Metastatic uveal melanoma (MUM) is a rare but highly invasive ocular malignant tumor with poor prognosis.At present, there is a lack of standardized methods for the treatment of MUM, resulting in poor prognosis.However, in recent years, the emergence of immune checkpoint inhibitors, new immune drug Tebenfos, comprehensive targeted therapy, combined sequential therapy and other treatment methods has brought new hope to MUM patients.This review aims to summarize the latest progress in the diagnosis, treatment, and prognosis of MUM.

Since the beginning of the 21st century, the rapid development of computer technology and artificial intelligence has brought a qualitative change in medical technology, with digital medicine gradually being accepted by the majority of medical researchers and applied in clinical practice.These innovations have not only updated various diagnostic and treatment equipment, but also introduced new concepts to the medical field and invigorated to the development of ophthalmology in China.With the help of digital technology, ophthalmology has been pushed to a more precise, personalized and minimally invasive direction.This article reviews relevant domestic and foreign literature, and the intelligent diagnostic technologies in digital medical care, such as 3D printing, surgical navigation, finite element analysis and extended reality, are reviewed.This article also reviews the current status and prospects of applying these digital innovations to assist with the treatment and clinical teaching of orbital diseases, including orbital fractures, orbital tumors, thyroid-related ophthalmopathy, traumatic optic neuropathy and orbital foreign bodies.

Metastatic uveal melanoma (MUM) is a rare but highly invasive ocular malignant tumor with poor prognosis.At present, there is a lack of standardized methods for the treatment of MUM, resulting in poor prognosis.However, in recent years, the emergence of immune checkpoint inhibitors, new immune drug Tebenfos, comprehensive targeted therapy, combined sequential therapy and other treatment methods has brought new hope to MUM patients.This review aims to summarize the latest progress in the diagnosis, treatment, and prognosis of MUM.

Since the beginning of the 21st century, the rapid development of computer technology and artificial intelligence has brought a qualitative change in medical technology, with digital medicine gradually being accepted by the majority of medical researchers and applied in clinical practice.These innovations have not only updated various diagnostic and treatment equipment, but also introduced new concepts to the medical field and invigorated to the development of ophthalmology in China.With the help of digital technology, ophthalmology has been pushed to a more precise, personalized and minimally invasive direction.This article reviews relevant domestic and foreign literature, and the intelligent diagnostic technologies in digital medical care, such as 3D printing, surgical navigation, finite element analysis and extended reality, are reviewed.This article also reviews the current status and prospects of applying these digital innovations to assist with the treatment and clinical teaching of orbital diseases, including orbital fractures, orbital tumors, thyroid-related ophthalmopathy, traumatic optic neuropathy and orbital foreign bodies.

The finite element method(FEM)is a widely employed mathematical technique in mechanical research that divides an object into discrete and interacting finite elements. Medically, finite element analysis(FEA)enables the simulation of biomechanical experiments that are challenging to conduct. Orbital surgery poses significant challenges to ophthalmologists due to its inherent difficulty and steep learning curve. FEM enables the simulation and analysis of the mechanical properties of orbital tissue, offering a novel approach for diagnosing and treating orbital-related diseases. With technological advancements, FEM has significantly matured in the diagnosis and treatment of orbital diseases, becoming a popular area of research in orbital biomechanics. This paper reviewed the latest advancements in orbital FEM, encompassing the development of orbital FEA models, simulation of orbital structure, and its application in orbital-related diseases. Additionally, the limitations of FEM and future research directions are also discussed. As a digital tool for auxiliary diagnosis and treatment, orbital FEA will progressively unlock its potential for diagnosing and treating orbital diseases alongside technological advancements.

Spinal surgical site infection (SSI), especially deep SSI after internal fixation is difficult in treatment, with long course of disease and poor prognosis. At present, there are many controversies in the diagnosis and treatment of spinal SSI, with unsatisfactory overall efficacy of its diagnosis and treatment. Besides, no diagnosis and treatment guideline based on evidence-based medicine has been in existence. To this end, the Spinal Infection Group of the Orthopedic Branch of the Chinese Medical Doctor Association and the Spinal Infection Group of the Spinal Surgery Branch of the Chinese Rehabilitation Medicine Association jointly organized relevant experts to formulate Evidence-based clinical guideline for the diagnosis and treatment of surgical site infection in spinal trauma ( version 2024) based on an evidence-based approach. A total of 10 recommendations were proposed on the diagnosis and treatment of spinal SSI, so as to provide a clinical reference for the diagnosis and treatment of spinal SSI.

In recent years,deep learning,a pivotal subset of artificial intelligence machine learning,has achieved noteworthy advancements in the medical domain.It facilitates precise detection,diagnosis and prognostic assessment of various diseases through the analysis of medical images.Within ophthalmology,deep learning techniques have found wide-spread application in the diagnosis and prediction of thyroid-related eye diseases,orbital blowout fracture,melanoma,bas-al cell carcinoma,orbital abscess,lymphoma,retinoblastoma and other diseases.Leveraging images from computed tomo-graphy,magnetic resonance imaging and even pathological sections,this technology demonstrates a capacity to diagnose,differentiate and stage orbital diseases and ocular tumors with a high level of accuracy comparable to that of expert clini-cians.The promising prospects of this technology are expected to enhance the diagnosis and treatment of related diseases,concurrently reducing the time and cost associated with clinical practices.This review consolidates the latest research pro-gress on the application of artificial intelligence deep learning in orbital diseases and ocular tumors,aiming to furnish clini-cians with up-to-date information and developmental trends in this field,thereby furthering the clinical application and widespread adoption of this technology.

Spinal surgical site infection (SSI), especially deep SSI after internal fixation is difficult in treatment, with long course of disease and poor prognosis. At present, there are many controversies in the diagnosis and treatment of spinal SSI, with unsatisfactory overall efficacy of its diagnosis and treatment. Besides, no diagnosis and treatment guideline based on evidence-based medicine has been in existence. To this end, the Spinal Infection Group of the Orthopedic Branch of the Chinese Medical Doctor Association and the Spinal Infection Group of the Spinal Surgery Branch of the Chinese Rehabilitation Medicine Association jointly organized relevant experts to formulate Evidence-based clinical guideline for the diagnosis and treatment of surgical site infection in spinal trauma ( version 2024) based on an evidence-based approach. A total of 10 recommendations were proposed on the diagnosis and treatment of spinal SSI, so as to provide a clinical reference for the diagnosis and treatment of spinal SSI.

Objective:To systematically analyze the efficacy of nasal endoscopic transsphenoidal decompression and glucocorticoid pulse therapy for traumatic optic neuropathy (TON).Methods:PubMed, Web of Science, Cochrane Library, ClinicalTrial.gov, CNKI, Wanfang, China Biomedical and other databases were searched to retrieve clinical studies on endoscopic surgery and hormone therapy for TON since their establishment to November 1, 2020.Two researchers screened the literature and evaluated the quality of the included literatures.The improvement of visual acuity before and after treatment was taken as an effective indicator.RevMan 5.3 statistical software was used for meta-analysis.The sensitivity of the results was analyzed atfer literature exclusion.The publication bias of each study was double checked by funnel plot and Begg test.Results:Eight studies were included, including 7 cohort studies and 1 randomized controlled trial.There was no significant difference between the endoscopic decompression group and glucocorticoid group in the efficiency of visual acuity improvement in the treatment of TON [odds ratio ( OR)=1.65, 95% confidence interval ( CI)∶0.75-3.66, P=0.22], neither in TON patients with residual vision before surgery ( OR=2.17, 95% CI: 0.94-4.98, P=0.07). For nasal endoscopic decompression surgery, early surgery (disease course<7 days) was more effective than late surgery (disease course>7 days) ( OR=4.73, 95% CI: 2.55-8.78, P<0.01). Sensitivity analysis suggested that the results of this literature analysis were not robust.The Begg test showed that there was no literature publication bias. Conclusions:There is no significant difference between nasal endoscopic surgery and glucocorticoid therapy in the treatment of TON.Early endoscopic surgery may help improve visual acuity in patients with residual vision.

Traumatic optic neuropathy and glaucoma can cause optic nerve degenerative changes leading to a significant decline in vision, which seriously affects the quality of life of patients.In recent years, research on mammalian optic nerve injury models has found that optic nerve injury involves pathophysiological processes such as apoptosis, inflammatory response, and oxidative stress.Researchers have explored the relevant mechanisms and regulatory signaling pathways of optic nerve injury, and have conducted research on the protection of optic nerve injury in the fight against retinal ganglion cell (RGC) apoptosis, new drug therapy, gene therapy, stem cell transplantation and natural extracts.Studies have shown that glucose regulatory protein 75, a member of the heat shock protein 70 family, and melatonin naturally secreted in the human retina may play an important role in the regulation of RGC apoptosis.Human granulocyte colony-stimulating factor (G-CSF) may play a protective role in RGC by directly activating the intrinsic G-CSF receptor and downstream signaling pathway.Targeting gene therapy is expected to become a powerful therapy for repair and regeneration of injured optic nerve.Adipose stem cell transplantation can resist the apoptosis of retinal cells in rat model.In addition, lycium barbarum polysaccharide can delay the secondary degeneration of axons, which may be a promising natural extract to delay the secondary degeneration of optic nerve injury.This article summarized the mechanism, regulation and protection of optic nerve injury.