Automatic diagnosis of diabetic retinopathy using vision transformer based on wide-field optical coherence tomography angiography

Diabetic retinopathy(DR)is one of the major causes of visual impairment in adults with diabetes.Optical coherence tomography angiography(OCTA)is nowadays widely used as the golden criterion for diagnosing DR.Recently,wide-field OCTA(WF-OCTA)provided more abundant information including that of the peripheral retinal degenerative changes and it can contribute in accurately diagnosing DR.The need for an automatic DR diagnostic system based on WF-OCTA pictures attracts more and more attention due to the large diabetic population and the prevalence of retinopathy cases.In this study,automatic diagnosis of DR using vision transformer was performed using WF-OCTA images(12 mm×12 mm single-scan)centered on the fovea as the dataset.WF-OCTA images were automatically classified into four classes:No DR,mild nonproliferative diabetic retinopathy(NPDR),moderate to severe NPDR,and proliferative diabetic retinopathy(PDR).The proposed method for detecting DR on the test set achieves accuracy of 99.55%,sensitivity of 99.49%,and specificity of 99.57%.The accuracy of the method for DR staging reaches up to 99.20%,which has been proven to be higher than that attained by classical convolutional neural network models.Results show that the automatic diagnosis of DR based on vision transformer and WF-OCTA pictures is more effective for detecting and staging DR.

Predictive visual field outcomes after optic chiasm decompressive surgery by retinal vessels parameters using optical coherence tomography angiography

AIM:To evaluate the predictive value of superficial retinal capillary plexus(SRCP)and radial peripapillary capillary(RPC)for visual field recovery after optic cross decompression and compare them with peripapillary nerve fiber layer(pRNFL)and ganglion cell complex(GCC).METHODS:This prospective longitudinal observational study included patients with chiasmal compression due to sellar region mass scheduled for decompressive surgery.Generalized estimating equations were used to compare retinal vessel density and retinal layer thickness preand post-operatively and with healthy controls.Logistic regression models were used to assess the relationship between preoperative GCC,pRNFL,SRCP,and RPC parameters and visual field recovery after surgery.RESULTS:The study included 43 eyes of 24 patients and 48 eyes of 24 healthy controls.Preoperative RPC and SRCP vessel density and pRNFL and GCC thickness were lower than healthy controls and higher than postoperative values.The best predictive GCC and pRNFL models were based on the superior GCC[area under the curve(AUC)=0.866]and the tempo-inferior pRNFL(AUC=0.824),and the best predictive SRCP and RPC models were based on the nasal SRCP(AUC=0.718)and tempo-inferior RPC(AUC=0.825).There was no statistical difference in the predictive value of the superior GCC,tempo-inferior pRNFL,and tempo-inferior RPC(all P>0.05).CONCLUSION:Compression of the optic chiasm by tumors in the saddle area can reduce retinal thickness and blood perfusion.This reduction persists despite the recovery of the visual field after decompression surgery.GCC,pRNFL,and RPC can be used as sensitive predictors of visual field recovery after decompression surgery.

Optical coherence tomography angiography of optic disc perfusion in non-arteritic anterior ischemic optic neuropathy

AIM：To compare the optic disc blood flow of non-arteritic ischemic optic neuropathy（NAION）eyes with normal eyes.METHODS：The optic disc blood flow densities of diagnosed non-acute phase NAION eyes（21 eyes,14 individuals）and normal eyes（19 eyes,12 individuals）were detected via Optovue optical coherence tomography angiography（OCTA）.The optic disc blood flow was measured via Image J software.Correlations between optic disc perfusion and visual function variables were assessed by linear regression analysis.RESULTS：The average percentage of the optic disc nonperfusion areas in the non-acute phase NAION patients（17.84%±6.18%）was increased,when compared to the normal control eyes（8.61%±1.65%）,and the difference was statistically significant（P〈0.01）.Moreover,there was a proportional correlation between the visual field mean defect（MD）and the optic disc non-perfusion area percentage,and the relationship was statistically significant（t=3.65,P〈0.01,R2=0.4118）.In addition,the critical correlation between the best corrected visual acuity（BCVA）and the optic disc non-perfusion area percentage was statistically significant（t=4.32,P〈0.01,R2=0.4957）.CONCLUSION：The optic disc non-perfusion area percentages detected via OCTA in NAION eyes were significantly increased when compared with the normal eyes.Both the BCVA and MD were correlated with the optic disc flow detected,revealing that OCTA may be valuable in the diagnosis and estimation of NAION.

Hydromassage of macular hole edges for large and persistent full-thickness macular holes

●AIM:To introduce the macular hole(MH)hydromassage technique as a potentially beneficial approach for the treatment of large or persistent MH.●METHODS:This retrospective observational case series comprised 16 consecutive patients(17 eyes)diagnosed with MH.Inclusion criteria involved a hole aperture diameter larger than 600μm or the presence of an unclosed MH larger than 600μm following the previous vitrectomy.Standard MH repair procedures were administered in all cases,involving the manipulation and aspiration of the hole margin through the application of water flow with a soft-tip flute needle.A comprehensive assessment was conducted for each case before and after surgery,and optical coherence tomography(OCT)images were captured at every follow-up point.●RESULTS:The mean preoperative aperture diameter was 747±156μm(range 611-1180μm),with a mean base diameter of 1390±435μm(range 578-2220μm).Following surgery,all cases achieved complete anatomical closure of MH,with 13 cases(76.5%)exhibiting type 1 closure and 4 cases(23.5%)demonstrating type 2 closure.No significant differences were observed in the preoperative OCT variables between the two closure types.Eyes with type 1 closure showed a significantly improved visual acuity(0.70±0.10,range 0.50-0.80)compared to those with type 2 closure(0.90±0.12,range 0.80-1.00,P=0.014).●CONCLUSION:The MH hydromassage technique demonstrates promising results,achieving acceptable closure rates in cases of large or persistent MH.This technique may serve as an effective adjunctive maneuver during challenging MH surgery.

A study of retinal parameters measured by optical coherence tomography in patients with multiple sclerosis

AIM: To investigate the difference of retinal nerve fiber layer (RNFL) thickness and macular fovea thickness/volume between multiple sclerosis (MS) patients and healthy normal individuals using optical coherence tomography (OCT) and assess its association with visual field parameters. METHODS: Thirty consecutive MS patients and 28 healthy controls were recruited in this prospective study. Comprehensive standardized ophthalmic examinations included visual acuity, cycloplegic refraction, intraocular pressure, gonioscopy, visual field, and RNFL thickness and macular fovea thickness/volume detection using Humphrey OCT. Mean values for the thickness of the peripapillary RNFL and macular volume were calculated. Associations between visual field parameters and RNFL thickness/macular volume were analyzed by Pearson correlation analysis. RESULTS: The RNFL thicknesses in each quadrant, the average macular thickness, and the average macular volume in MS patients were all less than those in healthy controls, with statistically significant differences. The RNFL thickness and macular fovea thickness/volume were greater in eyes without optic neuritis than in eyes with optic neuritis. The average visual field parameters had positive correlations with the RNFL thickness and negative correlations with macular parameters in MS patients. CONCLUSION: OCT measurements can effectively identify the nerve changes of MS patients, which provide more data for the diagnosis of MS.

Optical coherence tomography in ischemic optic neuropathy

Ischemic optic neuropathies are among the most common causes of sudden vision loss,especially in patients over age 50.The cause and prognosis of these disorders,and in particular non-arteritic anterior ischemic optic neuropathy,is poorly understood,and treatments remain poor in terms of restoring or preserving vision.Optical coherence tomography(OCT)and OCT angiography have allowed us to identify early and late structural changes in the optic nerve head and retina that may assist in predicting visual outcomes and may lead to greater understanding of pathogenesis and thus the development of effective medical interventions.

超广域SS-OCTA联合超广角激光扫描眼底成像对糖尿病视网膜病变的诊断价值

目的 超广域扫频源光学相干断层扫描血管成像(UWF SS-OCTA)联合超广角激光扫描眼底成像(UWF SLO)对糖尿病视网膜病变(DR)患者病变的检出率以及对DR分级诊断价值的研究。方法 横断面研究。招募在四川省人民医院眼科就诊的糖尿病患者。所有参与者都接受了UWF SS-OCTA、UWF SLO和荧光素眼底血管造影(FFA)检查,用于检测DR病变,包括微动脉瘤(MA)、视网膜内出血(IRH)、视网膜无灌注区(NPAs)、视网膜内微血管异常(IRMAs)、视网膜静脉串珠(VB)、视网膜新生血管(NVE)、视盘新生血管(NVD)及玻璃体积血(VH)。联合三类影像检查(以下简称三联影像)结果作为标准对照,对比不同影像两两联合对DR病变的检出率及对DR严重度分级的一致性。结果 共纳入101例175眼。与三联影像结果相比,UWF SS-OCTA联合UWF SLO对MA、IRH、NPAs、IRMAs、NVE、NVD及VH的检出率分别为91%、83%、77%、69%、27%、10%及12%,Kappa依次为0.812、1.000、1.000、1.000、0.986、0.970及1.000。与三联影像结果相比,UWF SS-OCTA联合UWF SLO对DR的严重度分级具有优异一致性(Kappa=0.943)。结论 UWF SS-OCTA联合UWF SLO能准确识别MA、IRH、NPAs、IRMAs、NVE、NVD及VH,对DR筛查及分级诊断准确性高,适用于临床上对DR的大规模筛查与管理。

青光眼患者随访电子化管理系统的初步设想

目的设想建立规范的青光眼患者随访电子化管理系统,解决青光眼患者病历资料比较分散、难以全面连续系统地阅读和分析的问题。方法选取1例原发性开角型青光眼患者连续10年的24 h眼压、视神经光学相干层析成像(OCT)及视野等数据进行分析并建立电子随访档案,通过曲线图、分布图及雷达图等实现各项数据的可视化。结果建立青光眼患者随访电子化管理系统,解决目前随访现状存在的问题,从而实现青光眼患者随访档案的电子化管理。结论建立青光眼患者随访电子化管理系统有助于青光眼患者的病情跟踪和分析,对青光眼临床医师的诊疗提供便利,对青光眼的诊治研究具有较大意义。

激光焊OCT熔深测量去噪及数据拟合方法研究

为了解决激光焊接熔深在线检测及光学相干光层析成像(OCT)熔深检测信号噪声多的问题,采用了一种百分位滤波加移动平均算法的熔深曲线拟合方法。通过光学相干光层析成像系统对304不锈钢匙孔焊过程进行了熔深在线检测,在使用百分位滤波从原始散点数据中提取出百分位熔深曲线过程中,发现该方法提取的百分位熔深曲线存在尖峰干扰噪声,通过移动平均算法对百分位熔深曲线进行低通滤波处理,最终从原始散点数据中提取拟合出OCT熔深测量曲线。结果表明,将OCT熔深测量曲线与焊缝纵抛面的实际熔深曲线进行对比,该方法获取OCT熔深测量曲线的测量精度最大提升了15%。该方法能从OCT原始散点数据中有效提取拟合出更为准确的OCT熔深测量曲线。

广域SS-OCTA下早期糖尿病性视网膜病黄斑区的改变

目的基于广域扫频光学相干断层扫描血管成像(SS-OCTA)观察早期糖尿病性视网膜病变(DR)黄斑视网膜微循环的改变及神经节细胞内丛状层(GC-IPL)结构的变化及其相关性。方法于2023年07月至2023年08月在安徽理工大学第一附属医院眼科共招募105例105眼DR患者,分为无DR组(NDR)53眼和轻至中度非增殖性DR组(NPDR)52眼两组,53例健康受试者作为对照组。采用SS-OCTA以黄斑为中心的12mm×12mm扫描成像并自动定量测算黄斑不同分区的浅层血管复合体(SVC)、深层血管复合体(DVC)的血管密度(VD)、灌注面积(PA),SVC的小血管密度(SVD)以及神经节细胞内从状层(GC-IPL)厚度,并进行相关性分析。结果与对照组相比,NDR组DVC中只有鼻侧象限PA差异有统计学意义(P=0.035);NPDR组除了SVC中VD的上、颞侧象限、PA的上象限、DVC中VD的鼻侧象限差异没有统计学意义(P=0.443、P=0.302、P=0.644、P=0.129),其余均有统计学意义(P<0.05)。与NDR组相比,NPDR组的SVC、DVC中平均VD、总PA以及各象限的和SVC中SVD平均以及各象限的差异均有统计学意义(P<0.05)。与对照组、NDR组相比,NPDR组鼻侧象限GC-IPL的差异均有统计学意义(P=0.020、P=0.003);与对照组相比,NDR组GC-IPL中的差异以及各象限无统计学意义(P=1.000)。在Spearman相关分析中,鼻侧象限GC-IPL与SVC中平均VD、总PA、SVD呈正相关性(r=0.438,P<0.001;r=0.417,P<0.001;r=0.439,P<0.001),中等相关;与DVC中平均VD、总PA呈正相关性(r=0.247,P=0.002;r=0.360,P<0.001),弱相关。结论随着DR进展,广域SS-OCTA可观察到视网膜微循环先代偿性增加后下降。浅层小血管的密度可作为临床前糖尿病视网膜病变早期客观检测影像学标志。早期DR视网膜微循环的改变和视网膜神经改变存在相关性。

OCT及OCTA观察垂体腺瘤患者黄斑区视网膜结构和微循环的改变

目的:应用光学相干断层扫描(OCT)及光学相干断层扫描血管成像(OCTA)观察垂体腺瘤(PA)患者黄斑区视网膜结构和微循环的改变。方法:横断面研究。纳入2021-09/2023-03在广东医科大学附属医院神经外科治疗的PA患者40例作为PA组,另选取年龄、性别相匹配的健康志愿者42例作为正常对照组,均进行视野、OCT和OCTA检查,并分析PA患者眼部参数的相关性。结果:PA组患者黄斑区视网膜各层血管密度(VD)均低于正常对照组,且黄斑区浅层血管复合体(SVC)-VD与神经节细胞复合体(mGCC)厚度(除内环鼻侧、外环下方)均呈正相关(P<0.05),黄斑区各象限mGCC厚度、视盘周围各象限视网膜神经纤维层(CP-RNFL)厚度与视野平均缺损(MD)值均呈负相关(P<0.05),中心凹无血管区(FAZ)面积与MD值呈正相关(P<0.05)。结论:OCT与OCTA检查相结合可以全面了解PA患者视网膜结构和微循环功能的微观变化,对评估PA患者术前视功能具有重要价值。

视盘黑色素细胞瘤病例报道1例并文献回顾

视盘黑色素细胞瘤(MCOD)是临床罕见的疾病,容易和脉络膜黑色素瘤相混淆,两者治疗方式截然不同,MCOD为良性疾病,存在恶性转化可能,因此与恶性疾病进行鉴别,及时发现肿瘤恶性转化对后续治疗至关重要。本文报道1例体积较大的右眼MCOD,最佳矫正视力为20/20,眼底照相可见右眼视盘区近似椭圆形的黑色肿物,边界不清,呈羽毛状;眼部B型超声可见右眼视盘上圆顶状隆起占位病灶;视野弓形缺损;光学相干断层扫描成像提示右眼神经节细胞层变薄;光学相干断层扫描血管成像提示右眼血流密度增高,脉络膜血流缺损。诊断考虑为MCOD,未进行干预治疗,观察随访4个月后,瘤体无明显变化,嘱患者每年定期复查。分析检查结果发现:弓形视野缺损区域与患眼神经节细胞变薄区域有一致性,与脉络膜血流缺损、视网膜黄斑区血管密度增高具有相关性。通过对此病历进行总结归纳,并回顾文献研究,为临床医生提供诊断依据。

静脉窦支架治疗难治性颅内压增高——神经眼科评估及预后

目的评估静脉窦支架(VSS)用于治疗国人难治性大脑假瘤综合征(PTCS)患者的疗效及安全性。方法单中心队列研究。纳入2019年3月—2022年6月在复旦大学附属眼耳鼻喉科医院神经眼科中心就诊的难治性PTCS患者并行VSS手术评估。收集患者人口学资料、术前及术后神经眼科检查包括视功能及光学相干层析成像(OCT)。结果共纳入评估患者11例(22眼),其中男性4例、女性7例,平均年龄为(50.00±11.88)岁(28~73岁),平均体重指数(BMI)为(24.67±2.36)kg/m2(21.8~28.0 kg/m2)。10例患者首诊表现为一过性视物模糊及耳鸣,3例患者头痛。术后8例患者视乳头水肿程度及视功能显著改善;3例高颅压晚期患者视神经萎缩及视功能稳定无进展。术后视盘周围神经纤维层(RNFL)厚度明显减低,而黄斑节细胞内丛状层复合体(GCIPL)稳定,未发现严重术后并发症。结论VSS用于治疗难治性PTCS有效且安全性好,尤其是早期行手术治疗。OCT测量GCIPL有助于预测疾病进展及预后。

光学相干断层扫描血管成像在常见眼底病诊断中的应用进展

光学相干断层扫描血管成像(OCTA)是近年来应用广泛的非侵入性眼底血管成像技术,与传统光学相干断层扫描相比,其分辨率更高,扫描速度更快。与眼底荧光素钠血管造影和吲哚菁绿血管造影相比,OCTA无需注射造影剂,检查时间短,可清晰显示视网膜和脉络膜的三维结构,在多种眼底内科疾病的诊疗中均显示了其优越性。虽然目前临床上OCTA不能替代眼底荧光血管造影,但在一定程度上仍是眼底疾病诊断中一项不可或缺的辅助检查方法,本文对近年来OCTA在老年性黄斑变性、视网膜静脉阻塞、糖尿病视网膜病变和中心性浆液性脉络膜视网膜病变等常见眼底内科病诊断中的应用进展进行综述。

非典型原发性闭角型青光眼误诊分析

目的总结非典型原发性闭角型青光眼的疾病特点,探讨误诊原因和防范措施。方法回顾性分析2020年8月—2022年10月收治的非典型原发性闭角型青光眼误诊5例的临床资料。结果本组5例中3例因无明显诱因单眼视力下降就诊;1例因头痛、眼胀就诊;1例因恶心、呕吐、眼眶轻微疼痛就诊。3例误诊为视神经炎,1例误诊为偏头痛,1例误诊为急性胃肠炎。误诊时间4~15 d。完善相关检查(眼压、视野、裂隙灯显微镜检查、前房角镜检查、视盘光学相干断层扫描)并结合患者症状,最终确诊为非典型原发性闭角型青光眼。4例行小梁切除术治疗,病情转归良好;1例拒绝手术,随访期间再次急性发作。结论非典型原发性闭角型青光眼临床表现多样且无典型症状,容易与其他内科疾病混淆,导致误诊。加强临床医生对非典型原发性闭角型青光眼的鉴别诊断能力,提高对该病的警惕性,可减少误诊。

不同年龄段中心性浆液性脉络膜视网膜病变患者患眼与对侧眼的影像学特征

目的:观察不同年龄段中心性浆液性脉络膜视网膜病变(CSC)患者患眼及其无症状对侧眼的影像学特征。方法:回顾性研究。选取2023-04/09在我院眼科确诊的CSC患者76例88眼及单眼CSC患者无症状对侧眼35例35眼纳入研究。根据年龄分为中青年组(<40岁)、中年组(40-50岁)和中老年组(>50岁),观察不同年龄段CSC患者患眼及其无症状对侧眼的影像学特征。结果:中青年组患者患眼中心凹下脉络膜厚度(SFCT)(487.30±83.33μm)明显大于中年组(414.17±96.02μm,P<0.05)和中老年组(409.4±107.42μm,P<0.05)。中老年组患者患眼脉络膜新生血管(CNV)发生率明显高于中年组(P<0.0167)。中青年组患者对侧眼SFCT(511.29±40.89μm)明显大于中老年组(364.76±82.26μm,P<0.05)。纳入患者患眼涡静脉吻合率高于90%,且对侧眼均存在涡静脉吻合或扩张。结论:不同年龄段CSC患者患眼及其无症状对侧眼影像学表现存在差异,SFCT普遍增厚,且随着年龄增长逐渐变薄,中老年患者患眼CNV发生率最高,同时,CSC患者患眼及其无症状对侧眼普遍存在涡静脉吻合及扩张。

Bruch's membrane opening-minimum rim width and visual field loss in glaucoma:a broken stick analysis

AIM：To determine the Bruch＇s membrane opening-minimum rim width（BMO-MRW） tipping point where corresponding visual field（VF） damages become detectable.METHODS：A total of 85 normal subjects and 83 glaucoma patients（one eye per participant） were recruited for the study.All of the patients had VF examinations and spectral-domain optical coherence tomography to measure the BMO-MRW.Total deviation values for 52 VF points were allocated to the corresponding sector according to the Garway-Heath distribution map.To evaluate the relationship between VF loss and BMOMRW measurements,a ＂broken-stick＂ statistical model was used.The tipping point where the VF values started to sharply decrease as a function of BMO-MRW measurements was estimated and the slopes above and below this tipping point were compared.RESULTS：A 25.9% global BMO-MRW loss from normative value was required for the VF loss to be detectable.Sectorally,substantial BMO-MRW thinning in inferotemporal sector（33.1%） and relatively less BMO-MRW thinning in the superotemporal sector（8.9%） were necessary for the detection of the VF loss.Beyond the tipping point,the slopes were close to zero throughout all of the sectors and the VF loss was unrelated to the BMO-MRW loss.The VF loss was related to the BMO-MRW loss below the tipping point.The difference between the two slopes was statistically significant（P≤0.002）.CONCLUSION：Substantial BMO-MRW loss appears to be necessary for VF loss to be detectable in patients with open angle glaucoma with standard achromatic perimetry.

Visual field defects and retinal nerve fiber layer damage in buried optic disc drusen: a new insight

AIM: To assess the association between buried optic disc drusen(BODD) location using spectral-domain optical coherence tomography(SD-OCT) and the location of associated visual field defects(VFD) using the Garway-Heath mapping.METHODS: This monocentric retrospective crosssectional study was led at the authors’ institution. Adult patients diagnosed with BODD who had complete records with a reliable Humphrey? 24-2 visual field, macular, and papillary OCT were enrolled. Fisher’s exact test was used to measure the association between BODD location and VFD distribution according to Garway-Heath’s mapping.RESULTS: Totally 20 eyes of 15 patients were included(60% females). The median age(interquartile range) was 63(43)y and the median best corrected visual acuity(BCVA) was-0.08(0.08) log MAR. BODD were mostly located in zones A, E, and F. The minimal rim width(MRW) was globally preserved. The retinal nerve fiber layer(RNFL) was predominantly altered in zones D, E, and F. There was a significant correlation between BODD location and that of RNFL alterations in zones D(P=0.03) and E(P=0.025);Moreover, the presence of BODD in the E zone was significantly related to damaged RNFL in the neighbouring sectors D and F(P=0.012;P=0.02 respectively). Sixty-three percent(12/19) of visual fields were abnormal and there was a significant match(Phi=0.7, P=0.009) between drusen location and VFD only in zone D.CONCLUSION: BODD do not only affect young patients and can be more harmful than usually expected, as we found VFD in 63% of cases. There is a correspondence between BODD location, RNFL damage, and VFD distributions. The presence of BODD induces the overestimation of MRW,thereby disrupting its sensitivity as an early indicator of ganglion fibers damage.

仿鹰视顶盖的眼底OCT图像重建方法

客观因素导致临床获得的眼底OCT图像存在对比度差、病灶区域边缘模糊等现象.为解决上述问题,借鉴鹰视觉系统的信息处理机制,提出单幅OCT图像的超分辨率重建方法EOTRN.它仿照鹰眼视顶盖逐步扩大感受野的思路,从纵、横两维度逐级挖掘高级语义特征.纵向维度上借助空洞卷积、密集连接、通道注意力实现感受野逐步扩大、不同网络层特征传播及不同通道特征间的“竞争”与“合作”,完成低频信号的高级语义特征的初步提取.横向维度上借助64个特征子空间剔除高级语义特征中的冗余信息,校正并突出显著信息,实现病灶区域的纹理、轮廓特征强化.最后对底层语义特征和高级语义特征进行上采样和深层重建,得到高清OCT图像.仿真表明,在×4放大倍数时,EOTRN对测试集3的PSNR和SSIM值比EMASRN分别提高了0.96%和1.36%,重建图像能够突出细节信息,真实反映眼底健康状况.EOTRN的参数量较少,适用于嵌入式系统的部署,实现眼底OCT图像的实时超清重建.

青光眼常用检查设备规范操作指南(2023)

青光眼是一种进行性视神经病变,也是位列首位的不可逆致盲性眼病,尽早明确诊断对于该病的防治至关重要。规范青光眼常用检查设备的操作可以提高青光眼检查结果的准确性,有助于眼科医生,尤其青光眼专科医生,更好地掌握青光眼常用检查方法,减少青光眼患者的误诊和漏诊,对青光眼的防治具有重要意义。本指南总结了青光眼的常用检查设备的规范操作,为规范青光眼的常用检查方法、提高基层医疗青光眼诊断效能提供参考指南。