目的：回顾2型神经纤维瘤病(neurofibromatosis type 2, NF2)患者的眼部表现，分析NF2眼部病变的临床和影像学特征，以助该病的早期诊断。方法：收集来自深圳市眼科医院的1例和来自中山眼科中心的3例NF2患者完整的临床资料并进行总结分析。结果：这4例患者均因眼部异常首诊于眼科且符合曼彻斯特诊断标准。4例患者中，3例为NF2早发型(<20岁)，1例为晚发型(>20岁)，男女比例1∶1。3例患者因视力下降、1例患者因复视首诊于眼科。3例行眼底光学相干断层成像(optical coherence tomography, OCT)检查显示，视网膜错构瘤2例，视网膜前膜2例，视盘隆起2例，视网膜神经纤维层和节细胞层变薄1例。其他表现包括麻痹性斜视2例，复视1例，白内障1例，球后段视神经增粗1例，眼眶肿瘤1例。结论：NF2的眼部表现多种多样，可出现在神经症状和听力损失之前。详细的眼科检查及影像学检查对年轻患者的早期诊断非常有价值，有助于选择更好的治疗计划。
Objective: Review the ocular manifestations of patients with neurofibromatosis type 2 (NF2), and analyze the clinical and imaging features of the ocular lesions in NF2, so as to facilitate the early diagnosis of this disease. Methods: The complete medical records of 1 case from Shenzhen Eye Hospital and 3 cases of NF2 from Zhongshan Ophthalmic Center were collected. Results: All four patients were first diagnosed in ophthalmology due to eye symptoms and met the Manchester diagnostic criteria. Of the four patients, three were NF2 early hairstyles (<20 years old), one was late hairstyle (>20 years old), and the male-to-female ratio was 1:1. Three patients were first diagnosed in the ophthalmology department due to decreased visual acuity, and one patient was first diagnosed due to diplopia. Optical coherence tomography (OCT) examinations were performed on three patients, which showed that there were two cases of retinal hamartoma, two cases of epiretinal membrane, two cases of optic disc elevation, and one case of thinning of the retinal nerve fiber layer and ganglion cell layer. Other manifestations included two cases of paralytic strabismus, one case of diplopia, one case of cataract, one case of thickening of the retrobulbar optic nerve, and one case of orbital tumor. Conclusions: The ocular manifestations of NF2 are diverse and can precede neurological symptoms and hearing loss. Detailed ophthalmic examinations and imaging studies are highly valuable for early diagnosis in young patients, aiding in the selection of a better treatment plan.
大型语言模型（large language models, LLMs）在眼科的应用为医疗领域带来了巨大的潜力，尤其是在提升诊断效率、优化医患沟通和促进个性化医疗方面。通过自然语言处理技术，LLMs可以协助医生进行临床数据的归纳和分析，可以结合患者的病史、影像资料和症状描述，提供精准的辅助诊断，并在复杂病例中提供参考。LLMs还可以帮助医生快速撰写病历报告，改善医疗记录管理效率。在医患沟通中，LLMs能够通过生成通俗易懂的解释，帮助患者理解疾病状况及治疗方案，缩短医生与患者之间的沟通障碍。在远程医疗场景下，LLMs可通过实时分析患者上传的图像文本信息，提供初步诊断建议，助力医生远程诊疗。个性化医疗也是LLMs的重要应用方向，借助患者的遗传数据和生活习惯，可以帮助医生制定更为精准的个性化治疗方案，并预测手术后的恢复情况。此外，LLMs可以通过与临床数据的不断交互进行自我优化，提升其在眼科诊疗中的智能化程度。尽管LLMs在眼科领域的应用前景广阔，但仍面临数据隐私、模型解释性、语言理解等方面的挑战。未来LLMs将继续作为医生的辅助工具，形成“人机协同”的诊疗新模式，为患者提供更好、更精准的医疗服务。
The application of Large Language Models (LLMs) in ophthalmology presents tremendous potential for the healthcare field, particularly in enhancing diagnostic efficiency, optimizing doctor-patient communication, and promoting personalized medicine. Through natural language processing technology, LLMs can assist doctors in summarizing and analyzing clinical data. They can integrate a patient's medical history, imaging data, and symptom descriptions to provide precise diagnostic support and reference for complex cases. LLMs can also help physicians quickly draft case reports, improving the management efficiency of medical records. In doctor-patient communication, LLMs can generate easy-to-understand explanations that help patients comprehend their conditions and treatment plans, thereby reducing communication barriers between doctors and patients. In telemedicine scenarios, LLMs can provide preliminary diagnostic suggestions by real-time analyzing images and textual information uploaded by patients, aiding doctors in remote diagnosis and treatment.Personalized medicine is another significant application direction for LLMs. By utilizing patients' genetic data and lifestyle habits, LLMs can assist physicians in formulating more precise personalized treatment plans and predicting postoperative recovery outcomes. Additionally, LLMs can self-optimize through continuous interaction with clinical data, enhancing their intelligence in ophthalmic diagnosis and treatment. Despite the broad application prospects of LLMs in the field of ophthalmology, challenges remain, including data privacy, model interpretability, and language understanding. In the future, LLMs will continue to serve as auxiliary tools for physicians, forming a new model of "human-machine collaboration" in diagnosis and treatment, ultimately providing better and more precise medical services to patients.
Background: Ophthalmology is an important medical science subject, but it is given with insufficient attention in undergraduate medical education. Flipped classroom (FC) and problem-based learning (PBL) are well-known education methods that can be integrated into ophthalmology education to improve students' competence level and promote active learning.Methods: We used a mixed teaching methodology that integrated a FC and PBL into a 1-week ophthalmology clerkship for 72 fourth-year medical students. The course includes two major sessions: FC session and PBL session, relying on clinical and real-patient cases. Written examinations were set up to assess students’ academic performance and questionnaires were designed to evaluate their perceptions.Results: The post-course examination results were higher than the pre-course results, and many students gained ophthalmic knowledge and learning skills to varying levels. Comparison of pre- and post-course questionnaires indicated that interests in ophthalmology increased and more students expressed desires to be eye doctors. Most students were satisffed with the new method, while some suggested the process should be slower and the communication with their teacher needed to strengthen.Conclusions: FC and PBL are complementary methodologies. Utilizing the mixed teaching meth of FC and PBL was successful in enhancing academic performance, student satisfactions and promoting active learning.
Background: Ophthalmology is an important medical science subject, but it is given with insufficient attention in undergraduate medical education. Flipped classroom (FC) and problem-based learning (PBL) are well-known education methods that can be integrated into ophthalmology education to improve students' competence level and promote active learning.Methods: We used a mixed teaching methodology that integrated a FC and PBL into a 1-week ophthalmology clerkship for 72 fourth-year medical students. The course includes two major sessions: FC session and PBL session, relying on clinical and real-patient cases. Written examinations were set up to assess students’ academic performance and questionnaires were designed to evaluate their perceptions.Results: The post-course examination results were higher than the pre-course results, and many students gained ophthalmic knowledge and learning skills to varying levels. Comparison of pre- and post-course questionnaires indicated that interests in ophthalmology increased and more students expressed desires to be eye doctors. Most students were satisffed with the new method, while some suggested the process should be slower and the communication with their teacher needed to strengthen.Conclusions: FC and PBL are complementary methodologies. Utilizing the mixed teaching meth of FC and PBL was successful in enhancing academic performance, student satisfactions and promoting active learning.
本文简要探讨了眼科青年医师在住院医师规范化培训过程中，应该重视人文素养的培养。眼科住院医师必须三基扎实，具备敏锐的临床科研嗅觉、优秀的现代医学人文素养。在科技高速发展与医疗环境日趋复杂的今天，培养具备精湛的专业技能与高尚的医学人文精神的眼科学领袖，对于眼科的发展显得尤为重要。
This article briefly discusses that in the process of standardized training of ophthalmology residents, the young physicians should focus on the training of humanistic accomplishment. Ophthalmology residents should master solid basic theory and skills, have keen sense of the clinical issue, and possess excellent modern medical humanities. Nowadays, it is particularly important to cultivate the ophthalmology leaders who hold superb professional skills and noble humanistic spirit because of the high-speed development of science and technology and the increasingly complex medical environment.
目的：探讨基于问题式教学法(problem-based learning，PBL)联合基于案例教学法(case-based learning，CBL)的模式在留学生眼科学教学中的效果。方法：将教学对象分为两组，其中传统教学组30人，联合教学组35人。传统教学组采用传统授课方法，联合教学组采用PBL联合CBL的教学方法。对其效果进行评估，评估指标包括发言次数、临床思维能力、学习兴趣、教学质量评分、教学满意度、理论分数、病例分析分数等。结果：与传统教学组相比，联合教学组学生在各项评估 指标上均明显优于传统教学组，且各项指标之间的差异均具有统计学意义。结论：PBL与CBL相结合的教学模式能有效提高眼科学教学质量，值得在临床教学中进一步推广应用。
Objective: To investigate the effect of problem-based learning (PBL) and case-based learning teaching (CBL) teaching approaches in the ophthalmology teaching of foreign students. Methods: The subjects were divided into a control group (30 students) and an experimental group (35 students). In the control group, the students were taught via traditional teaching methods. The PBL and CBL teaching approaches were applied in the experimental group. Then, the number of statements, clinical thinking ability, learning interest, teaching quality scores, teaching satisfaction, theoretical scores, and case analysis scores were assessed in these two groups. Results: Compared with the control group, the assessments in the experimental group were significantly better (P<0.05). Conclusion: The PBL and CBL teaching approaches can effectively improve the teaching quality of ophthalmology of foreign students. It is worth to popularize this method in clinical teaching.
