目的：通过分析基于眼底彩照的人工智能（artificial intelligence,AI）在糖尿病视神经病变（diabetic optic neuropathy,DON）中的参数特征，探索AI在DON诊断中的应用价值。
方法：收集2020年1月1日至2022年4月30日就诊于东莞东华医院、横沥医院及东莞市寮步镇社区卫生服务中心并诊断为糖尿病的患者，采集其一般信息并拍摄以黄斑为中心、图片边缘距离视盘中心超过1PD的50°眼底彩照。眼底彩照由人工智能诊断系统分析获得视盘及血管检测参数，由3-4名眼底专家阅片后分为DON(+)、DON(-)两组并作糖尿病视网膜病变（diabetic retinopathy,DR）分期诊断。比较两组间视盘、血管检测参数的差异性，并分析各项参数以及DR分期与DON发病的相关性。
结果：研究共纳入糖尿病患者526人（945眼），其中男性335人，女性191人；平均年龄为51.58±12.21岁，平均病程为5.51±5.20年。所有入组病例中，DON(+)组205眼，DON(-)740眼；根据专科医师判读结果，无DR 723眼，轻度非增殖期糖尿病视网膜病变（non-proliferrative diabetic retinopathy,NPDR）7眼，中度NPDR 184眼，重度NPDR 24眼，增殖期糖尿病视网膜病变（proliferrative diabetic retinopathy,PDR）7眼。AI检测的视盘及血管参数中，水平视杯直径、垂直视杯直径、水平杯盘比、垂直杯盘比、B区视网膜静脉血管当量、B区视网膜动静脉比值在有或无DON组间存在显著差异；水平视盘直径、垂直视盘直径、弧形斑和视盘面积比、B区视网膜动脉当量在两组之间无显著差异。相关性分析发现，水平视杯直径、垂直视杯直径、水平杯盘比、垂直杯盘比、B区视网膜动静脉比值与DON患病呈负相关；B区视网膜静脉血管当量、DR分期则与其呈正相关。
结论：DON患者的视杯直径、杯盘比、B区视网膜静脉血管当量等基于眼底彩照的人工智能检测参数有显著改变；DON的发病与DR病变严重程度有关。

Objective: To explore the application value of artificial intelligence (AI) in the diagnosis of diabetic optic neuropathy (DON) by analyzing the parameter characteristics of artificial intelligence (AI) based on fundus color photos.
Methods: From January 1, 2020 to April 30, 2022, patients diagnosed with diabetes were collected in Dongguan Donghua Hospital, Hengli Hospital of Dongguan and Community Healthcare Center of Dongguan Liaobu. General information was collected and 50°field vision fundus images(centered on macula and the edge of the images were more than 1PD away from the center of the optic disc) were taken. All the images were divided into DON(+) and DON(-) groups by 3-4 ophthalmologists. All the parameters were detected and analyzed by AI system, and their differences between the two groups were compared. The correlation between each parameter and DR stage with the incidence of DON was analyzed as well.
Results: A total of 526 diabetic patients (945 eyes) were included in this study, including 335 males and 191 females. The mean age was 51.58±12.21 years, and the mean disease duration was 5.51±5.20 years. All the enrolled cases were divided into DON (+) group (205 eyes) and DON (-) group (740 eyes) . According to ophthalmologists’ interpretation, 723 eyes had no DR, 7 eyes had mild nonproliferrative diabetic retinopathy (NPDR), 184 eyes had moderate NPDR, 24 eyes had severe NPDR, 7 eyes had Proliferrative diabetic retinopathy (PDR). Among the parameters detected by AI, there were significant differences in horizontal and vertical optic cup diameter, horizontal and vertical C/D, retinal vein equivalent(RVE) in zone B, and retinal arteriole-to venule ratio(AVR) in zone B between DON(+) and DON(-) groups. There were no significant differences between the two groups in horizontal and vertical optic disc diameter, arc-shaped spot-to-disc area ratio, and retinal artery equivalent(RAE) in zone B. In the analysis of risk factors, horizontal and vertical optic cup diameter, horizontal and vertical C/D, and AVR in zone B were negatively correlated with the diagnosis of DON. RVE in zone B and the severity of DR were positively correlated with the diagnosis of DON.
Conclusions: The AI detection parameters based on fundus color photography have significant changes in the diameter of optic cup, C/D and RVE in zone B in DON patients. The incidence of DON is related to the severity of DR.

视神经炎(optic neuritis,ON)是指视神经的炎性脱髓鞘病变，是引起中青年人视力下降的主要原因。近年来，髓鞘少突胶质细胞糖蛋白抗体阳性视神经炎(myelin oligodendrocyte glycoprotein antibody-positive ON,MOG-ON)成为神经眼科领域的研究热点，国内外报道不断增加。2021年3月，中华医学会眼科学分会神经眼科学组制定了《中国脱髓鞘性视神经炎诊断和治疗循证指南(2021年)》，将MOG-ON作为新的视神经炎亚型纳入脱髓鞘性视神经炎的诊疗体系，给广大眼科医生提供了新的参考依据。因此，临床医生需要充分认识MOG抗体相关疾病和MOG-ON的临床特征和治疗进展，努力提高其诊断和治疗水平，使此类患者能够得到更多的获益，造福于更多的视神经疾病患者。

Optic neuritis(ON)is an inflammatory demyelinating disease of the optic nerve, which is the main cause of vision loss in young and middle-aged people. In recent years, myelin oligodendrocyte glycoprotein antibody-positive ON(MOG-ON)has become a research hotspot in the field of neuro-ophthalmology, and reports at home and abroad are increasing.In March 2021, the Neuro-ophthalmology Group of Ophthalmology Branch of Chinese Medical Association formulated the Evidence-Based Guidelines for the Diagnosis and Treatment of Demyelinating Optic Neuritis in China(2021) , and included MOG-ON as a new optic neuritis subtype in the diagnosis and treatment system of myelinating optic neuritis providing a new reference for the majority of ophthalmologists. Therefore, clinicians need to fully understand the clinical features and treatment progress of MOG antibody-related diseases and MOG-ON, and strive to improve the level of diagnosis and treatment, so that such patients can get more benefits and benefit more patients with optic nerve diseases.

目的：探讨耳穴压豆疗法预防眼底荧光血管造影(fluorescence fundus angiography，FFA)胃肠反应的效果。方法：选取2019年10月至2020年4月在汕头大学·香港中文大学联合汕头国际眼科中心特殊检查科行眼底荧光素血管造影检查的患者583例，实验组298例，对照组285例。对照组在检查前予常规护理措施。试验组检查前在对照组的基础上实施耳穴压豆疗法。比较两组受检者在检查期间的胃肠道反应情况及配合度和舒适度的区别。结果：试验组胃肠道反应发生率低于对照组(P<0.05)。配合度得分试验组为(2.87±0.35)分，对照组为(2.96±0.19)分，两组差异有统计学意义(P<0.001)。舒适度得分试验组为(3.93±0.70)分，对照组为(3.91±0.56)分，两组差异无统计学意义(P=0.122)。结论：耳穴压豆疗法可以降低FFA检查胃肠道反应发生率，疗效安全可靠，操作简便易行，另外，耳穴压豆方法不会造成患者检查时舒适度下降，有助于患者顺利安全完成检查。

Objective: To explore the prevention efficacy of auricular points plaster therapy on gastrointestinal reaction caused by fundus fluorescein angiography (FFA). Methods: We selected 583 patients who underwent fundus fluorescein angiography in the special examination department of our hospital from October 2019 to April 2020, and divided these patients into experimental group (n=298) and control group (n=285). The control group was given routine nursing measures before the examination. The experimental group was treated with auricular points plaster therapy on the basis routine nursing measures before the examination. The gastrointestinal reactions, degree of patient compliance and comfortableness during the examination were compared between the two groups. Results: The incidence of gastrointestinal reaction in the experimental group was lower than that of control group (P<0.05). The score of patient compliance degree was 2.87±0.35 in the experimental group and 2.96±0.19 in the control group, and there was a significant difference between the two groups (P<0.001). Degree of comfortableness was 3.93±0.70 in the experimental group and 3.91±0.56 in the control group. There was no significant difference between the two groups (P=0.122). Conclusion: Auricular points plaster therapy can reduce the incidence of gastrointestinal reaction caused by fundus fluorescein angiography, which is safe and reliable, easy to operate. In addition, the auricular points plaster therapy will not affect patient’s comfortness during examination, and will comply the patients to the examnination smoothly. is helpful for patients to complete the examination comfortably and safely

目前对于成人圆锥角膜(keratoconus，KC)的研究已经很广泛，而对于儿童KC的研究则较少，其诊断和治疗常常基于成人KC的研究基础。与成人KC相比，儿童KC的发展更迅速、造成的后果更严重，其导致的儿童视觉障碍会追随其一生，对其生活质量以及教育发展产生严重的负面影响。为了对儿童KC的治疗有较全面的认识和理解，本文针对近几年儿童KC的治疗进展，对不同治疗方法的安全性、有效性和治疗时机等方面进行综述。

At present, the research on adult keratoconus has been extensive, while the research on pediatric keratoconus is few. The diagnosis and treatment of pediatric keratoconus are often based on the study of keratoconus in adults. Pediatric keratoconus is more aggressive than adult keratoconus, resulting in visual impairment that can follow throughout their lives and have a serious negative impact on their quality of life and educational development. In this paper, according to the treatment progress of pediatric keratoconus in recent years, the safety, effectiveness,and treatment timing of different treatment methods were summarized, in order to have a more comprehensive understanding of the treatment of pediatric keratoconus.

目的：探讨利用微信平台在有晶体眼人工晶体(implantable collamer lens，ICL)植入术后并发性白内障患者延续性护理的应用效果。方法：对13例(16眼)ICL植入术后并发性白内障患者利用微信平台随访和延续性护理，观察患者术前和术后1个月的护理满意度的自身对照。结果：13例患者(16眼)手术均顺利完成，术后均无出现并发症，术后视力均较术前有所提高，术后患者的护理满意度评分高于术前，差异有统计学意义(P<0.05)。结论：利用微信平台进行随访和延续性护理，可以提高患者护理满意度，是应用于ICL植入术后并发性白内障患者的有效护理方法。

Objective: To explore the application effect of WeChat platform in continuous nursing care for patients with complicated cataract after implantable collamer lens (ICL) implantation. Methods: Thirteen patients (16 eyes) with complicated cataracts after ICL implantation were followed up and continued nursing on the WeChat platform, then the self-control of the patients’ satisfaction on nursing before and one month after surgery was observed. Results: A total of 13 patients’ operation (16 eyes) went well, and they had no postoperative complications. The visual acuity of the patients was improved after operation compared with that of before operation, and the nursing satisfaction score of patients after operation was higher than that of before operation; the difference was statistically significant (P<0.05). Conclusion: Using WeChat platform for follow-up and continuous nursing can improve patients' nursing satisfaction, which was an effective nursing method for patients with complicated cataract after ICL implantation.

目的：了解白内障手术患者的临床分布特点，为基层医院白内障防治工作提供信息参考。方法：选取2019年1月至2019年1 2月在锦州医科大学附属第三医院眼科手术医治的白内障患者892例1 008眼。查阅相关病历资料，收集姓名、性别、年龄、手术眼别、入院时间、有无糖尿病史；术前视力、角膜内皮细胞密度、眼轴、晶状体混浊类型及白内障病因；手术方式、人工晶状体(intraocular lens，IOL)、术中并发症；术后第1天眼压、视力、眼部情况，进行统计学描述及分析。结果：入 选892例1 008眼，其中男357例401眼，女535例607眼，年龄(71.17±10.28)岁，90.7%的患者病因为年龄相关性白内障。入院时间集中在3~6月和9~12月。不同年龄段白内障患者具有各自的眼部特征。白内障类型与年龄差异有统计学意义(P<0.05)，相比皮质性、后囊膜下性，核性白内障患者入院年龄偏大。白内障类型与性别、有无糖尿病史差异无统计学意义(P >0.05)。白内障患者选择最多的手术方式是超声乳化吸除术联合IOL植入术，术中并发症少，术后恢复快。结论：白内障的防治工作任重道远。手术多为年龄相关性白内障患者，入院时多年龄偏大，视力偏低，错失了手术最佳时机。不同年龄段、不同类型白内障患者具有不同的特征。超声乳化吸除术因其优势成为患者首选手术方式。

Objective: To understand the clinical distribution characteristics of cataract surgery patients and provide reference for cataract prevention and treatment in primary hospitals. Methods: From January 2019 to December 2019, 892 cataract patients (1 008 eyes) were selected from the Department of Ophthalmology, Third Affiliated Hospital of Jinzhou Medical University. Medical records were collected, including patient’s name, gender, age, surgical eye, admission time and history of diabetes, preoperative vision, corneal endothelial cell density, eye axis, phacoscotasmus type and cataract etiology, surgery method, intraocular lens, intraoperative complications, intraocular pressure, visual acuity and eye recovery on the first day after operation. These data were statistically described and analyzed. Results: A total of 892 cataract patients (1 008 eyes) were included, including 357 males (401 eyes) and 535 females (607 eyes), with the average age of (71.17±10.28) years old. The 90.7% patients cause of disease was age-related cataract. Admission time of all patients was mainly in March–June and September– December. Cataract patients of different ages had their own ocular characteristics. There was a statistically significant difference between the type of cataract and age (P<0.05). Compared with the cortical patients and posterior subcapsular patients, nuclear cataract patients were older at admission. There was no significant difference in the type of cataract between the gender and the patients with diabetes or not (P>0.05). The most frequently selected surgical method for cataract patients was phacoemulsification and intraocular lens implantation, which has the advantages of less intraoperative complications and rapid postoperative recovery. Conclusion: We still have a long way to go in the prevention and treatment of cataract. Most of the operations were performed on age-related cataract patients, and most of them were older and had low vision when they were admitted to hospital, so the optimal timing of the operation was missed. Patients of different age groups and different types of cataract have different characteristics. Phacoemulsification is the first choice because of its own advantages.

目的：研究玻璃膜疣主要成分胆固醇对人视网膜色素上皮细胞ARPE-19中金属硫蛋白表达的影响。方法：体外培养ARPE-19细胞，将细胞分为对照组和胆固醇处理组(2.5 mg/mL)，取样时间为0，6，12，24，48，72h。通过实时定量PCR检测hMT1a，hMT2a和hMT3在转录水平的表达，用蛋白质印迹法检测总金属硫蛋白的表达。结果：在转录水平上hMT1a，hMT2a和hMT3受到胆固醇影响mRNA表达上调，且hMT3上调倍数最大；总金属硫蛋白的蛋白表达随着胆固醇处理时间延长明显增多。结论：玻璃膜疣主要成分胆固醇可以上调人视网膜色素上皮细胞中金属硫蛋白的表达，提示金属硫蛋白表达可受到玻璃膜疣形成起始阶段的刺激，其检测是否能用于年龄相关性黄斑变性的早期发现及早期诊断还需深入探讨。

Objective: To study the effects of cholesterol, the main component of drusen, on the expression of metallothionein of ARPE-19 cells. Methods: The ARPE-19 cell line was cultured in vitro, and the cells were divided into a control group and a cholesterol treatment group (2.5 mg/mL). The treatment time was 0, 6, 12, 24, 48, 72 hours. Real- time quantitative PCR was used to detect the expression of hMT1a, hMT2a and hMT3 at the mRNA level, and Western blot was used to detect the expression at the protein level. Results: The mRNA expression of hMT1a, hMT2a and hMT3 were up-regulated by cholesterol and the protein expression of total MTs was increased with cholesterol treatment. Conclusion: Cholesterol, the main component of drusen, can up-regulate the expression of metallothionein in human retinal pigment epithelial cells, suggesting that the expression of metallothionine can be stimulated by the initial stage of drusen formation. However, whether its detection can be used for the early detection and early diagnosis of age-related macular degeneration or not still needs to be further explored.

眼结核的表现形式多样，有时会被误诊漏诊。本病例为一年轻男性，以右眼视力突发下降为主诉就诊，眼部表现可见黄斑区脉络膜占位病灶及视网膜内小病灶，经γ-干扰素释放试验、胸部CT等检查，确诊为血型播散性肺结核，眼部诊断为结核性脉络膜结节联合视网膜结节，全身接受抗结核治疗后，眼部病灶消退。

Ocular tuberculosis encompasses a variety of clinical manifestations, which is easily misdiagnosed sometimes. In this article, a young male was admitted to our hospital with a chief complaint of sudden blurred vision in his right eye. His ocular examination detected a tiny mass in the choroid and a small lesion in the retina. After interferon-gamma release assay (IGRA) and chest CT scan, the patient was diagnosed with military tuberculosis. The ocular examination confirmed the diagnosis of choroidal tubercle complicated with intrarentinal tubercle, which were healed after systemic anti-tuberculosis therapy.

目的：观察急性中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy，CSC)的自然病程中渗漏点的形态及变化。方法：本研究为前瞻性研究，使用光学相干断层扫描(optical coherence tomography，OCT)观察从发病到发病后5~13个月的CSC患者的渗漏点的OCT形态，测量并计算Hall层、脉络膜全层各自厚度及比值，并进行比较。结果：共20例患者[男14例，女6例，年龄33~59(中位数41)岁]纳入研究。随访时间为5~13个月。在19例患者中观察到微小视网膜色素上皮脱离(pigment epithelium detachment，PED)。1例患者可见视网膜色素上皮(retinal pigment epithelium， RPE)小凸起。在随访期间，仅1例患者的PED完全恢复，其他19例患者在视网膜下液被完全吸收时，RPE和Bruch膜之间仍存在微小分离。渗漏点处的Haller层/脉络膜厚度显著高于中央凹处(初诊时0.806±0.08 vs 0.863±0.06，P=0.003；最后1次随访时为0.801±0.07 vs 0.851±0.06，P=0.004)。结论：本研究观察到在急性CSC患者自然病程中，即使视网膜下液吸收，OCT显示渗漏点处仍存在持续的PED，更厚的Haller层及更薄的内层脉络膜，这些发现为CSC的发病机制提供了更多线索。

Objective: To observe the morphology and changes of leakage points in the natural course of acute central serous chorioretinopathy (CSC). Methods: This study was a prospective study, using optical coherence tomography to observe the OCT morphology of leakage points in CSC patients from onset to 5 to 13 months after onset, measuring the thickness and ratio of Hall layer and the whole choroid, and then compare them. Results: A total of 20 patients were included in the study, including 14 males and 6 females, aged from 33 to 59, with the median being 41 years old. The follow-up time ranged from 5 months to 13 months. Minute retinal pigment epithelial detachments (PED) were observed in 19 patients. A small bulge of retinal pigment epithelium (RPE) was observed in 1 patient. During the follow-up, only one patient totally recovered. Small separation between RPE and Bruch membrane still exit even subretinal fluid were absorbed completely in the other 19 patients. The thickness of Haller layer or choroid at the leakage point was significantly higher than that of the fovea (0.806±0.08 vs 0.863±0.06, P=0.003, at the first visit; 0.801±0.07 vs 0.851±0.06, P=0.004, at the last follow-up). Conclusion: This study observed that in the natural course of acute CSC patients, even if the subretinal fluid was absorbed, OCT still showed that there was persistent PED at the leakage point, thicker Haller layer and thinner inner choroid layer. These findings provided more clues to the pathogenesis of CSC.