眼底疾病临床创新研究模式:六要素,三个一  

Clinical innovation research model for fundus diseases:6 elements,3 ones

作　　者：文峰[1] 张雄泽 李妙玲 甘雨虹 苏永悦 WEN Feng;ZHANG Xiongze;LI Miaoling;GAN Yuhong;SU Yongyue(State Key Laboratory of Ophthalmology,Zhongshan Ophthalmic Center,Sun Yat-sen University,Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science,Guangzhou 510060,China)

机构地区：[1]中山大学中山眼科中心,眼病防治全国重点实验室,广东省眼科视觉科学重点实验室,广州510060

出　　处：《眼科学报》2025年第2期85-95,F0002,共12页Eye Science

摘　　要：“六要素,三个一”是眼底影像基础阅片工作中进行眼底疾病临床创新性研究的模式要点,即在眼底阅片过程中捕捉到1个异常的病例后,通过积累病例、提炼特征、文献检索、寻同查异,进而扩展到1组病例,最后通过思辨创新,提出或完善1种新的疾病或疾病表征。近二十年来,在此模式的指导下,团队在眼底疾病研究工作中取得了一些原创性的成果:比如息肉状脉络膜血管病变的认识及其在国人新生血管性年龄相关性黄斑变性中发病比例第一,提出点状内层脉络膜病变病灶国际分期和命名新亚型,年龄相关的吲哚菁绿血管造影晚期散在弱荧光点揭示潴留性视网膜色素上皮脱离的发病机制,发现急性黄斑神经视网膜病变是登革热患者视力下降的主要原因,在全球最大的持续性鳞状黄斑病变的病例系列中明确病灶层次等创新性成果。“六要素”框架规范眼底影像研究流程,强调研究过程的严谨性与渐进性,且多次循环后衍生发散出更多研究线索和思路,极大拓展研究深度和广度。“三个一”路径体现了研究的层次性,从个体现象(点)到群体规律(线),最终构建疾病认知的立体网络(面);指导眼底异常影像征象、罕见病、新病种研究,加速疾病谱系完善。以“六要素”为纲,以“三个一”为略,将继续推动眼底疾病临床研究的创新与突破。The"6 Elements,3 Ones"constitutes a methodological framework for conducting innovative clinical research of ocular fundus diseases in foundational fundus imaging interpretation.This model emphasizes:1)identifying a single abnormal case during routine fundus evaluation;2)systematically expanding this observation into a case series through case accumulation,feature extraction,literature review,and comparative analysis;and 3)ultimately proposing or refining novel disease entities or manifestations through critical thinking and innovation.Over the past two decades,guided by this paradigm,our research team has achieved several original breakthroughs in fundus imaging studies,including:establishing polypoidal choroidal vasculopathy as the predominant subtype of neovascular age-related macular degeneration in Chinese populations;proposing an international staging system and novel subtypes for punctate inner choroidopathy;elucidating the pathogenesis of retentional retinal pigment epithelial detachment through the sign of age-related scattered hypofluorescent spots on late-phase indocyanine green angiography;identifying acute macular neuroretinopathy as the primary cause of vision loss in dengue fever patients;and precisely localizing lesion in the world's largest case series of persistent placoid maculopathy.The"6 Elements"framework standardizes fundus disease research protocols,emphasizing methodological rigor and progressive investigation while generating multiple research trajectories through iterative cycles,thereby expanding both the depth and breadth of scientific inquiry.The"3 Ones"pathway embodies hierarchical research progression-transitioning from individual phenomena(point observations)to population-level patterns(linear correlations),ultimately constructing a multidimensional disease cognition network(planar integration).This approach guides investigations ranging from signs of common disease to rare disorders and novel disease entities,accelerating the refinement of disease taxonomies.By adhering to the"6 E

关 键 词：眼底疾病 眼底影像 创新研究 工作模式 

分 类 号：R770.4[医药卫生—眼科] G312[医药卫生—临床医学]