目的:探讨中国西北地区60岁以上人群晶状体厚度(lens thickness, LT)和晶状体相对位置(relative lens position,RLP)的影响因素以及与眼前房角结构的相关性,为探索晶状体在原发性闭角型青光眼疾病中的作用机制提供依据。方法:横断面研究,纳入2024年4—6月在新疆喀什地区英吉沙县社区人群中检查的60岁以上正常受检者,采用眼前节相干光断层扫描仪等,测量双眼眼球生物学参数。将患者右眼纳入研究范围,通过相关性分析和线性回归模型分析晶状体参数变化与房角结构的相关性。结果:性别、腰围和眼轴长度(axial length, AL)为RLP的独立预测因子。年龄越大,晶状体越厚,70岁前LT与AL呈正相关,眼轴、LT和RLP是眼前房角巩膜突前500 μm开放距离(AOD500)的独立预测因子,其多元线性回归方程为:AOD500=-2.501 4+0.083 3AL-0.115 7LT+7.0211RLP-0.0026Sex-0.0010身高。 结论:新疆喀什地区60岁以上人群中,女性、腰围大和眼轴短提示晶状体相对位置靠前,而晶状体厚度、相对位置以及眼轴显著影响眼前房角开放距离,成为闭角型青光眼发病的潜在危险因素。
Objective: To explore the influencing factors of lens thickness (LT) and relative lens position (RLP) in individuals aged 60 and above in Northwestern China, as well as their correlation with anterior chamber angle structure. The aim is to provide evidence for exploring the role of the lens in the pathogenesis of primary angle - closure glaucoma. Methods: A cross - sectional study was conducted. Normal subjects aged 60 and above were enrolled from community - based examinations in Yingjisha County, Kashi, Xinjiang, between April and June 2024. An anterior segment optical coherence tomography was used to measure ocular biological parameters of both eyes. Only the right eyes of the subjects were included in the analysis. The correlation between changes in lens parameter and angle structure was examined through correlation analysis and linear regression models. Results: Gender, waist circumference and axial length emerged as independent predictors of the relative lens position. As age increased, the lens became thicker. Before the age of 70, lens thickness was positively correlated with axial length. Axial length, LT and RLP were identified as independent predictors of the anterior chamber angle scleral spur anterior 500 - μ m - opening distance (AOD500). The multiple linear regression equation is as follows: AOD500 (mm) = -2.5014 + 0.0833AL (mm) - 0.1157LT (mm) + 7.0211RLP - 0.0026Sex - 0.0010Height (cm). Conclusions: Among individuals aged 60 and above in Northwest China, being female, having a large waist circumference, and a short axial length are indicative of a relatively anterior lens position Furthermore, lens thickness, its relative position, and axial length significantly affect the anterior chamber angle opening distance, potentially contributing to the pathogenesis of angle-closure glaucoma.
目的:应用广角扫频源光学相干断层扫描成像(swept-source optical coherence tomography, SS-OCT)的en face结构投射图研究玻璃体早期液化特征。方法:使用SS-OCT进行18 mm×18 mm 的容积(Cube)扫描,创建并分析健康未成年人(年龄5~18岁)70眼的系列玻璃体en face结构投射图。 结果:在未成年人中,视网膜前的玻璃体包含4种液化结构,分别为后皮质前玻璃体囊袋(posterior precortical vitreous pocket, PPVP)、视盘前Martegiani区(the area of Martegiani, AM)、血管前液化裂隙(prevascular vitreous fissures,PVF)和液化池(cistern)。所有研究眼均能检出PPVP、AM和PVF,其中22眼(31.4%)的PPVP和AM连通。41眼(58.6%)可检出液化池,且其年龄大于未检出液化池的个体(P =0.01),液化池的发生与年龄呈正相关(rs=0.315,P =0.008)。液化池的象限空间分布频率依次为颞上(90.2%)、鼻上(58.5%)、颞下(36.6%)、鼻下(24.4%),最常累及颞上象限(P<0.001)。 结论:PPVP、AM和PVF是健康人群视网膜前玻璃体早期液化过程中均出现的特征。液化池的发生与年龄呈正相关,最常出现在颞上象限,可能是年龄相关性玻璃体液化变性的结果。
Objective: To investigate the early vitreous liquefaction characteristics using en face structural projection images obtained by wide-angle swept-source optical coherence tomography (SS-OCT). Methods: SS-OCT was employed to perform 18*18mm volumetric (Cube) scans. A series of en face structural projection images of the vitreous were created and analyzed for 70 eyes from healthy minors aged between 5 and 18 years. Results: In minors, four types of vitreous liquefaction structures were identified anterior to the retina: pre-posterior vitreous pocket (PPVP), the preoptic area of Martegiani (AM), pre-vascular liquefaction fissures (PVF), and cisterns. PPVP, AM, and PVF were detectable in all studied eyes, with PPVP and AM being interconnected in 22 eyes (31.4%). Cisterns were observed in 41 eyes (58.6%), and the mean age of individuals with cisterns was higher than those without (P =0.01). The occurrence of cisterns positively correlated with age (r=0.315; P=0.008). The frequency of cistern quadrant distribution was highest in the superotemporal quadrant (90.2%), followed by the superonasal quadrant (58.5%), inferotemporal quadrant (36.6%), and inferonasal quadrant (24.4%). The superotemporal quadrant was the most frequently affected (P <0.001). Conclusion: PPVP, AM, and PVF are features consistently observed in the early vitreous liquefaction process anterior to the retina in healthy individuals. The occurrence of cisterns positively correlates with age and is most common in the superotemporal quadrant, possibly representing the result of age-related vitreous liquefaction degeneration. These findings provide a theoretical foundation for studying the pathogenesis of vitreoretinal interface diseases.
先天性晶状体脱位(congenital ectopia lentis, CEL)是一种罕见的遗传相关性疾病,其主要临床特征是晶状体悬韧带先天性发育异常,导致晶状体偏离正常解剖位置。随着病情的进展,CEL可引起高度屈光不正甚至弱视外,还可能导致继发性青光眼和视网膜脱离等严重的并发症。目前,手术仍是改善CEL患儿视觉质量及防治并发症的主要手段。常用的手术方式包括晶状体摘除术、前房型人工晶状体(intraocular lens, IOL)植入术、囊袋支撑装置联合IOL植入术及经巩膜IOL固定术等,这些手术方式各具特点,但目前最佳手术方式仍未有定论。既往大量文献表明,手术能够显著改善CEL患儿视力,但随着眼球的生长发育,CEL患儿术后屈光状态常出现近视漂移。此外,术后并发症如缝线暴露,IOL瞳孔夹持、IOL脱位、视网膜脱离等仍有可能发生,需要长期的严密随访。这些因素都使得CEL的治疗具有挑战性。为此,文章就CEL的手术方式、视力预后、术后屈光变化及术后并发症进行综述,旨在为该疾病的临床诊断及治疗提供更为全面和深入的理解。
Congenital ectopia lentis (CEL) is a rare genetic disorder characterized by the displacement of the lens from its normal anatomical position due to abnormalities in the lens zonular. As the progression of the disease, CEL can lead to high refractive error, even amblyopia, as well as other serious complications such as secondary glaucoma and retinal detachment. Currently, surgical intervention remains the primary method to improve the visual quality and prevent complications in children with CEL.Common surgical options include lens extraction, anterior chamber intraocular lens (IOL) implantation, IOL implantation combined with capsular tension devices, and transcleral fixation of IOL. Each surgical approach has its own characteristics, but there is currently no consensus on the best surgical method. Previous literature has shown that surgery can significantly improve vision in children with CEL; however, due to the growth of the eye, postoperative refractive status often experiences myopic shift. Additionally, complications such as suture exposure, IOL pupil capture, IOL dislocation, and retinal detachment may still occur, necessitating long-term close follow-up. These factors make the treatment of CEL challenging. This article reviews the surgical approaches, visual prognosis, postoperative refractive changes, and postoperative complications associated with CEL, aiming to provide a more comprehensive and in-depth understanding for the clinical diagnosis and treatment of this disease.
白内障是世界范围内致盲的主要原因之一,占中低收入国家致盲病例的50%。随着人口老龄化程度的加深,到2050年中国白内障致盲病例预计达到2 000万。卫生支出占比低、医疗设备及眼科医生紧缺、筛查费用昂贵仍是中低收入国家无法开展大规模白内障筛查的主要原因。人工智能(artificial intelligence,AI)协助白内障诊断具有便捷、低成本、可远程进行等优点,有望减少甚至避免白内障致盲的发生。文章将对AI通过结合裂隙灯眼前节图像、眼底照片及扫频源光学相干层析图像进行白内障自动诊断等研究进行简要综述。
Cataract is a primary cause of blindness globally, particularly accounting for 50% of blindness cases in low- and middle- income countries. As the population ages, it is predicated that cataract blindness cases in China will rise to 20 million by 2050. However, low health expenditures, scarcity of medical equipment and ophthalmologists, and high screening costs continue to hinder mass cataract screening in these countries. Artificial intelligence(AI)-assisted cataract diagnosis offers significant advantages, including convenience, cost-effectiveness, and remote accessibility, potentially reducing or even eliminating cataract blindness. This review aims to concisely summarize the research on automatic cataract diagnosis utilizing AI, incorporating slit lamp images of anterior eye segment, fundus photographs, and swept source optical coherence tomography images.
患者,男性,1岁9个月。以“发现右眼上、下眼睑肿物25 d”首诊于眼科,要求切除,但经影像学及病理学检查,诊断为多发性朗格汉斯细胞组织细胞增生症,且全身骨骼多处出现溶骨性改变,不符合切除指征。给予多次全身化学治疗后眼部肿物明显变小。该例诊治提醒眼科医生,眼部肿物可由全身系统性疾病引起,不可盲目切除,必要时做进一步检查。术中切除物均建议行病理活组织检查,以免延误治疗。
patient, male, 1year and 9months old, was first diagnosed as “eye tumor” in the ophthalmology department and requested for excision. But it was diagnosed as multiple Langerhans cell histiocytosis (LCH) through imaging and pathological examination ultimately.Bone lytic changes appeared in many parts of the whole body, which did not meet the indication of excision.The tumor was smaller after systemic chemotherapy. The diagnosis and treatment of this case suggests ophthalmologists that eye tumors can be caused by caused by systemic diseases, systemic diseases. During operation, it is recommended to perform pathological biopsy to avoid treatment delay.
糖尿病视网膜病变是糖尿病引起的微血管病变之一,是不可逆性致盲的眼病。根据其病程可分为根据其病程可分为非增殖期和增殖期,其中还包括糖尿病性黄斑水肿。全科医师需要检测量裸眼视力、矫正视力和眼压,通过裂隙灯显微镜评估眼前节以及眼底检查来评估眼部整体情况。控制血糖、血压、血脂对改善预后很重要。需要重视餐前、餐后血糖,糖化血红蛋白和代谢记忆,一线降血压药物包括血管紧张素转化酶抑制剂和血管紧张素Ⅱ受体阻断剂,调脂药物首选他汀类,而非诺贝特有额外的视网膜保护作用。干预生活方式,宣教,早期发现也同样重要。全科医师需要进行眼底筛查和评分,及时转诊至眼科治疗。眼科治疗包括全视网膜激光光凝术、经平坦部玻璃体切除术、玻璃体抗血管内皮生长因子药物注射术。
Diabetic retinopathy is one of the microvascular diseases caused by diabetes, it is an irreversible blindness eye disease. According to its course, it can be divided into non-proliferative diabetic retinopathy and proliferative diabetic retinopathy, including diabetic macular edema. Te general practitioner needs to measure the uncorrected visual acuity, corrected visual acuity intraocular pressure, use the slit lamp microscope to exam the anterior segment and fundus to evaluate the overall condition of the eye. Controlling blood glucose, blood pressure and blood lipid is very important to improve the prognosis. Attach importance to pre- and postprandial blood glucose, glycosylated hemoglobin and metabolic memory should be carried out. The first-line antihypertensive drugs are angiotensin converting enzyme inhibitors and angiotensin II receptor blockers. Statins are the first choice for lipid-lowering drugs, fenofibrate has additional protective efect of retinal. Intervention in lifestyle, education and early detection are is important. Te general practitioner needs to perform fundus screening and scoring, timely refer to ophthalmology department for treatment. Ophthalmic treatment includes panretinal laser photocoagulation, pars plana vitrectomy, and intravitreal injection of anti-vascular endothelial growth factor drugs.
报告一例视神经脊髓炎谱系疾病(neuromyelitis optica spectrum disorders,NMOSD)合并人体免疫缺陷病毒(human immunodeficiency virus,HIV)感染/获得性免疫缺陷综合征(acquired immune deficiency syndrome,AIDS),并通过文献复习,总结其发病机制、临床特征、治疗及预后。检索文献包括7篇英文文献(8个病例),1篇中文文献,共报道9例NMOSD合并HIV感染/AIDS病例,结合本文报道的1例共10例,其中5例为女性,5例为男性,3例HIV感染/AIDS为新发,其他病例的HIV感染/AIDS发病均早于NMOSD。临床表现上,7例均为视神经炎和脊髓炎同时或相继发生,2例表现为单相病程或复发性脊髓炎,1例仅表现为双眼相继发生的视神经炎,10例患者头或脊髓MRI均有典型的视神经或脊髓异常信号,伴或不伴强化。2例患者未进行水通道蛋白4(aquaporin protein-4,AQP4)抗体IgG检测,其余8例中5例AQP4抗体阳性、3例阴性。针对AIDS的治疗,10例患者中,8例接受了高效抗逆转录病毒治疗(highly active antiretroviral therapy,HAART)。针对NMOSD的治疗,10例患者中,急性期有8例患者接受糖皮质激素冲击治疗、3例患者接受血浆置换、2例接受丙种球蛋白治疗,序贯治疗期有6例患者接受免疫抑制剂治疗,其中1例因高胆红素血症停药。发生视神经炎的7例中,2例患者经治疗仍失明、5例视力部分恢复,发生脊髓炎的8例中,5例患者遗留截瘫或轻瘫、3例肌力部分恢复。1例因严重并发症去世。NMOSD合并HIV感染/AIDS临床较罕见,预后差,往往遗留严重的视力障碍及瘫痪等,临床治疗较为棘手,糖皮质激素和免疫抑制剂并非使用禁忌证,但制定治疗决策前需要充分考虑风险与获益的平衡。
A case of neuromyelitis optica spectrum disorders(NMOSD) complicated with human immunodeficiency virus(HIV) infection/acquired immunodeficiency syndrome(AIDS) was reported, and the pathogenesis, clinical characteristics, treatment and prognosis were summarized through the literature review. The retrieved literatures included seven English literatures (eight cases) and one Chinese literature, in which a total of nine cases of NMOSD co-infected with HIV infection/AIDS were reported. Combined with the case reported in this paper, the total number of cases was ten, among which five cases were female and five cases were male, three cases of HIV infection/AIDS were newly developed, and the other cases had earlier onset of HIV infection/AIDS than NMOSD. In terms of clinical manifestations, seven cases all had simultaneous or sequential optic nerve and myelitis, two patients presented with a uniphasic course or recurrent myelitis, and one case presented only with bilateral optic neuritis occurring sequentially in both eyes. All ten patients had typical abnormal signals of the optic nerve or spinal cord with or without enhancement on cranial or spinal MRI. Two patients did not undergo AQP4 antibody IgG testing , and of the remaining seven cases, five were positive for AQP4 antibodies and three were negative. For AIDS treatment, eight of the ten patients received highly active antiretroviral therapy(HAART). For NMOSD treatment, among the ten patients, eight patients received intravenous methylprednisolone,three patients received plasmapheresis, and two patients received intravenous immunoglobulin in the acute phase. Six patients received immunosuppressive therapy during the sequential treatment period, and one of them was discontinued due to hyperbilirubinemia. Of the seven cases with optic neuritis, two patients remained blind after treatment and five had partial recovery of vision. Of the eight cases with myelitis, five patients were left with paraplegia or mild paralysis, and three had partial recovery of muscle strength. One case died due to serious complications.NMOSD combined with HIV infection/AIDS is rare in clinic and has a poor prognosis. Patients are often left with severe visual impairment and paralysis. Clinical treatment is quite difficult, hormones and immunosuppressive agents are not considered as contraindications. Treatment decisions need to be made with fully considered about the balance of risks and benefits.
眼睛由屈光系统和视觉神经系统两大部分构成,是人体最重要的感觉器官之一。眼部各组织的发育或功能异常都可能造成不同程度的视力损害。目前主要通过动物实验或体外细胞培养的方法探究眼病的病理生理机制和治疗手段,但上述两种方法都存在一定的局限性。体外细胞培养不能完全反映器官的形态、结构和生化特征,而动物模型的物种和遗传背景具有异质性。近年来,随着原代组织、胚胎干细胞、诱导多能干细胞衍生的体外三维结构类器官和器官微流控芯片技术的不断发展,构建出了与在体器官的结构、功能更为相似的器官克隆模型,能够提供更敏感、定量、规模化的表型分析,更好地应用于眼的发育、生理结构、疾病机制、个性化医学诊断和治疗方法等方面的研究。目前,眼科的微流控器官芯片与类器官技术在角膜、晶状体、泪腺、视网膜结构发育和疾病模型均展现出巨大的应用潜力。
The eye is composed of refractive system and visual nervous system. It is one of the most important sensory organs of the human body. The abnormal development or function of eye tissues may cause various degrees of visual impairment. At present, the pathophysiological mechanism and treatment of eye diseases are mainly explored through animal experiments and in-vitro cell culture. However, they are of certain limitations. The in-vitro cell culture cannot fully reflect the morphological, structural and biochemical characteristics of organs, whereas the animal models are heterogeneous of species and genetic background. In recent years, with the continuous development of in-vitro three-dimensional structure organoids and organ microfluidic organ-on-a-chip technology derived from primary tissues, embryonic stem cells and induced pluripotent stem cells, organ cloning models more similar to in vivo organs in terms of the structure and function have been constructed. These models can provide more sensitive, quantitative and large-scale phenotypic analysis, and can be better applied to the research of eye development, physiological structure, disease mechanism, personalized medical diagnosis and treatment. At present, microfluidic organ-on-a-chip and organoids technologies have shown great application potential in the structural development and disease models’ construction of cornea, lens, lacrimal gland and retina.
斜视作为眼科的常见疾病之一,多发生于儿童群体。传统的诊疗手段高度依赖医生的个人经验,效率欠佳,患者依从性差,极易延误病情,严重影响患儿视功能及身心发育。近年来,人工智能(artificial intelligence, AI)与虚拟现实(virtual reality, VR)技术作为数字智能技术中的前沿科技手段,已广泛应用于眼科疾病的筛查、诊断和治疗环节,并正推动斜视诊疗体系向智能化转型。AI技术凭借强大的图像识别与分析能力可自动检测斜视类型和角度,更全面地评估病情。同时,通过分析大量数据预测手术参数,辅助制定个性化的手术方案,并且评估手术效果,大幅提升了斜视诊疗的精准度和效率;而VR技术则通过眼动追踪和动态场景模拟,实现更全面的眼位测量和动态分析。在手术中为医生提供清晰全面的眼部视图,借助模拟试验提升操作精准度,降低手术风险。借助沉浸式的视觉训练有效优化了斜视的康复效果。本文系统地回顾了数字智能技术在斜视诊疗方面的创新应用实例,深入探讨了AI和VR在斜视诊疗中独特的技术优势以及显著的临床价值。AI与VR技术的协同创新,为斜视诊疗模式带来了智能化的变革,在未来,有望为眼科医疗领域的发展注入新的动力,推动整个行业迈向新的高度。
Strabismus is a prevalent ophthalmic disorder predominantly affects children. For a long time, its diagnosis and treatment have heavily relied on traditional methods, which are highly dependent on clinical expertise. This reliance often leads to inefficiency, poor patient compliance, and delayed treatment. These issues can severely impair visual function and hinder psychosocial development. Recently, there have been significant advancements in artificial intelligence (AI) and virtual reality (VR), both of which are cutting-edge digital technologies. These innovations have brought about a revolution in the screening, diagnosis, and treatment of ophthalmic diseases, driving the intelligent transformation of strabismus management. AI demonstrates remarkable capabilities in the automated detection of strabismus types and deviation angles. It achieves this through robust image recognition and analysis techniques, enabling a comprehensive evaluation of the disease. By analyzing vast amounts of data, AI can predict surgical parameters, assists in personalized surgical planning, and objectively assesses postoperative outcomes. This significantly enhances diagnostic accuracy and therapeutic efficiency. At the same time, VR technology enables holistic ocular alignment measurements and dynamic analysis via eye-tracking and simulated dynamic environments. During surgical procedures, VR offers surgeons an enhanced visualization of ocular structures and improves operational accuracy through simulated trials. As a result, it helps reduce surgical risks. After surgery, immersive VR-based visual training programs can optimize rehabilitation outcomes. This review systematically examines innovative applications of AI and VR in strabismus care, highlighting their unique technical advantages and clinical value. The synergistic integration of AI and VR has catalyzed an intelligent paradigm shift in strabismus management. This shift promises to inject new momentum into ophthalmic medicine and propel the field towards unprecedented advancements.
目的: 分析甲醇中毒性视神经病变的临床特征、影像学动态演变及治疗反应,探讨中毒程度、治疗时机与视功能预后的相关性,为优化临床诊疗路径提供循证依据。方法: 采用病例系列研究与文献回顾方法,回顾性纳入2017—2024年在中山大学中山眼科中心确诊的9例(18只眼)甲醇中毒性视神经病变患者,收集其临床资料包括瞳孔变化、眼底照相、光学相干断层成像(optical coherence tomography; OCT)、视野、视觉诱发电位(visual evoked potential; VEP)等,结合文献整合病例数据。纳入标准包括明确甲醇暴露史、急性视力下降伴视盘水肿或视网膜神经纤维层(retinal nerve fiber layer; RNFL)增厚、血/尿甲醇或甲酸浓度升高。排除既往视力不佳或视网膜病变者。通过多模态影像学评估视神经损伤特征,分析治疗反应及预后相关因素。结果: 9例(18只眼)患者年龄为23~51岁(男性7例,女性2例),中毒后就诊时间为3 d~3个月。最佳矫正视力为无光感(11眼)至1.0,66.7%(12/18眼)出现瞳孔变化,眼底表现为视盘水肿,VEP提示振幅下降伴视野缺损,OCT显示急性期视盘区域RNFL增厚,慢性期进行性萎缩、杯盘比显著增大。经治疗后,12只眼视力提高(随访2个月,4只眼中毒后视力为1.0,未纳入其中),持续随访(4个月~3年)的患者中,多数患者急性期干预后进入视力平台期,但少数患者仍存在迟发性神经退行风险。因此,部分患者通过早期干预联合全身激素冲击、血液透析、营养神经等治疗可能有助于改善视功能,而部分延迟治疗患者可出现不可逆视力丧失。瞳孔对光反射保留者预后更佳。结论: 甲醇中毒性视神经病变的预后与中毒程度、干预时机及瞳孔反射状态密切相关。早期给予激素冲击联合营养神经治疗可能改善部分患者的预后,但中毒时间长者易遗留不可逆视神经损伤,个性化分期治疗及长期视功能监测对保护残余视力至关重要。
Objective: To analyze the clinical characteristics, dynamic imaging changes, and treatment responses of methanol-induced toxic neuropathy. Additionally, it sought to explore the correlation between poisoning severity, intervention timing, and visual functional outcomes, so as to evidence-based insights for optimizing clinical diagnosis and treatment strategies. Methods: A case-series study combined with a literature review was conducted. Nine patients (18 eyes) diagnosed with methanol-induced toxic neuropathy at Zhongshan Ophthalmic Center, Sun Yat-sen University from 2017 to 2024, were retrospectively included. Clinical data, including pupillary changes, fundus photography, optical coherence tomography (OCT), visual field tests, and visual evoked potentials (VEP), were collected and integrated with findings from the literature. The inclusion criteria were a confirmed history of methanol exposure, acute vision loss accompanied by optic disc edema or retinal nerve fiber layer (RNFL) thickening, and elevated blood/urine methanol or formic acid levels. Patients with pre-existing poor vision or retinal diseases were excluded. Multimodal imaging was employed to evaluate the characteristics of optic nerve injury, and treatment responses and prognostic factors were analyzed. Results: The nine patients (18 eyes) ranged in age from 23–51 years (7 males, 2 females), with the time from poisoning to consultation spanning from 3 days to 3 months. The best-corrected visual acuity (BCVA) ranged from no light perception (NLP, 11 eyes) to 1.0. Pupillary abnormalities were observed in 66.7% (12/18 eyes) of the cases. Fundus examination showed optic disc edema, while VEP revealed reduced amplitude and visual field defects. OCT demonstrated RNFL thickening in the acute phase and progressive atrophy with an increased cup-to-disc ratio (C/D) in the chronic phase. After treatment, 12 eyes showed visual improvement (followed at 2 months; 4 eyes with post-poisoning BCVA of 1.0 were excluded from this analysis). Among patients with extended follow-up (4 months to 3 years), most reached a visual acuity plateau after acute-phase intervention, although a minority remained at risk of delayed neurodegenerative decline. Early intervention with systemic high-dose steroid therapy, hemodialysis, and neuroprotective treatment might improve visual function in some patients, whereas delayed treatment often led to irreversible vision loss. Patients with preserved pupillary light reflexes had more favorable prognoses. Conclusions: The prognosis of methanol-induced optic neuropathy is closely related to poisoning severity, intervention timing, and pupillary reflex status. Early high-dose steroid therapy combined with neuroprotective treatment may enhance outcomes in some patients; however, prolonged poisoning typically results in irreversible neurovisual damage. Personalized staged treatment and long-term visual function monitoring are essential for preserving residual vision.