中国临床视觉电生理学相关术语专家共识(2023年)

视觉电生理检查是评估视功能的客观方法, 是眼科临床检查的重要内容之一, 广泛用于疾病的诊断、鉴别诊断、随访和视功能鉴定。中华医学会眼科分会视觉生理学组和中国医师协会眼科医师分会视觉生理学组基于国际临床视觉电生理学会近年发布的多个标准和指南, 结合我国临床实践和近年研究进展, 针对中国临床视觉电生理学检查术语达成共识性意见, 以期帮助广大眼科工作者规范使用临床视觉电生理学术语, 进一步推进我国眼科临床视觉电生理学检查工作规范化。     

儿童视觉电生理检查

儿童尤其是婴幼儿的临床视觉电生理检查不同于成年人，其结果解读也不同，这是由于婴幼儿的视路以及相应的电生理发育都有一个成熟的过程。充分了解视路的发育过程以及电生理的成熟过程，结合不同年龄阶段儿童的身心特点，采用相应的检查方式，并根据相应年龄段的正常参考反应，结合临床需求，才能更好地进行儿童临床视觉电生理的检查和评估。（眼科， 2018, 27: 325-330）         

正确使用视觉电生理技术提高其临床应用价值

二十世纪是临床视觉电生理在眼科应用中开拓的时代 ,在这个时期 ,随着科学技术的发展 ,临床视觉电生理经历了开创、繁荣和深化的阶段 ,目前临床视觉电生理已成为眼科临床检查的重要手段之一 ,提供了从视网膜至视皮层无创伤性的、客观的、定量的、定位的视功能测试方法。临床视觉电生理包含内容丰富 ,测试项目繁多 ,操作技术易难不一 ,仪器品种多样 ,正确使用视觉电生理技术 ,提高其临床应用价值 ,已为眼科医生和有关工作者密切关注。1　正确认识和运用多焦视网膜电图和多焦视诱发电位　　二十世纪九十年代初 Sutter等研制了一种多焦视网膜…     

《罗兰视觉电生理仪测试方法和临床应用图谱学》一书出版

由中山大学中山眼科中心视觉电生理专家吴德正教授与北京同仁眼科中心刘妍博士主编的《罗兰视觉电生理仪测试方法和临床应用图谱学》一书已由北京科学技术出版社出版。该书通过电生理图形、眼底图片等方式，详细阐述了视觉电生理的临床应用，内容涉及临床上与视觉电生理有关的许多疾病；     

举办临床视觉电生理讲习班

1986年11月17-20日,广州中山眼科中心眼科研究所视觉生理室举办了临床视觉电生理讲习班,全国13个省、市、自治区的43名眼科医师和技术人员到会。这次讲习班就临床视觉电生理记录标准化问题,视网膜电图(ERG)、视觉眼电图(EOG)、视诱发电位(VEP)的基础和临床应用,以及视觉电生理仪器原理和使用方法等     

临床视觉电生理检测在我国的发展与推广

临床视觉电生理检测在我国的发展与推广曾丽芳我国５０年代到６０年代中期，北京、上海、广州等地少数眼科先后开展了视网膜电图检测，个别医学院校的眼科通过研究生培养，培训了一些专业人员，有的还开办过视觉电生理学习班，在眼科杂志上也有少数视网膜电图应用和研究的...     

视神经萎缩的闪光视觉诱发电位检查所见

视神经萎缩是眼科临床常见病变,可由多种原因所致。在对视神经萎缩患者的视功能进行判断时,除了传统的视力,视野检查等手段外,近年来逐渐将视觉电生理检查技术应用于其中,视觉诱发电位检查则是最常用的一种视     

临床视觉电生理的进展

二十世纪是临床视觉电生理在眼科应用中开拓的时代,在这个时期,随着科学技术的发展,临床视觉电生理经历了开创、繁荣和深化的阶段,目前临床视觉电生理已成为眼科临床检查的重要手段之一,提供了从视网膜至视皮层无创伤性的、客观的、定量的、定位的视功能测试方法。以下将从三个方面来评述临床视觉电生理的重要进展,特别阐述最新进展—多焦视网膜电图(ｍｕｌｔｉｆｏｃａｌｅｌｅｃｒｅｏｒｅｔｉｎｏｇｒａｍ,ＭＥＲＧ)和多焦视诱发电位(ｍｕｌｔｉｆｏｃａｌｖｉｓｕａｌｅｖｏｋｅｄｐｏｔｅｎｔｉａｌ,ＭＶＥＰ)的基本原理和临床应用,以…     

电刺激在视网膜退行性疾病治疗中的研究进展

视网膜病变和视神经损伤导致视觉信息无法正常传递到视觉中枢，对患者的视觉功能以及生活质量产生严重影响。临床工作中常见的眼部疾病如青光眼、外伤性视神经病变、视网膜色素变性等均伴有视网膜神经元和/或视神经的退行性病变，而目前临床上常用的神经保护疗法疗效非常有限。近年研究表明，电刺激对视网膜和视神经具有神经保护和促进再生的作用。本文通过对电刺激在眼科应用的进展进行综述，总结电刺激治疗的相关机制，推动电刺激在眼科疾病研究和应用中的发展。     

MVT系列多功能多导程视觉电生理仪研制

ＭＶＴ系列多功能多导程视觉电生理仪研制蔡浩然作者单位：１０００３４北京医科大学第一医院儿童视觉研究中心前言在眼科临床和科研上，使用视觉电生理指标，作为诊断和研究眼科一些疑难病手段越来越广泛，其中尤其是视觉诱发电位（ＶＥＰ）、视网膜电图（包括闪光ＦＥ...     

眼科临床见习教学的体会

眼睛的局部解剖精细复杂,专业特点强,眼科检查必须采用特殊的器械设备,加上眼科理论教学课时数少,都给眼科教学带来了困难.针对这些情况,我们教研室对临床医学专业八年制学生的眼科学临床见习教学环节进行了改进,注重理论与实践教学的衔接,取得了一些成功的教学经验.     

PBL教学在眼科临床实习教学中对临床思维能力的培养

目的：探讨以问题为导向的教学方法(problem-based learning,PBL)在眼科临床实习教学中培养学生临床思维的教学效果。

方法：选取2017/2018年上学期参加眼科学课程学习的临床本科学生141人,参加临床实习课时随机分为传统教学组(lecture based learning,LBL)69人及PBL模式教学组72人。两组学生前期所学课程相同,高考入学成绩、性别、年龄、眼科实习时间差异均无统计学意义(P>0.05)。实习结束通过学生课评问卷调查及临床考核成绩两种形式比较分析两种教学方式的教学效果。

结果：学生对课程各种能力的培养满意度评价显示：参与PBL教学组各能力满意度均高于LBL组。其中学习兴趣提升、知识拓展能力、解决问题能力及医患沟通能力差异具有统计学意义(P<0.05)。临床考核成绩中病例分析与技能操作两项PBL组高于LBL组,差异有统计学意义(P<0.05)。

结论：PBL教学法在眼科临床实习教学中的效果显著,有利于临床思维培养并提高教学质量。     

Teaching of ophthalmology in undergraduate curricula: a survey of Australasian and Asian medical schools

BACKGROUND: Despite established international guidelines on preferred teaching components for ophthalmology in undergraduate curricula, with increasingly less specialty-based undergraduate teaching within curricula, teaching of core ophthalmology knowledge and skills may become marginalized. This survey aims to evaluate the current state of undergraduate ophthalmology teaching in Australasia and proximate Asian medical schools. METHODS: A questionnaire was developed to determine the content and extent of ophthalmology teaching in the undergraduate medical curriculum. The questionnaire was sent to 25 medical schools throughout Australasia and Asia. RESULTS: Nineteen of the 25 questionnaires were returned (76% response rate). Ophthalmology teaching programmes ranged from 2 to 20 days: five (26%) medical schools having one ophthalmology attachment; six schools (32%) two attachments; and the remainder three or more. Only seven of the schools taught all 13 ophthalmology topics recommended in current curriculum guidelines. Ocular examination (100%), lens and cataract (95%) and ocular manifestations of systemic disease (95%) were the most commonly taught topics, with intraocular tumours only covered by 10 schools (53%). Students in 14 schools (74%) attended ophthalmology operating theatre, but only two schools (11%) offered attendance at optometry clinics. Ten schools (53%) required a pass in ophthalmology to complete the academic year. CONCLUSION: Ophthalmology may increasingly be a small, or even absent, component of undergraduate medical curricula. Despite established international ophthalmology curriculum guidelines, this survey highlights significant lack of uniformity in their implementation.     

University of Toronto's redesigned ophthalmology curriculum and eye dissection lab

ObjectiveTo present a multifaceted approach to ophthalmology undergraduate medical education and to assess the efficacy of an eye dissection laboratory in enhancing medical student learning.DesignCurriculum review, validation, and student feedback evaluations.ParticipantsYear 2 medical students enrolled in the University of Toronto's Doctor of Medicine Program.MethodsStudent feedback evaluations were compiled from the University of Toronto undergraduate medical education student surveys before 2012–2016 and following introduction of the redesigned foundations ophthalmology curriculum at the University of Toronto (2017–2018). Students who participated in the Eye Dissection Lab as part of the newly designed curriculum completed the pre- and postsession satisfaction and overall interest in ophthalmology questionnaires and a knowledge-based test.ResultsAnalysis of 1640 student evaluations demonstrated an increase in ophthalmology curriculum rating following the launch of the foundations ophthalmology curriculum (p = 0.015). Among the 335 students who completed the eye dissection lab, there was a significant increase in the average scores for the satisfaction questionnaire, knowledge-based test, and level of interest in the field of ophthalmology from before and after the session, with improvements in scores noted in 91%, 42%, and 36% of the educational parameters of the participants, respectively (p < 0.001).ConclusionsThe newly designed foundations ophthalmology curriculum and the eye dissection lab at the University of Toronto serve as effective means for enhancing ophthalmology teaching in medical schools across Canada.     

智能手机图像采集在眼科住院医师规范化培训教学实践中的应用

目的：探讨智能手机自带的图像及视频采集功能配合裂隙灯检查在眼科住院医师规范化培训教学中的应用。

方法：利用手机支架将智能手机与裂隙灯显微镜一侧目镜相连接,通过调节裂隙灯光带配合前置镜、三面镜、房角镜的使用获取清晰图片或动态视频,然后在教学活动中使用无线局域网络连接、微信等软件,将影像资料传输给眼科规范化培训医师进行学习与交流,考核评价教学效果。

结果：智能手机图像采集功能配合裂隙灯检查所获得的照片及动态视频能够清晰地显示眼部组织及病变特点; 影像资料的快捷传输可以让更多的学生同时受到教育,及时互相交流; 与传统裂隙灯检查教学方式相比很大程度上提高了规培生的学习兴趣、学习参与度及学习效率。

结论：手机支架购买方便,简单易得,高像素的智能手机普及广泛,成像质量完全可以满足临床教学需要且丰富了临床教学资源; 智能手机图像采集功能配合裂隙灯检查在眼科住院医师规范化培训教学实践中值得推广。     

新的眼科临床考核模式探索

目的为促进以学生有效掌握理论知识,提高临床实践能力,通过新的眼科临床教学考核模式的探索,为临床教学模式的变革积累相关经验。方法 (1)实施基础:依托我科目前的眼科检查设备,常见眼科疾病的各项临床资料均可以通过相关检查设备进行采集、保存;(2)考核环境的建立:基于上述基础,通过临床病例题库的建立,相应的考核软件的编制,基于网络平台,建立模拟临床环境的考核环境;(3)初步实践:进行基于网络的新的考核模式的实际应用,获得相关反馈。结果 (1)以CBL教学理念,初步建立基于临床病例的考核题库;(2)通过信息技术,建立了基于网络平台的临床模拟考核系统;(3)进行相关初步实践,获得反馈信息。结论新的以临床为导向的眼科考核模式将有助于培养医学生的临床实践能力,有助于推动目前的临床教学模式改革的探索。     

多种教学方法在眼科教学中的探索

【摘要】 在医学生的眼科学教学过程中,采用多媒体等形式,开展课堂互动式、讨论式教学,引入并培养循证医学思维,使医学生对眼科学的学习兴趣、学习主动性进一步提高,在掌握教学大纲要求的基础上具备了一定的临床、教学综合能力。以学生为主体多种教学方法合理的应用对提高眼科教学质量具有重要作用。（眼科,2012,21：286-288）     

An analysis of undergraduate ophthalmology training in Canada

Objective: To investigate the adequacy of undergraduate ophthalmology education in Canada in comparison with the International Council of Ophthalmology (ICO) guidelines.Design: Cross-sectional survey.Participants: First-year residents who had graduated from Canadian medical schools.Methods: Eligible residents were invited to participate in an online survey in 2007. Data were categorized by demographic variables, and basic statistics were done.Results: Responses were obtained from 386 of the 1425 individuals (27.0%) contacted. The majority (64.0%) stated they had “too little” or “no exposure” to ophthalmology in medical school. The majority (76.2%) of respondents stated that they had had 1 week or less of overall exposure to ophthalmology. Sufficient exposure to several ICO core subspecialty areas was reported, including lens/cataract (81.1%) and cornea/external diseases (81.6%); however, some areas did not receive adequate time allocation, such as vitreoretinal disease (41.9%). Similarly, competency was obtained in certain ICO examination skills, including assessment of visual acuity (83.3%) and pupillary reflexes (90.7%) but was not achieved for other skills, such as fundoscopy (52.3%), slit-lamp examination (44.8%), and intraocular pressure assessment (19.9%). When asked whether sufficient ophthalmology knowledge and skills had been obtained during medical school, only 42.9% and 25.9% agreed, respectively.Conclusions: Undergraduate ophthalmology training in Canada contains gaps in certain key areas. Developing a national, standardized curriculum could ensure that medical students acquire competency in the ophthalmology knowledge and skills required for future clinical practice.     

整合医学概念在眼科临床问题为导向教学中的应用

为了提高临床眼科教学效果, 探讨在整合医学理念下开展问题为导向（problem-based learning,PBL）教学法的改革实践。选择全身疾病的眼部表现章节为主要内容,以学生为中心的教育方式,分组分内容进行准备,课程后通过教学评估系统进行教学效果评价并与以往比较,发现评估分值明显提高。因此,PBL教学方法结合整合医学知识更适合于眼科临床课程教育阶段的医学生,使学生们树立整体与局部、眼与全身的理念,提高学生的自主学习能力。     

提升眼科教学质量的思考

如何在有限的教学课时内提高眼科学的教学质量一直是眼科教学工作者的研究课题。本文就调动学生的学习兴趣、适时修订教学大纲、执行集体备课、更新多媒体课件、培养高素质的眼科教师队伍及健全教学规章制度等提出几点思考。