Chronic disease is a major threat to human health. Fundus disease has become a major ophthalmic disease affecting daily life. Although great breakthroughs have been made in the treatment, compared with other chronic disease management, the management of patients with fundus disease is still in its infancy. To strengthen the management exploration of patients with fundus diseases, establish a management model of fundus diseases and strive to improve patients' awareness of fundus diseases and adherence to treatment and follow-up are the great challenges at present. All ophthalmic centers should strengthen patient education, establish a regional cooperation network, support the construction of grassroots medical capacity, cultivate talents, enhance training, promote the standardized treatment of fundus diseases, standardize fundus imaging inspection and diagnosis, and promote the homogeneous construction of diagnosis and treatment of chronic fundus diseases. We will accelerate the construction of a hierarchical diagnosis and treatment system and the ability to link consultation and referral. Through systematic management and intervention of fundus diseases, a large number of patients with fundus diseases will receive early screening, diagnosis, standardized continuous treatment and systematic management, and improve the quality of life of patients with fundus diseases.
The population of various fundus diseases in China is vast, and the number of patients is continuously increasing due to the aging population. In contrast, fundus disease awareness among the general public in China is low, and grassroots screening needs urgent improvement. At the same time, the diagnosis and treatment rate are quite low, and the treatment methods for late-stage diseases are limited, resulting in poor prognosis of visual function and high blindness rate. Chronic fundus diseases require long-term, standardized treatment and long-term follow-up, which can be burdensome for patients, leading to high missed visit rates and reduced therapeutic effects. The "14th Five-Year Plan for Eye Health (2021-2025)" clearly put forward the requirements of strengthening the construction of the fundus disease prevention and control system. We urgently need to develop a management model for chronic diseases of fundus diseases tailored to China's national conditions. This will require establishing corresponding management platforms, improving personnel allocation, and enhancing compliance in the treatment of fundus diseases, to improve treatment effectiveness and fundamentally reduce blindness rates. After China's authoritative experts in the field of fundus diseases through the organization of in-depth and comprehensive thematic discussion, and the use of the improved version of Delphi method for collective decision-making and opinion consultation, a series of consensus guidance and suggestions were finally formed. These valuable professional insights will strongly promote the establishment of an appropriate chronic fundus disease management system in China, ensure that patients with fundus disease get long-term, standardized medical services, and lay a solid foundation for improving the overall prevention and treatment of fundus diseases.
ObjectiveTo explore the necessity, construction plans, and implementation methods for the establishment of a fundus disease-specific biobank are discussed. MethodsAn evidence-based medicine study. “Biobank”, “Disease-specific biobank”, “Eye diseases”, “Fundus disease” were hereby used as search terms. Literatures were retrieved related to biobank construction from PubMed, Embase, China National Knowledge Infrastructure, and Wanfang databases since their establishment until October 2023. Two researchers independently selected and analyzed literature, extracting data for further analysis. ResultsAfter screening, 23 articles were included, comprising 11 articles in Chinese and 12 articles in English, involving 23 institutions. The disease-specific biobank has been built earlier abroad than domestically. Both domestic and foreign biobank have a scale of less than 1, 1 to 10, and more than 10 thousand samples, with the eye disease-specific biobank having less than 10 thousand samples. The majority of these disease-specific biobank focued on tumor-related diseases and consist of both physical and information components. Ethical committees were required to declare and record the construction of biobank, and dedicated personnel and information management systems are established. Quality control systems have been developed with standard operating procedures from sample collection to storage. These disease-specific biobank effectively supported research projects, but there was a lack of resource sharing domestically compared to abroad. Based on practical experience, the construction of fundus disease-specific biobank at West China Hospital of Sichuan University has been improved. Separate sample collection processes have been formulated for outpatient clinics and operating rooms. Standard operating procedures have been established for unique eye samples, including vitreous fluid, proliferative membranes of the retina, aqueous humor, tears, etc., to ensure sample quality. ConclusionEstablishing a fundus disease-specific biobank can promote basic and clinical research, advance the development of translational medicine, achieve resource sharing, and foster discipline development.
Based on the current situation of patients with retinal diseases in China and the clear requirements of the "14th Five-Year Plan for Eye Health (2021-2025)" to strengthen the construction of the prevention and control system for retinal diseases, experts in the field of retinal diseases in China have conducted in-depth and comprehensive thematic discussions, and used the modified Delphi method for collective decision-making and opinion solicitation, ultimately forming consensus and consistent guidance suggestions for the management of chronic diseases of retinal diseases that are in line with China's national conditions. This consensus includes key content such as definitions, treatment plans, and follow-up frequency for the management of chronic diseases of the fundus. It clearly proposes relevant measures to improve the management process of chronic diseases of the fundus, and elaborates on the advantages and feasibility of establishing an online remote platform for the management of chronic diseases of the fundus, in order to assist doctors in formulating personalized treatment plans and ensure that patients receive standardized treatment and follow-up. This consensus will provide guidance and reference for the management of chronic diseases and long-term standardized diagnosis and treatment of major fundus diseases in China.
Mast cell (MC) play a crucial role in non-allergic fundus diseases, including uveitis, diabetic retinopathy, and age-related macular degeneration. MCs can profoundly influence the pathological processes of these diseases by regulating inflammatory responses, promoting angiogenesis, and facilitating tissue remodeling through the degranulation and release of mediators such as histamine, cytokines, and enzymes. The application of MC-associated inhibitors has been shown to effectively mitigate or inhibit the progression of these pathologies, offering a promising strategy for treating ocular diseases. Understanding the current state of MC research in fundus diseases will enhance our insight into their role in the pathophysiological mechanisms of these conditions and encourage further research aimed at providing more effective treatment options for patients.