中华眼科杂志最新文献

The rise of minimally invasive glaucoma surgery (MIGS) has brought new options to glaucoma treatment. However, there are significant differences between MIGS and traditional trabeculectomy in terms of surgical philosophy, applicable populations, and long-term efficacy. As a classic procedure, trabeculectomy achieves a well-documented intraocular pressure (IOP)-lowering effect but is associated with a higher risk of complications. In contrast, MIGS features minimal invasiveness and rapid recovery, yet its IOP-lowering magnitude is limited, and its long-term efficacy remains a matter of debate. How to balance these two approaches, especially considering the varying availability of medical resources in China, represents a key challenge for Chinese clinicians. Drawing on the characteristics of Chinese glaucoma patients, the distribution of medical resources, and clinical practice experience, this paper explores in depth the indications, advantages, and limitations of MIGS and trabeculectomy, aiming to provide more targeted references for clinicians in China when selecting glaucoma surgical strategies.

A 65-year-old male patient presented with "blurred vision in the right eye for 1 week". At the first visit, the best corrected visual acuity (BCVA) of both eyes was 0.8, no obvious abnormalities were observed in fundus examination, and optical coherence tomography (OCT) revealed the loss of outer retinal layers adjacent to the macula in the right eye. Ten days after the initial visit, the visual acuity of both eyes declined. OCT showed loss of outer retinal layers in both eyes except for the macular area, accompanied by short-term visual acuity decrease and binocular visual field defects. Electroretinography (ERG) demonstrated decreased amplitudes of a-waves and b-waves in both eyes under light and dark adaptation. Combined with imaging findings of lung squamous cell carcinoma and positive anti-recoverin antibody, the clinical diagnosis was lung squamous cell carcinoma-associated retinopathy.

As the world's leading irreversible blinding eye disease, glaucoma is predominantly managed with pharmaceutical interventions in clinical practice. However, long-term use of traditional eye drops containing preservatives (e.g., benzalkonium chloride) may induce ocular surface toxicity, increase the incidence of dry eye, promote conjunctival fibrosis, and compromise the success rate of filtering surgery. In recent years, the field of ophthalmology has been actively advancing the research, development, and clinical application of preservative-free anti-glaucoma drugs. This article focuses on the research progress of preservative-free formulations in terms of innovative preparation technologies, characteristics of clinical benefits, and existing issues, while exploring their future development directions, aiming to provide references for clinical practice.

The prevalence of normal tension glaucoma (NTG) in China stands at 1%. The inappropriate demarcation of normal intraocular pressure values may lead to misdiagnosis. The Glaucoma Group of Ophthalmology Branch of Chinese Medical Association released the consensus on the diagnosis and treatment of NTG in 2019, which established important clinical guidelines for the NTG management. Since significant research advances have been made regarding NTG in recent years, the Glaucoma Group of Ophthalmology Branch of Chinese Medical Association, in collaboration with the Glaucoma group of Chinese Ophthalmologist Association, has developed updated evidence-based consensus recommendations through comprehensive expert discussions. This new consensus on the NTG diagnosis and treatment principles aims to serve as a practical reference for clinicians.

With the emergence of various multi-segment myopic defocus design spectacles, evaluating and verifying their myopia control effectiveness and controlling their quality and wearing safety have gradually attracted widespread attention. At present, myopia prevention and control spectacles have not been classified as medical devices directly supervised by relevant national departments in China. Multi-segment myopic defocus design spectacles, as an important intervention for retarding the progression of myopia, especially for children and adolescents, should ensure the myopia control effectiveness, safety, and adherence to standardized fitting protocols. Aiming to provide guidance and reference for healthcare institutions and practitioners, the Society of Contact Lens Safety Monitoring & Vision Health of Chinese Health Association and the Western Optometry Expert Committee of Sichuan Optometry Society, based on the current evidence-based medical research, combined with practical experience and extensive solicitation of opinions, have reached consensus opinions on the quality control, effectiveness evaluation (including long-term effectiveness), and safety evaluation of multi-segment myopic defocus design spectacles, as well as the service norms for the fitting of spectacles.

In recent years, cases of microsporidial keratoconjunctivitis in China have been increasingly reported. Patients are often misdiagnosed as viral or fungal keratitis before confirmation, leading to prolonged disease course due to inappropriate treatment, and clinical awareness of this disease has long been insufficient. Current diagnosis and treatment face multiple challenges: limited understanding of the biological characteristics of microsporidia and risk factors such as parrot exposure, difficulty in clinical differentiation between keratoconjunctivitis and stromal keratitis types, and the absence of uniform diagnostic and therapeutic standards. It is imperative to strengthen clinical awareness of early diagnosis for patients with risk factors, promptly launch multicenter studies to establish standardized diagnostic and therapeutic consensus, so as to improve overall management and ensure patients receive timely and effective treatment.

The World Health Organization proposed the global elimination of avoidable blindness in 2020. Screening for eye diseases in infants and young children serves as a fundamental approach to blindness prevention, holding significant importance. This article highlights the critical role of infant and young child eye disease screening from three perspectives: its position as a key component in the childhood blindness prevention, the current status and deficiencies in China's screening practices, and the establishment of effective screening models. The importance of eye disease screening in early childhood should be emphasized, which would help to enhance the standards of pediatric eye disease screening and advance blindness prevention efforts in China.

A male premature infant was diagnosed with mild vitreous hemorrhage, which obscured the macula, in the left eye at 57 days after birth. The follow-up examinations at 4.5 years and 10 years of age revealed high myopia in the left eye, which resulted in anisometropia. Optical correction with glasses was prescribed. Greater clinical attention should be directed toward neonatal vitreous hemorrhage and its long-term visual functional prognosis.

Occult macular dystrophy is an inherited macular disorder associated with cone degeneration. The characteristic clinical feature is decreased visual acuity despite a normal fundus appearance on ophthalmoscopy. Optical coherence tomography, infrared reflectance imaging, visual field testing, and multifocal electroretinography may detect structural and functional abnormalities in the macular region. This article reviews the latest advances in both domestic and international research, summarizing the clinical characteristics, pathogenic genes, genetic features, and molecular mechanisms, aiming to enhance clinical understanding of the disease and provide insights for further research and therapeutic exploration.

The development of artificial vision systems offers the potential to restore vision for patients with severe visual impairments or blindness. This review provides an overview of the current advancements in artificial vision technologies, focusing on retinal prostheses, optic nerve prostheses, cortical prostheses, and other emerging devices. Retinal prostheses are categorized into epiretinal devices, subretinal devices, and suprachoroidal implants, which work by electrically stimulating the retina or adjacent tissues to partially restore visual function. Optic nerve prostheses target the optic nerve to transmit visual signals directly to the brain, providing a potential solution for patients with retinal damage but intact optic nerves. Cortical prostheses bypass both the retina and optic nerve, directly stimulating the visual cortex, and hold promise for restoring vision in patients who are otherwise untreatable through conventional approaches. Additionally, this review discusses other emerging devices, including ultrasonic visual prostheses, liquid retina, and chemical retinal prostheses, which offer alternative strategies for specific patient populations. Finally, the review highlights cutting-edge advancements in nanomaterials, image processing, and novel electrode technologies, which are driving the development of artificial vision systems towards higher resolution, greater efficiency, and personalized solutions, paving the way for more effective visual restoration in the future.