Volume 62 · Issue 01 · 2026

This issue focuses on the research progress in the diagnosis and treatment of fundus diseases. The responsible editorial committee responsible for the planning, composition and review of this issue is Professor Wei Wenbin.

In medical practice, intraocular space-occupying lesions are a major category of diseases that are prone to clinical misdiagnosis and mistreatment. In the process of diagnosing these lesions caused by different etiologies, special attention should be paid to the establishment of diagnostic and therapeutic thinking patterns and clinical diagnosis, and vigilance should be exercised against the negative trend of using auxiliary examination results instead of clinical diagnosis. Ophthalmologists should enhance their understanding of intraocular space-occupying lesions, make accurate diagnoses, choose appropriate treatments, and perform enucleation surgery with caution.

Optical coherence tomography (OCT), with its advantages of non-invasiveness, non-contact, rapid imaging, and high resolution, has become an indispensable core imaging tool in the diagnosis and treatment of fundus diseases. It provides clinicians with critical structural insights for accurately assessing lesion characteristics and severity, dynamically monitoring disease progression and treatment efficacy, and optimizing therapeutic strategies. However, in the era of precision medicine, the application effectiveness of OCT still faces significant challenges. Deeply understanding and acknowledging its limitations is fundamental to maximizing the value of OCT and seeking effective solutions. This article focuses on the key bottlenecks and breakthrough paths of OCT in the diagnosis and treatment of fundus diseases, systematically analyzing the core issues from three dimensions, including the physical constraints of the device itself, the physiological and pathological variations among individual patients, and the subjectivity of physician interpretation. Closely following the cutting-edge trends and development opportunities in the OCT field, the counter strategies, like continuous technological innovation, deep integration of artificial intelligence, multimodal imaging integration, optimization of patient workflows and protocols, and standardized physician training, are also discussed. The aim is to provide clinicians with a comprehensive insight into the current status and future directions of OCT applications, helping them better understand existing challenges, more effectively utilize current technologies, and grasp the opportunities brought by technological innovation and diagnostic model transformation, and thus promoting the continuous improvement of precision diagnosis and treatment levels for fundus diseases.

The management of rhegmatogenous retinal detachment (RRD) primarily relies on two core surgical modalities: scleral buckling (SB) and pars plana vitrectomy (PPV). In recent years, the rapid advancement of PPV technology has facilitated its increasingly widespread clinical application. However, due to its steep learning curve, SB has become progressively marginalized in clinical practice. In some instances, it has even been substituted for cases that were originally indicated for SB. This article systematically analyzes the unique complications and indications of both surgical approaches, highlighting the irreplaceable value of SB in specific patient populations, such as pediatric patients and those with moderately complex RRD in phakic eyes. It is proposed that the selection of surgical strategy should be based on a comprehensive evaluation of lesion characteristics, patient-specific factors, and the inherent advantages of each technique, thereby enabling individualized and precise treatment.

To investigate the clinical effect of performing a 12 o′clock peripheral iridectomy during vitrectomy with heavy silicone oil tamponade in aphakic eyes.

This was a prospective controlled study. Patients diagnosed with tractional retinal detachment secondary to proliferative diabetic retinopathy and scheduled to undergo combined lens extraction and pars plana vitrectomy with heavy silicone oil tamponade at the Department of Ophthalmology, Second Affiliated Hospital of Harbin Medical University between January and December 2024 were enrolled in this study. Patients were randomly assigned, using a random number table, to either the combined group (undergoing aphakic vitrectomy with heavy silicone oil tamponade and a 12 o′clock peripheral iridectomy) or the simple group (undergoing aphakic vitrectomy with heavy silicone oil tamponade but without a peripheral iridectomy). Intraocular pressure (IOP) and best-corrected visual acuity (BCVA) were recorded preoperatively and at 1 day, 1, 4, and 12 weeks postoperatively. These measures, along with postoperative silicone oil migration into the anterior chamber, corneal condition, retinal reattachment status, and other complications, were compared between the two groups. Statistical analyses were performed using the independent-samples t-test, independent-samples Mann-Whitney U test, and chi-square (χ²) test.

A total of 20 patients (20 eyes) were enrolled, including 11 males (11 eyes) and 9 females (9 eyes), with a mean age of (59.65±8.92) years (range, 46 to 78 years). There were 10 eyes in each of the combined and simple groups. No statistically significant differences were found between the two groups in terms of age, BCVA, or IOP at baseline (all P>0.05). At 1, 4, and 12 weeks postoperatively, the IOP in the combined group [(20.78±4.06), (20.82±3.67), and (21.00±3.14) mmHg; 1 mmHg=0.133 kPa] was significantly lower than that in the simple group [(25.15±4.63), (28.52±8.12), and (29.80±8.34) mmHg], with statistically significant differences at all time points (all P<0.05). There were no statistically significant differences in BCVA between the two groups at any postoperative time point (all P>0.05). Silicone oil migration into the anterior chamber occurred in only one eye in the combined group at 12 weeks postoperatively, whereas in the simple group, 0, 2, 5, and 7 eyes exhibited silicone oil in the anterior chamber at 1 day, 1, 4, and 12 weeks, respectively. Regarding corneal edema (grade≥1), the number of affected eyes in the combined group was 3, 1, 1, and 1 at the corresponding time points, while in the simple group it was 3, 2, 5, and 6, respectively. Additionally, at 12 weeks postoperatively, one eye in the simple group showed persistent retinal detachment, and one eye in the combined group exhibited closure of the peripheral iridectomy incision.

Performing a 12 o′clock peripheral iridectomy during vitrectomy with heavy silicone oil tamponade in aphakic eyes can effectively control postoperative IOP, reduce the incidence of silicone oil migration into the anterior chamber, alleviate postoperative complications, and enhance surgical safety.

To describe and compare the internal vascular features of choroidal melanoma (CM) and choroidal nevus on optical coherence tomography angiography (OCTA).

This cross-sectional study included patients clinically diagnosed with CM or choroidal nevus at Beijing Tongren Hospital between July 2019 and March 2025. Tumor-centered OCTA images were acquired, and the intrinsic tumor vasculature was reconstructed on two en face planes, the choriocapillaris slab and the full-thickness choroid slab. The malignant transformation risk of choroidal nevus was assessed using the multimodal imaging-based TFSOM-DIM criteria. Nevi with two or more high-risk features were classified as high-risk nevi, and the OCTA features of high and low-risk nevi was analyzed. The OCTA features were compared between the CM and nevus groups using the χ² test or Fisher′s exact test.

A total of 95 eyes (95 patients) were included, consisting of 49 right eyes and 46 left eyes. There were 45 males (47.4%) and 50 females (52.6%), with a mean age of (47.6±14.1) years. All patients had unilateral involvement. The CM group included 67 patients (67 eyes), with 35 right eyes and 32 left eyes, comprising 36 males (53.7%) and 31 females (46.3%), with a mean age of (47.1±14.3) years. The choroidal nevus group included 28 patients (28 eyes), with 14 right eyes and 14 left eyes, consisting of 9 males (32.1%) and 19 females (67.9%), with a mean age of 48.8±13.6 years. There were no significant differences between the two groups in eye laterality (χ²=0.04, P=0.842), age (t=0.53, P=0.299), or sex distribution (χ²=3.69, P=0.055). In the choroid en face slab, disorganized vascular networks and vascular loops were observed in 66 CM cases (98.5%) and 14 nevus cases (50.0%; χ²=34.95, P<0.001). In the choriocapillaris en face slab, patchy avascular areas were detected in 54 CM cases (80.6%) and 9 nevi (32.1%; χ²=20.79, P<0.001), while the intrinsic tumor vasculature was present in 52 CM cases (77.6%) and 8 nevi (28.6%; χ²=20.41, P<0.001). Two distinct vascular patterns were identified within choroidal nevi on the choroid slab: 14 nevi (50.0%) exhibited diffusely attenuated flow signals without identifiable tumor vasculature, whereas the other 14 nevi (50.0%) demonstrated melanoma-like disorganized vascular networks. Among 17 low-risk and 11 high-risk nevi, melanoma-like disorganized vascular networks were present in 9 low-risk nevi (29.4%) and 5 high-risk nevi (81.8%), with a statistically significant difference (χ²=7.34, P=0.018).

In OCTA images, CMs and choroidal nevi exhibit different internal vascular networks. CMs typically exhibit disorganized vasculature with vascular networks and loops, whereas choroidal nevi more often show attenuated flow signals or finer, more orderly vascular structures. The presence of melanoma-like disorganized vascular networks in choroidal nevi may significantly predict malignant transformation and serve as an imaging indicator for identifying high-risk nevi.

To investigate microstructural changes of the macular area after surgery for idiopathic macular epiretinal membrane (IMEM) using optical coherence tomography angiography, so as to preoperatively predict the postoperative vision.

This was a single-center, retrospective case series study. The clinical data of patients diagnosed with IMEM who underwent surgical treatment at the Affiliated Hospital of Guizhou Medical University from May 2019 to October 2020 were included. All affected eyes were treated with vitrectomy combined with epiretinal membrane and internal limiting membrane peeling. Data on best-corrected visual acuity (BCVA), foveal avascular zone (FAZ) area and acircularity index of the superficial capillary plexus were collected preoperatively and at 1 week, 1 month, and 3 months postoperatively. Changes in these indicators and their correlations were analyzed. BCVA was expressed in terms of the logarithm of the minimum angle of resolution (logMAR). Repeated measurement data were analyzed using a mixed linear model, and the Spearman correlation analysis was used for correlation assessment.

A total of 30 patients (30 eyes) were included. All patients had monocular involvement, including 18 cases in the right eye and 12 cases in the left eye. The mean age of the patients was (34.47±8.10) years. There were 17 male patients (56.7%) and 13 female patients (43.3%). The median BCVA was 0.82 (0.70, 0.85) before surgery, 0.70 (0.52, 0.82) at 1 week postoperatively, 0.70 (0.52, 0.70) at 1 month postoperatively, and 0.52 (0.49, 0.70) at 3 months postoperatively. There was a statistically significant difference in the BCVA between preoperative and postoperative time points (F=34.67, P<0.001). The median FAZ area was 0.13 (0.06, 0.30) mm² preoperatively, 0.17 (0.08, 0.26) mm² at 1 week postoperatively, 0.19 (0.13, 0.33) mm² at 1 month postoperatively, and 0.27 (0.18, 0.40) mm² at 3 months postoperatively. A statistically significant difference in the FAZ area was observed between preoperative and postoperative time points (F=43.69, P<0.001). The median preoperative acircularity index was 0.67 (0.54, 0.81), compared to 0.71 (0.66, 0.77) at 1 week postoperatively, 0.72 (0.66, 0.80) at 1 month postoperatively, and 0.75 (0.55, 0.84) at 3 months postoperatively. There was a statistically significant difference in the acircularity index between preoperative and postoperative time points (F=58.15, P<0.001). The BCVA at 3 months postoperatively was positively correlated with the preoperative BCVA (r=0.579, P=0.001). Additionally, the BCVA at 3 months postoperatively was negatively correlated with the preoperative FAZ area of the superficial capillary plexus (r=-0.461, P=0.010) and preoperative acircularity index (r=-0.402, P=0.028).

Significant improvements in BCVA, FAZ area, and acircularity index were achieved in IMEM patients after pars plana vitrectomy combined with epiretinal membrane and internal limiting membrane peeling. The preoperative BCVA, FAZ area, and acircularity index can serve as predictive indicators for postoperative visual acuity in patients with IMEM.

To investigate the etiological characteristics, clinical manifestations, and prognosis of patients with endogenous endophthalmitis (EE).

This was a retrospective case series study. Clinical data from patients diagnosed with EE and treated at Henan Eye Hospital between January 2024 and December 2024 were collected. Preoperative examinations included best-corrected visual acuity, intraocular pressure, and ocular B-ultrasound. The ocular status was evaluated using a slit-lamp biomicroscope and indirect ophthalmoscope. Samples of the aqueous humor and vitreous body were obtained for pathogenic bacterial culture or next-generation sequencing. Patients with previous etiological test results of blood or body fluids were included in the analysis. All patients received systemic antibiotic or antifungal treatment. Depending on disease severity, patients underwent intravitreal injection, pars plana vitrectomy (PPV), or evisceration with artificial eye socket implantation. Etiological characteristics, clinical manifestations, and treatment outcomes were assessed. Statistical analyses were performed using the Fisher′s exact test or Monte Carlo exact method. The logistic regression analysis was applied to identify factors influencing the visual acuity improvement by calculating the odds ratio (OR) and its 95% confidence interval (95%CI).

A total of 38 eyes of 33 patients, 19 (57.6%) males and 14 (42.4%) females, diagnosed with EE were included. There were 16 cases (48.5%) in the right eye, 12 cases (36.4%) in the left eye, and 5 cases (15.1%) in both eyes. The age ranged from 22 to 80 years old, with a mean age of (59.5±13.0) years. Among the 38 affected eyes, 23 eyes (60.5%) had bacterial infections, including 13 eyes (34.2%) with Klebsiella pneumoniae, 5 eyes (13.2%) with Staphylococcus aureus, 2 eyes (5.3%) with Escherichia coli, 1 eye (2.6%) with Nocardia species, 1 eye (2.6%) with coinfection of Listeria monocytogenes and Enterobacter cloacae complex, and 1 eye (2.6%) with no available etiological test results. Thirteen eyes (34.2%) had fungal infections, including 5 eyes (13.2%) with Candida albicans, 2 eyes (5.3%) with Candida parapsilosis, 2 eyes (5.3%) with Aspergillus fumigatus, 1 eye (2.6%) with Fusarium species, 1 eye (2.6%) with Aspergillus flavus, 1 eye (2.6%) with Chaetomium globosum, and 1 eye (2.6%) with negative etiological test results in the vitreous humor. Two eyes (5.3%) had mixed fungal and bacterial infections. In all patients, ocular B-mode ultrasonography revealed severe vitreous opacity. Three eyes (7.9%) underwent evisceration combined with orbital implant placement. Treatment was discontinued for 2 eyes (5.3%) due to severe systemic conditions in the respective patients. The remaining 33 eyes (86.8%) were included in the visual acuity analysis at the last follow-up, of which 22 (66.7%) showed improved visual acuity, 4 (12.1%) had decreased visual acuity, and 7 (21.2%) had stable visual acuity. The logistic regression analysis revealed that PPV improved the final visual acuity (OR=0.068, 95%CI: 0.014-0.337, P=0.004).

The single-center data from 2024 indicated that bacteria were the predominant pathogenic organisms of EE, followed by fungal species. Patients with EE exhibited severe vitreous opacity, and PPV played a crucial role in the visual prognosis.

To investigate the clinical and histopathological characteristics of orbital diffuse large B-cell lymphoma (O-DLBCL).

It was a retrospective case series study. The clinical data of patients diagnosed with O-DLBCL in Xi′an People′s Hospital (Xi′an Fourth Hospital) and Shaanxi Eye Hospital from January 2016 to December 2024 were included. The clinical manifestations, imaging and pathological characteristics of the patients were collected. Immunohistochemical indicators such as CD20, C-MYC, CD10, Bcl-2, Bcl-6, MUM1, P53 and CD30 were detected by immunohistochemistry EnVision method, and they were typed according to the Hans method. Fisher′s exact probability method was used for data analysis.

A total of 19 patients (19 eyes) were included, including 9 males and 10 females. The median age was 56.0 (50.3, 63.0) years, and the range was 30~83 years. There were 9 cases in the left eye and 10 cases in the right eye. Among them, 17 cases were primary O-DLBCL and 2 cases were secondary O-DLBCL. The clinical manifestations of the patients included exophthalmos in 16 cases, eye movement restriction in 14 cases, eyelid swelling in 15 cases, eyelid drooping in 4 cases, orbital swelling and pain in 11 cases, positive intraorbital pressure in 10 cases, conjunctival hyperemia and edema in 9 cases, lacrimation in 5 cases, diplopia in 4 cases, and visual acuity loss in 3 cases. Imaging manifestations showed irregular soft tissue density shadows in the orbit, infiltrative growth, invasive growth that could invade surrounding soft tissues or orbital bones, 3 cases invaded the maxillary sinuses or nasal sinuses, and 6 patients were considered benign lesions on imaging. The median maximum diameter of tumors was 2.2 (1.0, 3.0) cm, and the range was 0.6-5.0 cm. 5 cases involved the lacrimal glands, 2 cases involved the eyelids, 15 cases were histologically typed as centroblasts, and 4 cases were immunoblasts; According to the Hans typing method, there were 13 cases of non-erminal center b-cell-like (non-GCB) type and 6 cases of GCB type. Immunohistochemistry showed that 16 patients were positive for Bcl-2, 11 cases were positive for C-MYC, 9 cases were co-expressed for Bcl-2 and C-MYC, 3 cases were positive for CD30, 11 cases were positive for P53, and 13 cases had a high proliferation index (Ki67≥80%). All 19 patients underwent intraorbital mass resection, of which 8 were partial mass resection, 11 cases were complete mass resection, and 3 patients underwent intranasal or intramaxillary sinus mass resection at the same time. 16 patients were followed up for 2~48 months, of which 10 patients survived, 6 patients died, 1 case developed lung metastasis after 2 months of follow-up, and the rest did not have lymphoma from other sites. There are 8 patients treated with R-CHOP regimen (rituximab, cyclophosphamide, doxorubicin, vincristine combined with prednisone) for 2~9 courses, of which 3 cases had complete remission, 4 cases had partial remission, and 1 case died after treatment.

O-DLBCL is mostly a centroblastic type and a non-GCB type, with high Ki67 and high dual expression ratios of Bcl-2 and C-MYC, and should be actively treated to reduce its mortality rate.

A patient presented to the ophthalmology department with bilateral blurred vision, with a history of intravenous infusion of Pucotenlimab injection for malignant melanoma. Examinations revealed right anterior chamber inflammation, bilateral papilledema and macular edema. Optical Coherence Tomography (OCT) showed choroidal elevation in the macular area of both eyes, accompanied by multifocal exudative neurosensory detachment and pigment epithelial detachment. Indocyanine Green Angiography (ICG-A) demonstrated multifocal patchy hyperfluorescence in the posterior pole of both eyes in the early phase, weak fluorescence of horizontal choroidal folds, and hyperfluorescence in the posterior pole in the late phase. Based on the medical history, the patient was diagnosed with bilateral drug-related Vogt-Koyanagi-Harada (VKH) syndrome-like lesions. Treatment with intravitreal injection of dexamethasone sustained-release implant in the right eye combined with systemic glucocorticoid therapy resulted in improvement of ocular symptoms.

A 57-year-old male patient presented to the ophthalmology department with right eye pain, swelling, and epiphora. He was initially diagnosed with a right orbital mass, right globe rupture, and possible choroidal melanoma. MRI revealed abnormal signals in the right vitreous body. Under general anesthesia, the patient underwent right eye enucleation. Intraoperatively, opening the globe revealed a large grayish-black mass. Pathological examination confirmed choroidal melanoma. Postoperatively, the patient was transferred to the oncology department for prevention of orbital tumor recurrence and metastasis.

Age-related macular degeneration (AMD) is the leading cause of vision loss in individuals aged 65 years and older. In the advanced stage of the disease, subretinal fibrotic scars develop, leading to irreversible vision impairment. The formation of subretinal scars is driven by interactions among various cellular and molecular components, involving multiple pathological processes including immune responses and inflammatory reactions; however, the exact underlying mechanism remains elusive. This review summarizes the current animal models and experimental studies employed to investigate its mechanism and explore novel therapeutic targets.

Uncorrected refractive errors are the main cause of visual impairment, and correcting refractive errors, especially wearing glasses, is a cost-effective and simple and feasible intervention. To this end, the World Health Organization (WHO) has formulated the WHO SPECS 2030 Global Initiative (S stands for improving the accessibility of refractive error correction services, P stands for enhancing the capacity of practitioners to provide refractive error correction services, E stands for strengthening eye health awareness and education, C stands for reducing the cost of refractive error correction, and S stands for strengthening monitoring and research), calling for global action to make quality, affordable and people-centered refractive error correction services available to everyone WHO needs refractive error correction. This article introduces and interprets the five strategic pillars, objectives, quantitative indicators, three core modules and 10 action guideline toolkits of the WHO SPECS 2030 Global Initiative, as well as the monitoring tools of eye health service strategies and actions, for Chinese ophthalmologists to refer to and use in their work, aiming at promoting the improvement of China's eye health level and promoting the continuous development of global eye health.