因素，为临床制定针对性的干预措施提供依据。方法：采用便利抽样法，选取2025年1—3月在中山大学中山眼科中心干眼与眼表疾病门诊就诊的患者为研究对象。调查工具为一般资料调查表、中国干眼问卷及干眼患者知信行问卷。知信行问卷包括知识（16个条目）、态度（7个条目）、行为（9个条目） 3个维度，共32个条目。使用单因素分析及多元线性回归分析确定影响因素。 结果：有效回收调查问卷325份，325例干眼患者的知信行问卷平均得分为（62.89±9.00）分；标准分为（78.61±11.25）分，处于中等水平。其中知识维度平均得分为（9.89±4.88）分，134例（41.2%）处于较差水平；态度维度得分较高，总均分为（26.92±2.24）分，标准分（96.16±8.03）分，处于较高水平；行为维度总均分为（26.06±5.43）分，标准分（72.41±15.09）分，处于中等水平。单因素分析结果显示，不同年龄、文化程度、家庭人均月收入、是否经常使用电子设备、是否主动查询疾病知识的干眼患者，其知信行得分比较差异有统计学意义（P<0.05）。年龄、文化程度、是否主动查询疾病知识是干眼患者知信行得分的影响因素（P<0.05）。 结论：干眼患者知信行水平处于中等，表现为疾病知识掌握片面、防治态度较积极但行为水平有待提高，且受多因素影响，应制订精准、个性化健康教育内容，以提高干眼患者的知信行水平。

Objective: To investigate the current status and identify the influencing factors regarding the knowledge, attitudes, and practices related to dry eye disease (DED) among patients. This study aims to provide a solid foundation for the development of targeted clinical interventions. Methods: With convenience sampling, patients diagnosed with DED were selected at the Dry Eye and Ocular Surface Disease Clinic of Zhongshan Ophthalmic Center from January to March 2025 as study subjects. The survey tools consisted of a general information questionnaire, the Chinese Dry Eye Questionnaire, and the Knowledge, Attitudes, and Practices (KAP) Questionnaire for DED patients. The KAP questionnaire was structured into three dimensions: knowledge (16 items), attitudes (7 items), and practices (9 items), making a total of 32 items. Univariate analysis and multiple linear regression were employed to identify influencing factors. Results: A total of 325 valid questionnaires were collected. Among the 325 DED patients, the average KAP score was 62.89±9.00, and the standardized score was 78.61±11.25, indicating a moderate level. In the knowledge dimension, the average score was 9.89±4.88 and 134 patients (41.2%) had poor scores. The attitudes dimension showed a relatively high level, with a total mean score of 26.92±2.24 and a standardized score of 96.16±8.03, reflecting that the patients generally held positive attitudes towards the prevention and treatment of DED. For the practices dimension, the total mean score was 26.06±5.43, and the standardized score was 72.41±15.09, indicating a moderate level of behaviorial practices. Univariate analysis revealed significant differences in KAP scores among patients with different ages, education levels, monthly household income per capita, frequencies of electronic device use, and whether they actively sought disease-related knowledge (P<0.05). Further, age, education level, and proactive information-seeking behavior were identified as significant influencing factors for KAP scores (P<0.05). Conclusions: The KAP level of DED patients is moderate. Their disease knowlege is fragmented, while they exhibit positive attitudes toward prevention and treatment. However, their behavioral practices are subptimal and are influenced by multiple factors. Therefore, it is essential to develop tailored and personalized health education programs to enhance the KAP level of DED patients.

目的：探讨环保试剂在眼科组织病理技术中的应用。方法：选取中山眼科中心2023年6月—2024年3月送检病理科手术标本190 例，一式两份分别采用环保试剂和传统试剂固定、脱水、透明、浸蜡、染色和封片，对两组试剂制片和染色的组织切片进行评价和判读、比较。结果：环保试剂组脱水、染色处理组织与传统试剂组相比，脱水效果良好，切片软硬适中，切面完整、无裂隙；苏木精-伊红(hematoxylineosin, HE)染色镜下可见细胞核结构清晰、核质对比鲜明、背景干净，两组优良片率分别为97.9%、98.4%，各级片差异无统计学意义(Z = –0.645，P=0.519)；免疫组织化学染色的组织抗原性完好，阳性信号强、定位准确，无背景染色。结论：应用环保试剂替代传统试剂在眼科组织标本中脱水、染色应用效果良好，可满足病理日常制片和染色需求，全流程无二甲苯，具有环保优点，成本可控，值得推广应用。

Objective: To investigate the utilization of environmentally-sustainable reagents in ophthalmic tissue pathology techniques. Methods: We prospectively collected 190 surgical specimens submitted to the pathology department of Zhongshan Ophthalmic Center between June 2023 and March 2024. Each specimen was divided into two sets, one treated with environmentally-sustainable reagents and the other with conventional reagents for fixation, dehydration, clearing, infiltration, staining, and mounting. The quality of histological sections from both groups was evaluated and compared. Results: Compared to the conventional reagent group, environmentally-sustainable reagent group showed good dehydration performance, moderately soft and hard tissue sections with intact cut surfaces and no cracks. H&E staining sections prepared with environmentally-sustainable reagents exhibited clear nuclear structures, distinct nuclear-cytoplasmic contrast, and clean backgrounds. The excellent section rates were 97.9% and 98.4% for the two, respectively. There was no significant difference in section quality between the two groups (Z = –0.645, P = 0.519). Tissue antigenicity was well-preserved during immunohistochemical procedures, with strong positive signals and accurate localization without background staining. Conclusions: The use of environmentally-sustainable reagents as a replacement for conventional reagents in the dehydration and staining of ophthalmic tissue yields satisfactory results, meeting the daily requirements for routine histological sectioning and staining. The entire process is xylene-free, environmentally-sustainable, cost-effective and worth being applied widely.