中华眼科杂志最新文献

{"title":"[Paying attention to challenges in clinical research on optic neuroprotection in primary open-angle glaucoma].","authors":"J J Li","doi":"10.3760/cma.j.cn112142-20251123-00493","DOIUrl":"10.3760/cma.j.cn112142-20251123-00493","url":null,"abstract":"<p><p>Primary open-angle glaucoma (POAG) is a common type of glaucoma in clinical practice and an important irreversible blinding eye disease. Basic and clinical research related to optic nerve protection has been conducted in related fields for many years, but there is still a lack of methods that can truly exert optic nerve protection in POAG clinical practice. This article analyzes and summarizes the challenges and difficulties encountered in clinical research on optic nerve protection in POAG from four perspectives: disease and pathophysiology, research design and ethics, drugs and their mechanisms of action, and translational medicine. In addition, this article actively explores possible coping strategies and future development directions for the aforementioned issues, aiming to provide guidance and reference for clinical research on optic neuroprotection in POAG.</p>","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"62 3","pages":"166-170"},"PeriodicalIF":0.0,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Correlation between macular edema and the anterior chamber angle status in patients with retinal vein occlusion].","authors":"X J Yang, K Xu, X N Wang, X Yang, L L Wu","doi":"10.3760/cma.j.cn112142-20250619-00279","DOIUrl":"10.3760/cma.j.cn112142-20250619-00279","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the correlation between macular edema and the anterior chamber angle status in patients with retinal vein occlusion (RVO). <b>Methods:</b> A retrospective case series analysis was adopted. Consecutive RVO patients treated at the Ophthalmology Department of Peking University Third Hospital from October 2011 to May 2013 were included. All patients underwent fluorescein fundus angiography for RVO classification. They were divided into the macular edema and non-macular edema groups based on the angiography results. Static and dynamic gonioscopy were performed to determine the anterior chamber angle status. The statistical analysis was performed using the independent samples <i>t</i>-test, Welch's <i>t</i>-test, chi-square test, or Fisher's exact test. The multivariate logistic regression analysis was used to identify factors associated with the occurrence of macular edema by calculating odds ratios and their 95% confidence intervals. <b>Results:</b> A total of 308 RVO patients (308 eyes) who completed all required examinations were included in the study, consisting of 155 males and 153 females, with a mean age of (58.78±14.45) years. Among them, 59 cases (19.16%) had angle closure, while 249 cases (80.84%) had open angles; 221 patients had macular edema (71.75%). The multivariate regression analysis revealed that the main risk factor for the development of macular edema in eyes with RVO was angle closure (odds ratio=2.59, 95% confidence interval: 1.23-6.05, <i>P=</i>0.018), while other factors such as age, gender, eye laterality, intraocular pressure, type of RVO, and cup-to-disc ratio showed no statistically significant association (all <i>P></i>0.05). <b>Conclusion:</b> The risk of macular edema is significantly higher in RVO patients with angle closure compared to those with open angles.</p>","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"62 3","pages":"187-192"},"PeriodicalIF":0.0,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Recurrence of peripheral anterior synechiae following phacoemulsification combined with intraocular lens implantation and goniosynechialysis in primary angle-closure glaucoma: an intermediate and long-term analysis].","authors":"Y H Tang, Y Y Li, J J Zuo, X J Wang, Y Q Xie, S D Zhang, S X Xu, R R Le, G X Li, J H Li, L Fu, Y B Liang","doi":"10.3760/cma.j.cn112142-20250425-00198","DOIUrl":"10.3760/cma.j.cn112142-20250425-00198","url":null,"abstract":"<p><p><b>Objective:</b> To report the recurrence of peripheral angle synechiae (PAS) in primary angle-closure glaucoma (PACG) after phacoemulsification combined with intraocular lens implantation and goniosynechialysis (PEI-GSL) during an intermediate-and long-term follow-up. <b>Methods:</b> This retrospective case series included patients with acute or chronic PACG who underwent PEI-GSL performed by the same surgeon at the Eye Hospital of Wenzhou Medical University between January 2017 and December 2019, with complete postoperative gonioscopic records. The primary outcome measures were the incidence and extent (in clock hours) of recurrent PAS at the last follow-up. The secondary outcomes included the surgical success rate, intraocular pressure, and the number of intraocular pressure-lowering medications. The intergroup comparisons were performed using the generalized estimating equation. The intragroup comparisons before and after surgery were analyzed using the Wilcoxon signed-rank test. The categorical data were compared using the Chi-square test or Fisher's exact test. <b>Results:</b> A total of 57 patients (69 eyes) were included, with a mean follow-up of 23.3±9.0 months. Among them, 37 patients (41 eyes) had acute PACG [9 males (24.3%), 28 females (75.7%); mean age, (68.6±8.6) years], and 20 patients (28 eyes) had chronic PACG [8 males (40.0%), 12 females (60.0%); mean age, (65.1±8.8) years]. There were no statistically significant differences in gender or age between the two groups (both <i>P></i>0.05). At the last follow-up, 46.4% (32/69) of eyes maintained a full-circle anterior chamber angle opening or had only several spot adhesions, 82.6% (57/69) had PAS limited to one quadrant, and 89.9% (62/69) had PAS involving fewer than 6 clock hours. The recurrence rate of PAS was 31.9% (22/69) in all eyes, while it was 26.8% (11/41) in eyes with acute PACG, and 39.3% (11/28) in eyes with chronic PACG, with no statistically significant difference (<i>χ</i>²=1.92, <i>P=</i>0.165). However, the extent of recurrent PAS was greater in chronic PACG patients [4.50 (2.50, 8.50) clock hours] than in acute PACG patients [3.00 (1.50, 4.50) clock hours], and this difference was statistically significant (Wald <i>χ</i>²=5.39, <i>P=</i>0.020). <b>Conclusions:</b> Approximately 30% of eyes with PACG develop recurrent PAS after PEI-GSL, but 90% maintain an angle opening over 180°.</p>","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"62 3","pages":"202-208"},"PeriodicalIF":0.0,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Establishment of the 4R classification system of minimally invasive glaucoma surgery].","authors":"J M Wang, W Chen, N L Wang","doi":"10.3760/cma.j.cn112142-20250713-00308","DOIUrl":"10.3760/cma.j.cn112142-20250713-00308","url":null,"abstract":"<p><p>Minimally invasive glaucoma surgery (MIGS) is characterized by minimal injuries and complications, with its surgical volume increasing annually in China. It encompasses a diverse range of surgical techniques. To accurately understand and select appropriate surgical indications and ensure optimal therapeutic outcomes, this article emphasizes the necessity of proposing a new classification system for MIGS. By discussing the structural and functional complexity of the trabecular meshwork and Schlemm's canal and comparing the efficacy of MIGS with different design principles, we introduce the MIGS 4R classification system based on the structural and functional integrity of the trabecular meshwork and Schlemm's canal, along with a sequential surgical selection approach, to provide reference for ophthalmologists in clinical practice.</p>","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"62 3","pages":"171-176"},"PeriodicalIF":0.0,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Chinese expert consensus on the management of glaucoma as a chronic disease (2026)].","authors":"","doi":"10.3760/cma.j.cn112142-20250401-00168","DOIUrl":"10.3760/cma.j.cn112142-20250401-00168","url":null,"abstract":"<p><p>With the rapid aging of the population in China, the prevalence of glaucoma, as the leading cause of irreversible blindness worldwide, continues to rise. The limited public awareness of glaucoma, coupled with inadequate diagnostic and therapeutic capacity at the primary healthcare level, substantially impedes early detection and timely intervention. As a chronic and progressive optic neuropathy requiring lifelong monitoring and management, glaucoma poses a significant and growing public health burden. Consequently, the establishment of a comprehensive and standardized chronic disease management system for glaucoma is critical to reducing the disease burden and preventing vision loss. Against this background, the Committee of Chronic Eye Disease Management of the China Association of Geriatric Health Care, in collaboration with glaucoma experts from across China, convened to discuss strategies and methodologies for the chronic disease management throughout the course of glaucoma. Based on these deliberations, a consensus has been developed to provide guidance and reference for advancing the glaucoma prevention and control efforts in China.</p>","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"62 3","pages":"177-186"},"PeriodicalIF":0.0,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Application of artificial intelligence in pathological diagnosis of ocular tumors].","authors":"Y W Bi, Y P Li","doi":"10.3760/cma.j.cn112142-20250428-00207","DOIUrl":"10.3760/cma.j.cn112142-20250428-00207","url":null,"abstract":"<p><p>Ocular tumors encompass ocular surface tumors, orbital tumors, and intraocular tumors, characterized by high heterogeneity and complex classifications, which pose considerable challenges to pathological diagnosis. The scarcity of specialized ophthalmic pathologists further exacerbates the difficulty in diagnosing these tumors. In recent years, artificial intelligence (AI) has penetrated diverse areas of healthcare, particularly in departments with intensive medical imaging and image-based workflows, such as radiology, pathology, and ultrasonography. With the advent of the digital pathology era, the role of AI in aiding pathological diagnosis has become increasingly prominent. In recent years, it has been tentatively applied to several ocular tumors, including eyelid sebaceous carcinoma, basal cell carcinoma, malignant melanoma, and orbital lymphoproliferative disorders, exerting an auxiliary diagnostic function. AI can also assist in predicting the prognosis of uveal malignant melanoma and retinoblastoma. In the future, with the increasing popularization and refinement of AI-assisted pathological diagnosis technologies, it will not only enhance the diagnostic accuracy and work efficiency of ocular tumors, better guide clinical treatment, but also alleviate the issues of inadequate medical resources and a shortage of specialized ophthalmic pathologists.</p>","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"62 3","pages":"227-232"},"PeriodicalIF":0.0,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A case of antiphospholipid syndrome complicated with hyperhomocysteinemia presenting initially with central retinal vein occlusion in a young male].","authors":"X W Ji, Z Y Wang, Y H Zhang, C L Chen","doi":"10.3760/cma.j.cn112142-20250409-00179","DOIUrl":"10.3760/cma.j.cn112142-20250409-00179","url":null,"abstract":"<p><p>A 28-year-old male presented to the ophthalmology department with decreased visual acuity in the left eye for 4 months. Four months prior, he was diagnosed with central retinal vein occlusion (CRVO) in the left eye at another hospital and received three intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) agents. Laboratory examinations revealed elevated levels of homocysteine, lupus anticoagulant (LA) 1 screening test result, LA1/LA2 ratio, and anti-β2 glycoprotein 1 antibody. The patient was treated with oral folic acid tablets, systemic anticoagulants, and additional intravitreal anti-VEGF therapy. He achieved a favorable prognosis after treatment.</p>","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"62 3","pages":"223-226"},"PeriodicalIF":0.0,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical observation of the 6-month safety of the corneal endothelium after trabeculotome tunnelling trabeculoplasty surgery].","authors":"X D Huang, Q Qiu, S Z Wang, N L Wang, L Z Zeng","doi":"10.3760/cma.j.cn112142-20251031-00454","DOIUrl":"10.3760/cma.j.cn112142-20251031-00454","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the safety of trabeculotome tunnelling trabeculoplasty (3T) in treating primary open-angle glaucoma (POAG) by observing the changes in corneal endothelial cell quantity and morphology after surgery. <b>Methods:</b> This was a retrospective case series study. Patients diagnosed with POAG who underwent successful 3T surgery were recruited from the Department of Ophthalmology, Chengdu First People's Hospital between April 2023 and September 2025. Parameters such as the number of cells, corneal endothelial cell density, average size, hexagonal cell ratio of endothelial cells, and central corneal thickness were recorded preoperatively and at 6 months postoperatively. Data were analyzed using the t-test. <b>Results:</b> The cohort comprised 48 patients, involving 52 eyes (27 left eyes, 25 right eyes), of whom 36 (75%) were male and 12 (25%) were female. The mean age of the patients was (51.37±12.90) years, ranging from 18 to 72 years. The preoperative number of cells was (196±40) cells, which decreased to (170±56) cells at 6 months postoperatively (<i>P<</i>0.05). The preoperative endothelial cell density was (2 686±416) cells/mm², compared to (2 302±563) cells/mm² at 6 months postoperatively (<i>P<</i>0.05). The average size increased from (381±76) μm² preoperatively to (470±161) μm² at 6 months postoperatively (<i>P<</i>0.05). The hexagonal cell ratio was (52±9)% preoperatively and (50±8)% at 6 months postoperatively, with no significant difference (<i>P></i>0.05). The central corneal thickness was (517±49) μm preoperatively and (514±39) μm at 6 months postoperatively, with no significant difference (<i>P></i>0.05). <b>Conclusions:</b> Although the 3T surgery for POAG results in a slight reduction in corneal endothelial cell count, as well as changes in corneal endothelial cell morphology and size, it does not induce corneal endothelial decompensation during the 6-month follow-up period and shows favorable short-term safety.</p>","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"62 3","pages":"209-213"},"PeriodicalIF":0.0,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Study on Corneal-Scleral Morphology guided by Pentacam corneal-scleral profile analysis module for scleral lens fitting in low to moderate myopia].","authors":"F F Ma, Y Hu, J H Liu, Y F Jiang, J S Xue","doi":"10.3760/cma.j.cn112142-20251108-00466","DOIUrl":"10.3760/cma.j.cn112142-20251108-00466","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the anterior segment parameters and morphological characteristics of corneoscleral topography in patients with simple refractive errors, so as to provide a basis for the design and fitting of scleral lenses. &lt;b&gt;Methods:&lt;/b&gt; This was a cross-sectional study. A total of 41 adult patients (82 eyes) with low to moderate myopia who visited the Contact Lens Clinic of the Eye Hospital Affiliated to Nanjing Medical University from August to September 2023 were enrolled, including 28 females and 13 males, with an age of (26.20±5.44) years. All patients underwent routine ophthalmic examinations. In addition, the Corneal-Scleral Profile (CSP) Analysis Module of the Pentacam anterior segment analysis system was used to obtain sagittal plane images and corneoscleral topographic maps within a diameter of 18.0 mm in the anterior ocular segment. Data such as sagittal height (SH), corneal angle (CA), and scleral angle (SA) at chord lengths (CL) of 10.0, 12.8, 13.5, 15.0, 16.0, and 17.0 mm were collected respectively. After adjusting for the non-independence of binocular data using Generalized Estimating Equations, univariate linear regression analysis was performed to explore the quantitative relationship between chord length and mean sagittal height. &lt;b&gt;Results:&lt;/b&gt; There were no statistically significant differences in corneoscleral sagittal height between the right and left eyes at different chord lengths and orientations (all &lt;i&gt;P&lt;/i&gt;&gt;0.05). At the chord length of 10.0 mm, the superior sagittal height was the highest in both eyes [right eye: (1 818.00±12.13) μm, left eye: (1 815.41±14.23) μm], and the temporal sagittal height was the lowest [right eye: (1 724.68±9.72) μm, left eye: (1 717.12±10.82) μm]. For chord lengths of 12.8 mm and above, the inferior sagittal height was the highest and the nasal sagittal height was the lowest; moreover, the nasal sagittal height was smaller than the temporal one, and the superior sagittal height was smaller than the inferior one (&lt;i&gt;P&lt;/i&gt;&lt;0.05). At all chord lengths, the nasal corneoscleral angle of both eyes was smaller than the temporal one (&lt;i&gt;P&lt;/i&gt;&lt;0.05). At chord lengths of 10.0, 12.8, 13.5, 15.0, 16.0, and 17.0 mm, the proportions of eyes with corneoscleral sagittal height difference&gt;150 μm between orthogonal meridians were 2.44% (2/82), 18.29% (15/82), 26.83% (22/82), 75.61% (62/82), 87.80% (72/82), and 92.68% (76/82), respectively. Taking the mean sagittal height as the dependent variable (&lt;i&gt;y&lt;/i&gt;) and chord length as the independent variable (&lt;i&gt;x&lt;/i&gt;), the univariate linear regression equations after adjusting for relevant factors were: right eye: &lt;i&gt;y&lt;/i&gt;=-2 663.71+434.86&lt;i&gt;x&lt;/i&gt; (adjusted &lt;i&gt;R&lt;/i&gt;²=0.99), left eye: &lt;i&gt;y&lt;/i&gt;=-2 516.56+422.82&lt;i&gt;x&lt;/i&gt; (adjusted &lt;i&gt;R&lt;/i&gt;²=0.99) (both &lt;i&gt;P&lt;/i&gt;&lt;0.001). &lt;b&gt;Conclusions:&lt;/b&gt; The corneoscleral morphology of low to moderate myopic eyes presents non-rotational symmetry, which is characterized by a flatter nasal sclera than the temp","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"62 2","pages":"130-139"},"PeriodicalIF":0.0,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146126780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Advances in clinical diagnosis and treatment of pythium keratitis].","authors":"D Yan, W Huang, K S Li","doi":"10.3760/cma.j.cn112142-20250820-00351","DOIUrl":"10.3760/cma.j.cn112142-20250820-00351","url":null,"abstract":"<p><p>Pythium insidiosum is an aquatic algal oomycete that can induce Pythium insidiosum keratitis (PIK). PIK typically presents as acute, highly invasive corneal ulcers, rapidly progressing to corneal dissolution and perforation, and in severe cases, may lead to blindness. Due to its clinical presentation resembling fungal infections, it is often misdiagnosed as fungal keratitis. Epidemiological studies indicate that PIK is predominantly found in tropical and subtropical regions, with a higher incidence during the monsoon season. It is often associated with exposure to contaminated water sources or minor trauma caused by plants. Diagnostic methods include staining of corneal scrapings, PCR, metagenomic next-generation sequencing, and confocal microscopy. Since PIK shows a poor response to conventional antifungal treatments, antibiotics are the preferred treatments, with a combination of linezolid and azithromycin often used as the first-line therapy. Severe cases may require penetrating keratoplasty. In China, reports of PIK cases are relatively rare. This review summarizes the epidemiology, etiology, clinical manifestations, diagnosis, and treatment of PIK, aiming to provide a reference for its clinical management.</p>","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"62 2","pages":"156-160"},"PeriodicalIF":0.0,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146126737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}