R —— Retina推荐PERSISTENT LOCULATED SUBRETINALFLUID AFTER RHEGMATOGENOUS RETINAL DETACHMENT SURGERY孔源性视网膜脱离术后持续性视网膜下积液Purpose：To identify factors associated with persistent subretinal fluid (SRF) after small-gauge pars plana vitrectomy for primary rhegmatogenous retinal detachment.目的：为了确定原发性孔源性视网膜脱离患者用微创玻璃体切除术治疗后的持续性视网膜下液（SRF）的相关因素。Methods：This retrospective study included patients from 2 tertiary centers whounderwent pars plana vitrectomy for repair of rhegmatogenous retinal detachment between2013 and 2016. Preoperative and intraoperative parameters were examined for associationwith development of SRF.方法：这项回顾性研究包括来自2013年至2016年间行平坦部玻璃体切除术修复孔源性视网膜脱离的两个三中心的患者。检查了术前和术中参数与SRF发生的相关性。Results：Overall, 153 eyes of 153 patients, mean age of 55.2 ± 17.9 years were included. Persistent SRF occurred in 15.0% (n = 23) and was associated with high myopia (65.22 vs. 26.15%, P , 0.001), macula-involving retinal detachment (91.30 vs. 66.15%, P = 0.02), phakic lens status (86.96 vs. 66.15%, P = 0.04), and younger age (47.8 ± 18.7 vs. 56.5 ± 17.5, P = 0.04) while drainage retinotomy was protective (13.04 vs. 34.11%, P = 0.04). In multivariate analysis, high myopia (P = 0.009) and macula-involving retinal detachment (P = 0.004) were associated with SRF, while drainage retinotomy was protective (P = 0.03). Persistent SRF was associated with outer retinal band irregularity (30.4 vs. 9.3%, P = 0.005). There were no significant differences in terms of change in best-corrected visual acuity from presentation (P = 0.70), or final best-corrected visual acuity (P = 0.54).结果：总共纳入153例患者的153眼，平均年龄为55.2±17.9岁。持续性SRF发生率为15.0%（n=23），与高度近视（65.22 vs.26.15%，P，0.001）、黄斑部视网膜脱离（91.30 vs.66.15%，P=0.02）、晶状体状态（86.96 vs.66.15%，P=0.04）和较年轻（47.8±18.7 vs.56.5±17.5，P=0.04）有关，而引流性视网膜切开术是保护性的（13.04 vs.34.11%，P=0.04）。在多变量分析中，高度近视（P = 0.009）和累及黄斑的视网膜脱离（P = 0.004）与SRF相关，而引流性视网膜切开术具有保护性（P = 0.03）。持续性SRF与视网膜外带不规则相关（30.4对9.3％，P = 0.005）。从呈现的最佳矫正视力（P = 0.70）或最终最佳矫正视力（P = 0.54）的变化来看，无显着差异。Conclusion：Eyes with preoperative high myopia and macular involvement, and those inwhich a drainage retinotomy was not performed, were more likely to develop persistent SRF.结论：术前高度近视和视网膜脱离面积累及黄斑的眼以及未进行视网膜切开术引流的眼更有可能发生持续性SRF。推荐理由:文章讨论了确定原发性孔源性视网膜脱离患者用微创玻璃体切除术治疗后的持续性视网膜下液（SRF）的相关因素。结果显示，持续性SRF与高度近视，在多变量分析中，高度近视和累及黄斑的视网膜脱离与SRF相关。文章特别之处在于，作者创新性的参考了多个不同的眼科疾病，通过不同的疾病与SFR相关性来对比，并且通过数理统计，得出术前高度近视和黄斑受累眼以及未进行引流视网膜切开术眼与SFR密切相关，即高度近视、晶状体状态和低年龄关联不大。该文章存在一定的局限性。一方面其样本取样主要年龄集中在年龄为55.2±17.9岁，缺乏低龄组对照；另一方面，研究时间仅做了2013-2016三年时间，需要更长观察时间和频次的数据来支撑。另外，该文章变量关于对侧眼情况的影响没有纳入研究。
I —— Investigative Ophthalmology & Visual Science 推荐Increased Glial Fibrillary Acid Protein and Vimentin in Vitreous Fluid as a Biomarker for Proliferative Vitreoretinopathy玻璃体液中胶质纤维酸性蛋白和波形蛋白的增加是增殖性玻璃体视网膜病变的生物标记Purpose：Glial fibrillary acid protein (GFAP) and vimentin are type III intermediate filament proteins, ubiquitously expressed in retinal glial cells. Under retinal stress, both GFAP and vimentin are well-known sensitive markers for retinal gliosis. However, little is known about whether these proteins are released into the vitreous body in response to retinal gliosis or are related to the severity of retinal gliosis seen in proliferative vitreoretinopathy (PVR).目的：胶质纤维酸性蛋白（GFAP）和波形蛋白是III型中间丝蛋白，普遍表达在视网膜神经胶质细胞中。众所周知，在视网膜应急状态下，GFAP和波形蛋白是视网膜胶质增生的重要标记。然而，对于这些蛋白是由于视网膜胶质增生而释放到玻璃体中，还是与增生性玻璃体视网膜病变（PVR）中视网膜胶质增生的严重程度有关，目前还知之甚少。Methods：Vitreous fluids were collected from 44 patients who underwent pars plana vitrectomy for macular hole (Group 1; n = 8), epiretinal membrane (Group 2; n = 8), or retinal detachment (RD) with various degrees of PVR (Group 3; n = 28). The severity of PVR was determined by cumulative scores using PVR classification. GFAP, vimentin, and total protein levels from the vitreous samples were measured.方法：收集了44例接受玻璃体平坦部切除术患者的玻璃体液，这44个入选患者病因分别是黄斑裂孔(第1组；8例)、黄斑区视网膜前膜(第2组；8例)，或伴有不同程度PVR的视网膜脱离(RD)(3组；28例)。PVR的严重程度通过PVR分类的累积分数来确定。测定样本的GFAP、波形蛋白和总蛋白水平。Results：Both GFAP and vimentin levels were significantly elevated in vitreous fluid from Group 3 (RD) compared with Groups 1 and 2 (P < 0.01). GFAP levels (ng/mL) were 12.4± 9.8, 17.5 ± 17.7, and 572.0 ± 11659.7, and vimentin levels (ng/mL) were 40.8 ± 61.9, 88.6 ± 86.8, and 3952.8 ± 8179.5 in Groups 1, 2, and 3, respectively. Total protein levels were not significantly different among the three groups. Elevated GFAP and vimentin levels in Group 3 were positively correlated with the areas of RD (P < 0.01, r = 0.53 in GFAP and P < 0.05, r = 0.46 in vimentin) and PVR scores (P < 0.05, r = 0.46 in GFAP and P < 0.00001, r = 0.76 in vimentin).结果：与第1组和第2组相比，第3组（RD）的玻璃体液中GFAP和波形蛋白的水平均显着升高（P <0.01）。1、2、3组GFAP水平(ng/mL)分别为12.4±9.8、17.5±17.7、572.0±11659.7，波形蛋白水平(ng/mL)分别为40.8±61.9、88.6±86.8、3952.8±8179.5。三组间总蛋白水平无显著差异。第三组的GFAP和波形蛋白水平升高与RD的面积（GFAP的P <0.01，r = 0.53，波形蛋白的P <0.05，r = 0.46）和PVR评分（GFAP的P <0.05，r = 0.46 ，波形蛋白的P <0.00001，r = 0.76）呈正相关。Conclusion：Our data suggest that human vitreous GFAP and vimentin are protein biomarkers for PVR, and reactive gliosis may play a part in PVR formation.结论：数据表明，人玻璃体GFAP和波形蛋白是PVR的标志蛋白，反应性胶质增生可能诱导了PVR的形成。推荐理由：本研究中对比了黄斑裂孔(组1)、黄斑区视网膜前膜(组2)和不同程度PVR的视网膜脱离(RD)(组3)三组接受PPV患者的玻璃体液中胶质纤维酸性蛋白(GFAP)、波形蛋白和总蛋白水平，以及三种蛋白水平与RD面积、PVR评分的关系。结果显示，三组间总蛋白水平无显著差异，组3中GFAP和波形蛋白水平较其他2组均显著升高，且与RD面积和PVR评分呈正相关。本研究是第一个证明玻璃体GFAP和波形蛋白升高与PVR严重程度相关的研究，在尚无PVR治疗方法的现在，早期识别和预防PVR形成对于防止视力的进一步丧失是很重要的。该研究表明，RD后玻璃体内GFAP和波形蛋白水平升高可能是PVR形成的标志，这种情况下的患者需要更积极的治疗和预防。本研究的局限性在于患者数量较少，玻璃体GFAP和波形蛋白缺乏正常生理价值，眼球的横断面设计限制了研究者来进一步分析这些蛋白的来源或这些蛋白在视网膜脱离和PVR中的因果关系。未来需要进一步研究GFAP和波形蛋白在形成PVR过程中的作用。
O —— Ophthalmology 推荐Myopia and Childhood Migration:A Study of 607 862 Adolescents近视与儿童迁移:一项607862名青少年的研究Purpose：Immigration studies can shed light on myopia development and reveal high-risk populations. To this end, we investigated the association among immigration, age at immigration, and myopia occurrence during adolescence.目的：移民研究可以揭示近视的发展和高危人群。为此，我们调查了移民、移民年龄和青少年近视发生率之间的关系。Design：Population-based, retrospective, cross-sectional study.设计：基于人群的,回顾性横断面研究。Participants：Six hundred seven thousand eight hundred sixty-two adolescents, Israeli born and immigrants, with origins in the former Union of Soviet Socialist Republics (USSR), Ethiopia, or Israel, assessed for medical fifitness for mandatory military service at 17 years of age between 1993 and 2016.参与者：入选出生于以色列的或生于前苏维埃社会主义共和国联盟（苏联）、埃塞俄比亚后移民以色列的六十七千八百六十二名青少年，这些入选青少年是在1993年至2016年期间满足年满17岁的强制服兵役的进行医疗能力评估的人。Methods：Myopia and high myopia were defined based on right eye refractive data. Age at immigration was categorized into 0 to 5 years of age, 6 to 11 years of age, and 12 to 19 years of age. Univariate and multivariate logistic regression models were created. Myopia odds ratios (ORs) were calculated according to immigration status, with Israeli-born natives as controls. Next, myopia ORs were calculated according to age at immigration, with Israeli-born of same origin as controls. Main Outcome Measures: Myopia prevalence and ORs.方法：根据右眼屈光度度数，定义近视眼和高度近视眼。移民年龄分为0至5岁、6至11岁和12至19岁三组。建立了单变量和多变量logistic回归模型。近视发病率（ORs）根据移民身份计算，以以色列出生的本地人为对照。其次，根据移民年龄计算ORs，对照组为出生在同一时间的以色列人。主要观察指标：近视发病率和ORs。Results：Myopia was less prevalent among immigrants than Israeli-born controls. When stratifified according to age at immigration, a decrease in myopia prevalence and ORs with increasing age at migration were observed, most prominent in immigrants arriving after 11 years of age, who also showed lower high-myopia ORs. The immigrants from the USSR and Ethiopia arriving after 11 years of age showed a myopia OR of 0.65 (95% con- fifidence interval [CI], 0.63e0.67; P < 10e205) and 0.52 (95% CI, 0.46e0.58; P < 10e27) compared with the Israeliborn controls. Notably, Ethiopians arriving earlier than 5 years of age showed a 2-fold higher myopia OR than those migrating after 11 years of age.结果：与以色列出生的对照组相比，近视在移民中的发病率较低。按移民年龄分层后，近视发病率和ORs 随移民抵达年龄的增加而降低，以11岁以后移民的高度近视ORs最为显著。与以色列对照组相比，来自苏联和埃塞俄比亚的移民在11岁以后出现近视的比例为0.65（95%置信区间[CI]，0.63e0.67；P<10e205）和0.52（95%置信区间，0.46e0.58；P<10e27）。值得注意的是，早于5岁到达的埃塞俄比亚人近视率是11岁以后移民的2倍。Conclusion：Immigrants arriving after 11 years of age showed markedly lower ORs for myopia and high myopia relative to Israeli-born controls or those arriving during early childhood, likely because of environmental and lifestyle changes. Differences between immigrants arriving up to 5 years of age and those arriving between 6 and 11 years of age were relatively smaller, suggesting exposures at elementary school age play a greater role in this population.结论：与以色列出生的对照组或儿童早期抵达的移民相比，11岁后抵达的移民近视和高度近视的ORs明显较低，这可能是由于环境和生活方式的变化。5岁以下的移民与6岁至11岁的移民之间的差异相对较小，这表明小学年龄段的接触因素在这一人群中发挥了更大的作用。推荐理由：青少年的视力健康关系着祖国的未来，位处于当代计算机时代背景下，了解青少年近视因素对保护青少年视力至关重要。文章通过入选大量青少年17岁体检数据，对青少年的近视发病率和移民年龄进行了对比分析。得出结论，在以色列本土孩子中，具有较高的发病率，而移民年龄在11岁以后的孩子，近视的发病率相对低一些。暗示以色列的本土小学年龄段的相关接触因素对近视率的增加具有相关性。文章采用样本量充足，数据具有可靠性。通过设立多个对照，确定了生存环境的改变对视力的间接影响是毋庸置疑的，暗示我们关注环境改变对青少年的影响，尤其是多媒体时代的不断改变，即便我们同处一个环境，也要关注多年前的环境和当代环境对青少年的视力影响。文章的局限性在于，文章只有眼睛屈光度数据与移民年龄数据，对于相关的环境因素、教育因素和社会因素都没有设计，未来针对这一点可以考虑进行进一步的原因分析。三篇论文原文已放在百度网盘中，点击“链接”，输入提取码：bp9j ，即可下载论文。
