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.

目的：检索并总结开角型青光眼患者眼部用药规范化护理管理的最佳证据，为临床实践提供参考。方法：通过护理循证方法提出实践问题，按照循证证据检索数据库的“6S”分类模型，检索有关开角型青光眼患者眼部用药管理的所有证据资源类型，包括临床指南、最佳实践信息册、证据总结、系统评价和专家共识等。由2名循证护理研究员对纳入文献的质量进行独立评价并进行证据的归纳总结。结果：最终纳入12篇文献，包括4篇指南、3篇证据总结和5篇系统评价；汇总了19条有关开角型青光眼眼部用药管理的最佳证据，包括滴眼技术指导、依从性管理和信息提供3个方面。结论：总结开角型青光眼眼部用药管理的最佳证据，可为临床医务人员管理患者提供参考和借鉴，以达到患者规范用药、控制眼压和延缓疾病进展的目的。

Objective: To retrieve and summarize the best evidence on standardized ocular medication management among open-angle glaucoma patients. Methods: With evidence-based nursing method, practical problemswere identified. According to the “6S” pyramid model of evidence resource, studies on standardized ocular medication management among open-angle glaucoma patients were retrieved, including clinical guidelines, best practice information booklet, systematic reviews, and expert consensus. Two evidence-based nursing researchers independently evaluated the quality of the included literature and summarized the evidence. Results: A total of 12 articles were ultimately enrolled, including 4 clinical guidelines, 3 evidence summaries and 5 systematic reviews. Finally, 3 aspects including 19 pieces of best evidence were summarized, which were Eye drop technical instruction, medication adherence management and related information provision. Conclusion: The best evidence for the medication management of open-angle glaucoma patients were summarized, which provide reference for clinical medical staffs to manage patients, so as to achieve the purpose of standardizing medication,controlling intraocular pressure and preventing disease progression.

眼健康是国民健康的重要组成部分，包括盲在内的视觉损伤严重影响人民群众的身体健康和生活质量，加重家庭和社会负担，威胁社会经济生产活动，是涉及民生的重大公共卫生问题和社会问题。弱视作为幼儿期起病的主要视觉障碍性疾病之一，是致使青少年低视力的首要因素，影响青少年自身学业和心理健康，增加致盲风险，故做好弱视的预防及康复工作刻不容缓。通过梳理研究发现，国内外对弱视的传统治疗方法有遮盖疗法、屈光矫正、压抑疗法等，知觉学习、视功能训练、电子视频游戏、针灸等则是近年逐渐新兴起并被广泛运用的弱视康复治疗方法，近年来关于年龄对弱视康复治疗影响的相关研究也较多。通过整理前人研究成果，提出建立儿童青少年视力档案、建立五位一体弱视康复治疗布局模式、进行联合临床治疗青少年弱视的对策，以期为青少年弱视提供康复治疗手段参考和选择，促进青少年弱视康复治疗眼健康事业发展。

Eye health is an important part of national health. Visual impairment, including blindness, seriously affects people’s physical health and quality of life, increases the burden on families and society, threatens social and economic production activities, and is a major public health and social problem related to people’s livelihood. Amblyopia,as one of the main visual disorders in early childhood, is the primary factor causing low vision in adolescents, which affects their academic and mental health and increases the risk of blindness. Therefore, it is urgent to do a good job in the prevention and rehabilitation of amblyopia. By summarizing existing studies, it is found that traditional treatment methods for amblyopia at home and abroad include occlusion therapy, refractive correction, and depressive therapy, while perceptual learning, visual function training, electronic video games, acupuncture and so on are gradually emerging in recent years and widely used in recent years. There are numerous studies on the impact of age on the rehabilitation of amblyopia. By sorting out the previous research results, this paper puts forward the countermeasures of establishing visual acuity files for children and adolescents, establishing the five- in-one rehabilitation treatment layout model, and combining clinical treatment for adolescent amblyopia, in order to provide reference and choice for the rehabilitation treatment of adolescent amblyopia, and promote the development of the eye health cause of adolescent amblyopia rehabilitation.

目的：探讨督导式教学门诊在眼科住院医师规范化培训中的具体实践和教学效果。方法：通过合理排班、限制号源等措施设立每周固定的督导式教学门诊时间，安排老师和学员出诊；在教学门诊开展4个月后，通过问卷调查和临床技能考核的形式采集反馈意见并评估教学效果。 结果：共有16名老师和8名学员参加了督导式教学门诊，调查问卷结果显示100%的带教老师和学员认可该教学模式，参加过教学门诊的学员临床技能考核得分显著高于对照组(t =3.631， P<0.05)。结论：督导式教学门诊应用于眼科住院医师规范化培训具有实际可行性，并可以提高学员的临床技能水平。

Objective: To explore the application and effects of supervised teaching clinic in standardized training of ophthalmology residents. Methods: A weekly supervised teaching clinic was set through reasonable scheduling and limiting the registration numbers. After 4 months of application, feedbacks were collected through questionnaire survey from both the teachers and residents. Clinical skills assessments were also taken to evaluate the teaching effect. Results: A total of 16 teachers and 8 residents participated in the supervised teaching clinic. The results of the questionnaire showed that 100% of the teachers and residents agreed with the teaching mode. The clinical skill assessment scores of the residents who participated in the teaching clinic were significantly higher than those of the control group (t=3.631, P<0.05). Conclusion: The application of supervised teaching clinic in standardized training of ophthalmology residents is feasible and can improve the clinical skills of the residents. 

近年来，使用人工智能(artificial intelligence，AI)技术对临床大数据及图像进行分析，对疾病做出智能诊断、预测并提出诊疗决策，AI正逐步成为辅助临床及科研的先进技术。生物样本库作为收集临床信息和样本供科研使用的平台，是临床与科研的桥梁，也是临床信息与科研数据的集成平台。影响生物样本库使用效率及合理共享的因素有信息化建设水平不均衡、获取的临床及检验信息不完全、各库之间信息不对称等。本文对AI和区块链技术在生物样本库建设中的具体应用场景进行探讨，展望大数据时代智能生物样本库信息化建设的核心方向。

In recent years, artificial intelligence (AI) technology has been applied to analyze clinical big data and images and then make intelligent diagnosis, prediction and treatment decisions. It is gradually becoming an advanced technology to assist clinical and scientific research. Biobank is a platform for collecting clinical information and samples for scientific research, serving as a bridge between clinical and scientific research. It is also an integrated platform of clinical information and scientific research data. However, there are some challenges. First, clinical and laboratory information obtained is incomplete. Additionally, the information among different databases is asymmetric, which seriously impedes the information sharing among different Biobanks. In this article, the specific application scenarios of AI technology and blockchain in the construction of a Biobank were discussed, aiming to pinpoint the core direction of the information construction of an intelligent Biobank in the era of big data.

当下，我国眼科的发展存在失衡现象，大城市与农村及偏远地区在眼科相关诊疗设施水平、诊疗技术等方面存在巨大差异，仍需探寻新的智能诊疗模式以解决失衡问题。由于眼球是唯一可以直接观察人体血管和神经的器官，眼部可反映其他脏器的健康状态，部分眼科检查的医学图像可对眼部疾病做出诊断等特点，眼科开展人工智能(artificial intelligence，AI)具有独到的优势。此外，人工智能可在一定程度上提高跨时间空间传递信息的精准度及效率。人工智能在眼科及远程信息传递的优势为解决眼科发展失衡状况提供了助力。本文从眼科人工智能在眼科远程医疗相关应用的角度，主要分析并总结当下我国人工智能在眼科相关疾病远程医疗中的发展程度、所具优势以及存在问题，并讨论眼科人工智能在远程医疗的应用展望。

At present, there is an imbalance in the development of ophthalmology in China. There are huge differences in the level of ophthalmology related facilities, diagnosis and treatment technologies between big cities and rural, remote areas. New intelligent diagnosis and treatment models are still needed to solve the imbalance. Since the eye is the only organ that can directly observe the blood vessels and nerves of the human body, the eye can reflect the health status of other organs and diagnosis of eye diseases based on medical images of some ophthalmic examinations can be made as well as other characteristics. Therefore, the development of artificial intelligence in ophthalmology has unique advantages. In addition, artificial intelligence can improve the accuracy and efficiency of information transmission across time and space to a certain extent. The advantages of artificial intelligence in ophthalmology and telematics are helping to solve the imbalance in ophthalmology development. From the perspective of the application of ophthalmic artificial intelligence in telemedicine, this paper mainly analyzes and summarizes the development degree, advantages and existing problems of artificial intelligence in the telemedicine of ophthalmic diseases in China, and discusses the prospect of the application of ophthalmic artificial intelligence in telemedicine.

帕金森病(Parkinson’s disease，PD)是老年人常见的神经系统退行性疾病，眼部及视觉功能障碍是PD常见的非运动症状之一，进一步影响其生活质量。已有研究表明PD患者视网膜内存在多巴胺浓度的减少以及α突触核蛋白的沉积。目前，PD仍缺乏有效的早期诊断及病情评估工具，光学相干断层扫描及光学相干断层扫描血管成像技术可以显示视网膜各层微细结构及微血管的异常，应用该技术研究者发现PD患者视乳头旁视网膜神经纤维层及黄斑区视网膜的厚度均存在不同程度的变薄，视网膜浅层及深层毛细血管丛的毛细血管密度和复杂性下降。进一步研究者应用该技术在PD临床应用中进行了探索，并发现其可用于检测早期PD中发生的病理变化，反映疾病的病程及严重程度，并且在鉴别诊断中起到一定的作用。总而言之，视网膜相关检测可能成为评估PD患者脑病理严重程度的指标，并且帮助疾病诊断和监测疾病的进展，不过这仍需要大样本、多中心的重复研究以提供更多理论依据。

Parkinson’s disease is a common neurodegenerative disease in the elderly, and ocular and visual dysfunction is one of the common non-motor symptoms of PD, further affecting PD patients’quality of life. Reduced dopamine concentrations and deposition of α-synuclein in the retina of PD patients have been shown in studies. At present, there is still a lack of effective tools for early diagnosis and assessment of PD. Optical coherence tomography and optical coherence tomography angiography can reveal abnormalities in the microstructure and microvasculature of the retinal layers, and researchers applying these techniques have found that the thickness of the parapapillary retinal nerve fiber layer and the retina in the macula in PD patients have had varying degrees of thinning, and the density and complexity of capillaries in the superficial and deep capillary plexus of the retina have been reduced. Further, investigators have explored the clinical application of these techniques in PD and have found that they can be used to detect pathological changes occurring in early PD, reflect the course and severity of the disease, and play a role in differential diagnosis. In conclusion, retinal-correlated testing may be an indicator to assess the severity of brain pathology in PD patients and to aid in disease diagnosis and monitoring the progression of PD, although large sample, multicenter replication studies are still needed to provide more reliable results.

目的：观察学龄儿童的近视进展情况，分析近视进展的危险因素。方法：于2014年纳入温州2所小学二、三年级近视儿童，每年随访1次，直至小学毕业。检查内容包括非睫状肌麻痹主觉验光、双眼视功能检查(隐斜、调节性集合/调节、正负相对调节、正负融像性聚散)和问卷调查。采用无序多分类logistic回归分析近视进展速度的危险因素。结果：共纳入152名近视儿童[年龄7~9岁，95名(62.5%)男性]，初始屈光度为?1.30±0.95屈光度(diopter，D)，年近视进展量为?0.68±0.35 D。回归分析表明：与慢速组相比(年近视进展量>?0.50 D)，中速组(?1.00 D<年近视进展量≤?0.50 D)与快速组(年近视进展量≤?1.00 D)中初始屈光度≤?1.00 D的儿童占比更大(中速组：OR=3.51，P=0.003；快速组：OR=3.29，P=0.044)，快速组中女性占比更大(OR=4.52，P=0.012)，基线双眼视功能参数在不同组间差异均无统计学意义(均P>0.05)。结论：学龄儿童近视进展速度与性别、初始屈光度相关，与基线双眼视功能无关。女孩、初始近视程度大(7~9岁时，屈光度≤?1.00 D)的儿童近视进展快。

摘要英文

目的：观察学龄儿童的近视进展情况，分析近视进展的危险因素。方法：于2014年纳入温州2所小学二、三年级近视儿童，每年随访1次，直至小学毕业。检查内容包括非睫状肌麻痹主觉验光、双眼视功能检查(隐斜、调节性集合/调节、正负相对调节、正负融像性聚散)和问卷调查。采用无序多分类logistic回归分析近视进展速度的危险因素。结果：共纳入152名近视儿童[年龄7~9岁，95名(62.5%)男性]，初始屈光度为?1.30±0.95屈光度(diopter，D)，年近视进展量为?0.68±0.35 D。回归分析表明：与慢速组相比(年近视进展量>?0.50 D)，中速组(?1.00 D<年近视进展量≤?0.50 D)与快速组(年近视进展量≤?1.00 D)中初始屈光度≤?1.00 D的儿童占比更大(中速组：OR=3.51，P=0.003；快速组：OR=3.29，P=0.044)，快速组中女性占比更大(OR=4.52，P=0.012)，基线双眼视功能参数在不同组间差异均无统计学意义(均P>0.05)。结论：学龄儿童近视进展速度与性别、初始屈光度相关，与基线双眼视功能无关。女孩、初始近视程度大(7~9岁时，屈光度≤?1.00 D)的儿童近视进展快。

摘要英文

目的：观察学龄儿童的近视进展情况，分析近视进展的危险因素。方法：于2014年纳入温州2所小学二、三年级近视儿童，每年随访1次，直至小学毕业。检查内容包括非睫状肌麻痹主觉验光、双眼视功能检查(隐斜、调节性集合/调节、正负相对调节、正负融像性聚散)和问卷调查。采用无序多分类logistic回归分析近视进展速度的危险因素。结果：共纳入152名近视儿童[年龄7~9岁，95名(62.5%)男性]，初始屈光度为?1.30±0.95屈光度(diopter，D)，年近视进展量为?0.68±0.35 D。回归分析表明：与慢速组相比(年近视进展量>?0.50 D)，中速组(?1.00 D<年近视进展量≤?0.50 D)与快速组(年近视进展量≤?1.00 D)中初始屈光度≤?1.00 D的儿童占比更大(中速组：OR=3.51，P=0.003；快速组：OR=3.29，P=0.044)，快速组中女性占比更大(OR=4.52，P=0.012)，基线双眼视功能参数在不同组间差异均无统计学意义(均P>0.05)。结论：学龄儿童近视进展速度与性别、初始屈光度相关，与基线双眼视功能无关。女孩、初始近视程度大(7~9岁时，屈光度≤?1.00 D)的儿童近视进展快。

摘要英文