抗血管内皮生长因子(vascular endothelial growth factor，VEGF)治疗视网膜静脉阻塞(retinal vein occlusion，RVO)继发黄斑水肿(macular edema，ME)的有效性及安全性已得到广泛证实。但抗VEGF治疗方案尚无统一标准。现行的治疗方案主要包括固定治疗方案、按需(pro re nata，PRN)治疗方案、稳定性标准驱使的按需(stabilization criteria-driven PRN)治疗方案、治疗与延长(treat and extend，T&E)方案。近年来不少研究综合比较了各个治疗方案在改善视功能、量化评估疾病活动性、调整随访频率等多个维度的表现，为临床医生提供选择抗VEGF治疗方案的参考依据。本文旨在回顾并总结近年来对抗VEGF药物治疗RVO继发ME的研究，阐述抗VEGF治疗方案的研究进展。
The efficacy and safety of anti-vascular endothelial growth factor (VEGF) in the treatment of macular edema (ME) secondary to retinal vein occlusion (RVO) have been widely confirmed. However, there is no unified standard for anti-VEGF treatment regimens. Current treatment regimens mainly include fixed treatment regimen, pro re nata (PRN) treatment regimen, stabilization criteria-driven PRN treatment regimen, and treat and extend (T&E) regimen. In recent years, many studies have compared different treatment regimens in composite dimensions,including improving visual function, assessing disease activity quantitatively and adjusting the follow-up frequency,to provide clinicians with a reference of choosing anti-VEGF treatment regimens. The purpose of this article is to review and summarize recent researches on anti-VEGF drugs in the treatment of ME secondary to RVO, and to clarify the research progress in the anti-VEGF treatment regimens.
青光眼睫状体炎综合征(Posner-Schlossman syndrome，PSS)表现为单眼反复发作性非肉芽肿性前葡萄膜炎，伴有眼压升高，可发展为慢性继发性青光眼，最终导致视神经损伤。尽管PSS总体预后良好，但仍有部分患者因反复眼压骤升造成视神经损伤持续进展，甚至导致失明。目前，PSS的确切病因尚不明确，治疗方式以控制炎症及眼压为主。本文将从病因及治疗两方面阐述PSS的研究现状，以期为PSS相关基础研究及临床诊治提供思路及参考。
Posner-Schlossman syndrome (PSS), also called glaucomatocyclitic crisis, is characterized by recurrent non-granulomatous anterior uveitis, accompanied by elevated intraocular pressure. It is able to develop into chronic secondary glaucoma and eventually lead to optic nerve injury. Although the overall prognosis of PSS is favourable, there are still some patients whose optic nerve injury continues to progress and even lead to blindness due to recurrent attacks of ocular hypertension. At present, the exact cause of PSS is not clear, and the treatment is mainly to control inflammation and intraocular pressure. This article will elaborate the research status of PSS from two aspects of etiology and treatment to provide ideas and reference for the basic research clinical diagnosis and treatment of PSS.
过敏性结膜炎经典的发病机制包括了IgE介导的I型超敏反应以及T淋巴细胞介导的IV型超敏反应，其中肥大细胞、肥大细胞脱颗粒释放的组胺、嗜酸性粒细胞等在过敏性结膜炎病理发展中发挥了重要作用。然而，临床发现针对上述机制的治疗药物临床疗效欠佳，有相当数量的过敏性结膜炎患者无法获得较好的生存质量，因此研究和阐明过敏性结膜炎的新机制，寻找新的治疗手段和药物靶点具有重要的临床意义。目前研究发现Th17细胞等多种炎性细胞和IL-17等细胞因子、过敏原介导神经调节机制、菌群失调机制、脂质介质作用方面可能与过敏性结膜炎发病相关，这对过敏性结膜炎新机制的研究有着重大的临床意义。本文将对过敏性结膜炎发病机制的新进展进行综述，以期为过敏性结膜炎的治疗提供新思路。
The classic pathogeneses of allergic conjunctivitis include type I hypersensitivity and type IV hypersensitivity, in which mast cells, eosinophils and some active substances such as histamine play important role. However, sincethe therapeutic drugs have not achieved satisfactory efficacy in clinical practices, a significant number of patients fail to achieve a good quality of life. The pathogenesis of allergic conjunctivitis remains to be further studied.Current studies have identified a variety of inflammatory cells such as Th17 cell and cytokines such as IL-17, the mechanisms of neuromodulation, flora dysregulation mechanisms, and lipid mediators that may be involved in the pathogenesis of allergic conjunctivitis, which has significant clinical implications for the study of mechanisms of allergic conjunctivitis. In this article, we will review the recent research progress of the pathogenesis of allergic conjunctivitis in order to provide new ideas for the treatment of allergic conjunctivitis.
睑板腺功能障碍(meibomian gland dysfunction，MGD)是一种慢性、弥漫性的睑板腺病变，通常以睑板腺终末导管的阻塞或分泌的睑脂数量或质量发生改变为特征，临床上可以引起泪膜异常、角膜上皮损害、眼部刺激等干眼表现。MGD病因复杂且受多种因素影响，因此MGD发病机制的研究对于指导临床工作至关重要。本文对研究MGD的动物模型进行了介绍，并根据一些基础研究对MGD相关的细胞及分子机制等方面进行综述。
Meibomian gland dysfunction (MGD) is a chronic and diffuse disease of the eyelid gland. It is usually characterized by obstruction of the terminal duct of the eyelid gland or changes in the quantity/quality of the eyelid fat secreted. It can clinically cause dry eye symptoms such as abnormal tear film, corneal epithelial damage and eye irritation. The etiology of MGD is complex and affected by a variety of factors. Therefore, the study on the pathogenesis of MGD is of great importance to guide clinical work. This article introduces the animal research model of MGD, and reviews the cellular and molecular mechanisms related to MGD based on some basic research.
近年来，由于经济社会不断发展，社会压力增大，人们精神障碍和干眼的发病率不断增加，这既影响人们身心健康，也给社会经济造成一定负担。大量研究表明精神障碍与干眼显著相关，精神障碍是干眼的独立危险因素之一。然而在临床工作中，精神障碍与干眼间的关系在过去一直未受到重视，本文将从精神障碍与干眼关联性入手，探讨其中介作用，总结了精神障碍因素影响干眼症状和体征分离，并进一步倡导跨学科综合管理来治疗干眼，形成对干眼的正确感知并降低疼痛及健康焦虑水平，以期为干眼临床诊疗提供新的视角。
In recent years, due to the continuous development of economy and society and the increasing social pressure, the incidence rate of mental disorders and dry eyes is increasing, which not only affects people’s physical and mental health, but also creates a certain burden on the social economy. A large number of studies have shown that mental disorder is significantly related to dry eye, and mental disorder is one of the independent risk factors of dry eye. However, in clinical work, the relationship between mental disorder and dry eye has not been paid attention in the past. This paper will start with the correlation between mental disorder and dry eye, explore the mediating effects, summarize the mental disorder factors that affect the separation of symptoms and signs of dry eye, and further advocate interdisciplinary comprehensive management to treat dry eye, form a correct perception of dry eye and reduce the level of pain and health anxiety, In order to provide a new perspective for clinical diagnosis and treatment of dry eye.
白内障作为一种常见的眼科疾病，是全球第一位致盲眼病，目前尚无药物能够治疗，手术是唯一有效的办法。随着现代眼科手术技术的发展以及人工晶状体(intraocular lens，IOL)设计和功能的更新升级，人们对视觉质量的要求越来越高，白内障超声乳化联合IOL植入术已经从单纯的复明手术转变为个性化的屈光手术。为满足不同需求的患者术后获得较好的视觉质量，IOL经历了从单焦点到多焦点、球面到非球面的发展，还有散光型IOL和各类功能性IOL的临床应用，也为患者提供了更多的选择。充分了解不同类型IOL的优势和特点，根据患者自身眼部情况、日常用眼习惯以及需求，个性化地选择IOL植入对视觉质量的恢复和满意度起着至关重要的作用。因此本文将针对不同类型的IOL，从设计与分类、术后临床效果及适应人群进行综述，为IOL的选择提供指导建议。
As a common eye disease, cataract is the first-leading cause of blindness in the world. Currently, there is no drug to treat it, and surgery is the only effective way. With the development of modern ophthalmic surgical technology and the updating and upgrading of the design and function of intraocular lens (IOL), people have higher and higher requirements for visual quality. Cataract phacoemulsification combined with IOL implantation has transformed from a simple vision restoration to personalized refractive surgery. In order to meet the needs of patients with different needs to obtain better visual quality after surgery, IOL has experienced the development from monofocal to multifocal, spherical to aspherical, as well as the clinical application of astigmatic IOL and various functional IOLs, which also provides more choices for patients. Fully understanding the advantages and characteristics of different types of IOLs, according to the patient’s own eye conditions, daily eye habits and needs, individualized selection of IOL implantation plays a crucial role in the recovery and satisfaction of visual quality. Therefore, this article will review different types of IOLs from the aspects of design and classification, postoperative clinical effects and adaptation to the population, and provide guidance for the selection of IOLs.
泪膜是覆盖于眼球表面的一层液体薄膜，从内而外分为黏液层、水液层和脂质层，每层成分的改变都会导致泪膜不稳定，进而导致干眼的发生。在研究泪膜破裂方式及相关泪液成分改变的基础上，学者Yokoi及其团队分别在2012年和2013年提出了有关干眼治疗和诊断的新概念，称为泪膜导向治疗(tear film-oriented therapy，TFOT)和泪膜导向诊断(tear film-oriented diagnosis，TFOD)，就是根据泪膜破裂模式(tear film break-up pattern，TFBUP)的不同，推断出相应的泪膜成分改变，补充不足的泪膜成分，这种诊疗方法目前正逐渐被接受。本文对不同泪膜破裂方式与泪膜成分改变的关系做了汇总分析，旨在为干眼的诊断和治疗提供更为科学实用的指导方案。
Tear film is a layer of fluid film covering the surface of eye global, which is divided into mucus layer, aqueous layer and lipid layer from inside to outside. The change of each layer composition will lead to tear film instability, resulting in the occurrence of dry eye. On the basis of numerous studies on the correlation between tear composition and tear film break-up patterns, Yokoi and his team proposed new concepts on the diagnosis and treatment of dry eye called tear film-oriented therapy (TFOT) and tear film-oriented diagnosis (TFOD) in 2012 and 2013. That is according to different tear film break-up patterns (TFBUP), so changes in tear film composition can be deduced and supplemented, and this diagnosis and treatment method is gradually being accepted. In this paper, we summarized and analyzed the relationship between different tear film break-up patterns and changes in tear film composition to provide a more scientific and convenient guidance program for the diagnosis and treatment of dry eye.
特发性先天性眼球震颤(idiopathic congenital nystagmus，ICN)是一种常见的眼科疾病，患者常有明显的特征性的眼部异常，多伴有学习、社交障碍，对其身心健康影响较大。ICN遗传倾向明显，多表现为X染色体连锁(显性或隐性)，目前研究发现以FRMD7基因突变致病较为显著。近10余年来，国内外学者们在遗传学方面针对ICN和FRMD7基因做了大量的研究工作，取得了令人瞩目的结果。本文就2006年以来研究者们在FRMD7基因所致X连锁ICN的突变类型及位点作一总结，归纳并探讨FRMD7突变可能的致病机制，旨在为学者们提供以往研究结果的查证和未来研究方向的参考。
Idiopathic congenital nystagmus (ICN) is a common ophthalmic disease in which patients often have obvious and characteristic eye abnormalities. ICN patients are often accompanied by learning and social disorders, have a great impact on their physical and mental health. ICN which has an obvious genetic tendency and is mostly manifested as X chromosome linkage (dominant or recessive). Current studies have found that the mutation of FRMD7 gene is the most significant pathogenic factor. In the past 10 years, researchers have done a lot of work on the genetics of ICN and FRMD7 gene, and achieved remarkable results. This review summarizes the typ mutations caused by FRMD7 gene since 2006, and also discusses the possible pathogenesis of FRMD7 mutations, aiming to provide references for scholars to verify previous research results and future research directions.
外伤、感染、先天性疾病等均可能破坏角膜的组织结构和细胞稳态，同时造成角膜干细胞缺损，进而导致组织无法正常愈合，引起角膜盲，是世界范围内致盲的重要原因之一。目前已有多种干细胞相关的技术方法应用于重建功能性角膜组织，取得了瞩目的治疗效果。本综述以角膜缘干细胞缺乏症为主，旨在介绍多种来源的干细胞在角膜重建中的研究现状和最新进展，同时对不同干细胞的特异性标志物的研究进展进行阐述。
Trauma, infection and congenital diseases may disrupt the tissue structure and cellular homeostasis of the cornea, while causing impaired function of corneal stem cell defects, which in turn may even lead to corneal blindness caused by the inability of the tissue to heal properly. Corneal blindness is one of the major causes of blindness worldwide. Several stem cell-related techniques have been applied to reconstruct functional corneal tissue with impressive therapeutic results. This review focuses on corneal limbal stem cell deficiency and aims to present the current status and recent progress of research on stem cells from multiple sources in corneal reconstruction, as well as to describe specific markers of corneal stem cells.
Ahmed青光眼引流阀植入术作为难治性青光眼的主要治疗方案，能很大程度控制眼压，且疗效和预后均优于常规滤过性手术。但是远期引流盘周围被纤维包裹后会阻塞房水流出，引起术后高眼压，导致手术失败。因此，解决引流盘纤维包裹能很大程度地提高青光眼阀植入术后远期成功率，这也是目前的研究热点。目前临床上主要采用术前预防及术后二次操作对纤维包裹进行干预，但长期效果欠佳。本文就青光眼引流阀纤维包裹发生的组织病理学及分子机制、临床目前解决方案、前沿研究进展以及对Ahmed青光眼阀门的材料改造的探索进行综述。
Ahmed glaucoma valve implantation, as the main treatment option for refractory glaucoma, can control intraocular pressure (IOP) to a large extent. And its efficacy and prognosis are superior to those of conventional filtration surgery. IOP is well-controlled in the early postoperative stages. However, long-term fibrosis of encapsulated bleb inhibits fluid exchange and causes elevated IOP, leading to surgical failure. Therefore, treating fibrosis of encapsulated bleb can improve the long-term success rate after glaucoma valve implantation, which is also a research hotspot. Currently, the main clinical interventions are preoperative prophylaxis and postoperative secondary operations for fiber wrapping, but its long-term efficacy is not satisfactory. This article reviews the occurrence, histopathology and molecular mechanism of fibrous encapsulation, treatment in a clinical setting, cutting-edge research progress, and exploration on material modification of Ahmed glaucoma valve.
