本期推荐发表于《眼科学报》的5篇眼科疾病研究相关双语文章，涵盖弱视、近视、青光眼、糖尿病视网膜病变等眼科常见病种，欢迎阅读！
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01
外泌体在眼科疾病中的研究进展
Research progress of exosomes in eye diseases
【摘要】外泌体（exosomes）是一类直径50～150nm的细胞外膜泡，可以递送生物活性分子（如蛋白质、脂质、DNA、miRNA等）至靶细胞中，以发挥细胞间通讯作用。外泌体介导的细胞间通讯影响靶细胞的凋亡、侵袭、迁移、免疫应答及氧化损伤修复等功能。近年来外泌体研究在眼科学领域迅速开展，本文总结了在眼科疾病中外泌体相关研究的最新进展。
【Abstract】Exosomes are nanoscale vesicles with a diameter of 30 nm to 150 nm, which are composed of lipid bilayers, proteins, and genetic material. Almost all types of cells in the human body can secrete exosomes. They play key roles in cellular communication, immune regulation, inflammatory responses and neovascularization. At present, exosomes have been widely studied in tumors, cardiovascular and urinary systems. In recent years, the role of exosomes in eye diseases has attracted more and more attention. The exosomes play an important role in the occurrence and development of common eye diseases such as keratopathy, age-related macular disease, diabetic retinopathy, glaucoma, etc. Currently it is a hot topic that the therapeutic potential of extracellular vesicles derived from different mesenchymal stem cells in eye diseases. The exosomes derived from mesenchymal stem cells have anti-inflammatory, anti apoptotic, neuroprotective and tissue repairing effects, which are similar to those of mesenchymal stem cells. Thus, exosomes may be a novel direction of research in the treatment of many eye diseases without cell therapy. Further understanding of the biological characteristics of exosomes and the latest research progress of exosomes in common eye diseases will provide reference for the pathogenesis and prevention strategies of related eye diseases.
02
青少年弱视康复治疗研究进展
Research progress on rehabilitation treatment of adolescent amblyopia
【摘要】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。
【Abstract】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 fivein-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.
03
视障辅助技术在低视力康复中的应用进展
The application of assistive technology for visual impairment in low vision rehabilitation
【摘要】因不同的眼部和神经性疾病，导致视觉功能严重受损，为低视力患者日常活动（如阅读及驾驶）及生活质量、心理健康带来严重的影响。人们对外界信息的感知主要来源于视觉，除威胁生命的重大疾病外，对人感官影响最大的损害当属视觉损伤。且随着人口日益老龄化，该问题日趋加重，低视力已成为目前全球范围内一个严重的公共卫生问题。目前，低视力康复发展面临着临床和科研的巨大挑战，要研发出一种能有效改善视觉功能，同时能兼顾多种功能的视障辅助技术，这需要医学、生物学、工程学、微电子学、计算机学等多学科的共同发展和相互合作。低视力康复通过为患者提供适宜的视障辅助技术，最大化利用患者的残余视力及视觉功能，改善与低视力相关的功能限制，有效改善其独立性和整体生活质量，使其独立生活、工作并融入社会成为可能。该文对经典的助视器、人工视觉（视觉假体/视觉感官替代设备）、经颅刺激及视觉生物反馈训练等视障辅助技术在低视力康复中的应用进展进行综述。
【Abstract】Patients with low vision are severely impaired in visual function due to different ocular and neurological disorders, which have a serious impact on their daily activities (such as reading and driving), quality of life and mental health. People’s perception of external information mainly comes from vision. Expect for the life-threatening major diseases, visual damage has the greatest impact on people’s senses. With the ageing of the population, the problem is getting worse, and low vision has become a serious public health problem in the world. Currently the development of low vision rehabilitation is facing a huge challenge in clinical and scientific research, to develop a visual impairment assistance technology that can effectively improve visual function while balancing multiple functions. It requires the joint development and cooperation of multiple disciplines such as medicine, biology, engineering, microelectronics, and computer science. Low vision rehabilitation provides patients with appropriate visual impairment assistance technology, maximizing the use of residual vision and visual function of patients, improving the functional limitations associated with low vision, effectively improving their independence and overall quality of life, and makes it possible for them to live, work and integrate into the society independently. This article reviews the progress in the application on visual impaired assistive technologies such as classic visual aids, artificial vision (visual prostheses/visual sensory replacement devices), transcranial stimulation and visual biofeedback training in low vision rehabilitation.
04
高度近视视神经改变与原发性开角型青光眼的相关性研究进展
Research progress on the correlation between optic neuropathy and primary open-angle glaucoma in high myopia
【摘要】初步高度近视（high myopia，HM）作为一种特殊类型的屈光型眼病，不仅会导致进行性、退行性眼底改变，其视神经损伤的患病率也很高。青光眼是全球范围内最常见的一种不可逆致盲性眼病，原发性开角型青光眼（primary open-angle glaucoma，POAG）是最常见的青光眼类型。近年来的研究发现HM与POAG的病理改变存在相似之处。由于HM眼底改变与早期POAG眼底改变容易混淆，HM患者早期发现POAG对延缓或阻止疾病进展很重要。HM患者长期随访不仅要观察黄斑病变，视神经形态与结构改变的观察也不容忽视。
【Abstract】As a special type of refractive eye disease, high myopia (HM) not only causes progressive and degenerative fundus changes, but also has a high prevalence of optic nerve damage. Glaucoma is the most common form of irreversible blinding eye diseases worldwide, among which,primary open-angle glaucoma (POAG) is the most common type.In recent studies, HM is found to have similarities on pathological changes as that of POAG. And HM fundus changes are easily confused with early stage POAG fundus changes; thus, the early detection of POAG on HM patients is highly important on disease deferment or prevention of disease progression. Macular degeneration as well as optic nerve morphology and structural changes are to be observed in the long-term follow-up for HM patients.
05
人工智能诊断系统在基层眼底视网膜疾病筛查领域的应用实践
Application practice of artificial intelligence diagnosis system in the field of primary fundus retinal disease screening
【摘要】目的：借助于人工智能（artificial intelligence，AI）眼底筛查远程接转诊系统，探索“患者-社区-医院”远程筛查模式，推进眼科分级诊疗和双向转诊实施，为地市级医疗机构开展眼底疾病人工智能筛查工作提供一定的经验借鉴。方法：通过AI辅助远程筛查基层医疗机构的4 886例患者，完成眼科检查并经AI初判、人工复核形成眼底诊断结论。通过医联体和专科联盟模式，对基层医疗机构的4 886例患者的AI诊断系统结果和上级医师审核结果进行对照分析，分析AI诊断系统在眼科常见病种筛查中的推广应用的可信度和可行性。结果：AI检出DR的灵敏度为94.70%，特异度96.06%；DME的灵敏度96.43%，特异度96.55%；AMD的灵敏度77.55%，特异度95.74%；同时，其在病理性近视、白内障、青光眼等常见病种眼底筛查中也有一定作用。结论：AI辅助远程筛查系统对于绝大多数眼底疾病有较高的敏感性和特异性，适用于眼底疾病的筛查工作，利于基层医院或社区医院对于眼底疾病的初步诊断，落实眼科分级诊疗，有借鉴推广意义。
【Abstract】Objective: With the help of artificial intelligence (AI) based fundus screening remote referral telemedicine system, it enables us to explore the remote screening mode of patient-community-hospital, and promote the two-way referral and ophthalmic graded diagnosis. This investigation provides certain practice experiences for prefecture-level medical institutions to carry out AI screening for fundus diseases. Methods: Ophthalmologic examination was performed on 4 886 patients in primary medical institutions through AI-aided remote screening, and the final fundus diagnosis conclusion was formed after AI preliminary judgment and manual review. Through the Medical Consortium and specialty alliance model, the results of the AI diagnosis system and the audit results of superior physicians for 4 886 patients in primary care institutions were compared and analyzed, and the credibility and feasibility of the AI diagnosis system application in the screening of common ophthalmic diseases were discussed. Results: The sensitivity and specificity of AI detection of diabetic retinopathy were 94.70% and 96.06%, respectively. In the diabetic macular edema classification, the sensitivity and specificity were 96.43% and 96.55%, respectively. In the age-related macular degeneration classification, the sensitivity and specificity were 77.55% and 95.74%, respectively. Meanwhile, it also plays a role in screening common fundus diseases such as pathological myopia, cataract and glaucoma. Conclusions: The AI-aided remote screening system has high sensitivity and specificity for most of fundus diseases, indicating it is promising for fundus diseases screening in primary medical institutions. It is conducive for primary hospitals or community hospitals to carry out the initial diagnosis of fundus diseases, as well as the implementation of graded diagnosis and treatment of ophthalmology, which has reference and promotion significance.
期刊推荐
《眼科学报》中文版（月刊，ISSN：1000-4432；CN：44-1119/R）及英文版《Eye Science》（季刊，ISSN：3005-9984；e-ISSN：3005-9992）创刊于1985年，是由中华人民共和国教育部主管、中山大学主办、中山大学中山眼科中心出版及发行的国际化医学学术期刊。由中山大学中山眼科中心林浩添教授担任主编，中山大学中山眼科中心刘臻臻教授担任执行主编，由来自20多个国家的30多名国际知名眼科专家组成编委会。《眼科学报》致力推动全球眼科与多学科联合创新眼病防治策略，相关领域包括但不仅限于眼科基础与临床研究、眼病创新治疗与转化应用、眼科流行病学等领域的最新研究进展。
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