1
|
Bohler F, Garden A, Santiago CJ, Bohler L, Taranikanti V. Characterizing the initial effects of the single accreditation system merge on the ophthalmology residency match. Med Educ Online 2024; 29:2307124. [PMID: 38262001 PMCID: PMC10810612 DOI: 10.1080/10872981.2024.2307124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/12/2024] [Indexed: 01/25/2024]
Abstract
INTRODUCTION In 2020, the American Osteopathic Association merged its residency programs into one system under the Accreditation Council for Graduate Medical Education (ACGME). The effects of this transition on the ophthalmology match is not fully understood. The purpose of this study is to assess the early impact of the transition to ACGME accreditation on MD, DO, and IMG representation in ophthalmology residency programs. MATERIALS AND METHODS Information about resident medical degree and resident medical school was gathered from ophthalmology residency program websites from a resident class before and after the Transition. Additionally, the medical degree of residency program directors (PD) was collected to analyze MD vs DO leadership in ophthalmology residency programs and to further stratify resident data to identify any trends in PD preference for different medical graduates. RESULTS Data was obtained for 915 ophthalmology residents in 110 residency programs that met the study's inclusion criteria. Of these programs, 102 were allopathic with MD leadership, 1 was allopathic with DO leadership, 3 were osteopathic with MD leadership, and 4 were osteopathic with DO leadership. Overall, MD representation increased while DO and IMG representation decreased although not significantly. For both classes analyzed, DO and IMG representation was disproportionately low. DISCUSSION The transition to ACGME accreditation seems to have primarily harmed DO and IMG applicants in the ophthalmology match while benefitting MDs. Various factors such as loss of protected residency positions for DO applicants and the closure of osteopathic ophthalmology residency programs are likely reasons to blame for this decrease in osteopathic representation.
Collapse
Affiliation(s)
- Forrest Bohler
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Allison Garden
- Edward Via College of Osteopathic Medicine - Carolinas Campus, Spartanburg, SC
| | - Christian J. Santiago
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | | | - Varna Taranikanti
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| |
Collapse
|
2
|
Liu GT. The Consortium of Pediatric Neuro-Ophthalmologists (CPNO) and Fundamentals of Pediatric Neuro- Ophthalmology. J Neuroophthalmol 2024; 44:141-142. [PMID: 38551666 DOI: 10.1097/wno.0000000000002131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2024]
Affiliation(s)
- Grant T Liu
- Neuro-ophthalmology Service, Division of Ophthalmology, Children's Hospital of Philadelphia and Division of Neuro-Ophthalmology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; and Departments of Neurology and Ophthalmology at the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| |
Collapse
|
3
|
Daniel D, Bacchi S, Casson R, Chan W. Sulfonamides in ophthalmology: adverse reactions : Evidence-based use of sulfa drugs in ophthalmology. Int Ophthalmol 2024; 44:214. [PMID: 38700759 PMCID: PMC11068664 DOI: 10.1007/s10792-024-03045-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/18/2024] [Indexed: 05/06/2024]
Affiliation(s)
- David Daniel
- The University of Adelaide, Adelaide, Australia.
| | | | | | - Weng Chan
- The University of Adelaide, Adelaide, Australia
| |
Collapse
|
4
|
Madadi Y, Delsoz M, Khouri AS, Boland M, Grzybowski A, Yousefi S. Applications of artificial intelligence-enabled robots and chatbots in ophthalmology: recent advances and future trends. Curr Opin Ophthalmol 2024; 35:238-243. [PMID: 38277274 PMCID: PMC10959691 DOI: 10.1097/icu.0000000000001035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2024]
Abstract
PURPOSE OF REVIEW Recent advances in artificial intelligence (AI), robotics, and chatbots have brought these technologies to the forefront of medicine, particularly ophthalmology. These technologies have been applied in diagnosis, prognosis, surgical operations, and patient-specific care in ophthalmology. It is thus both timely and pertinent to assess the existing landscape, recent advances, and trajectory of trends of AI, AI-enabled robots, and chatbots in ophthalmology. RECENT FINDINGS Some recent developments have integrated AI enabled robotics with diagnosis, and surgical procedures in ophthalmology. More recently, large language models (LLMs) like ChatGPT have shown promise in augmenting research capabilities and diagnosing ophthalmic diseases. These developments may portend a new era of doctor-patient-machine collaboration. SUMMARY Ophthalmology is undergoing a revolutionary change in research, clinical practice, and surgical interventions. Ophthalmic AI-enabled robotics and chatbot technologies based on LLMs are converging to create a new era of digital ophthalmology. Collectively, these developments portend a future in which conventional ophthalmic knowledge will be seamlessly integrated with AI to improve the patient experience and enhance therapeutic outcomes.
Collapse
Affiliation(s)
- Yeganeh Madadi
- Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Mohammad Delsoz
- Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Albert S. Khouri
- Institute of Ophthalmology and Visual Science, University of Medicine and Dentistry of New Jersey, NJ, USA
| | - Michael Boland
- Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA
| | - Andrzej Grzybowski
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznan, Poland
| | - Siamak Yousefi
- Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, TN, USA
- Department of Genetics, Genomics, and Informatics, University of Tennessee Health Science Center, Memphis, TN, USA
| |
Collapse
|
5
|
Romano V, Ferrara M, Gatti F, Airaldi M, Borroni D, Aragona E, Rocha-de-Lossada C, Gabrielli F, Papa FT, Romano MR, Calza S, Semeraro F. Topical Antiseptics in Minimizing Ocular Surface Bacterial Load Before Ophthalmic Surgery: A Randomized Controlled Trial. Am J Ophthalmol 2024; 261:165-175. [PMID: 38211781 DOI: 10.1016/j.ajo.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/28/2023] [Accepted: 01/05/2024] [Indexed: 01/13/2024]
Abstract
PURPOSE To investigate the reduction of the ocular surface bacterial load induced by 2 commercially available ophthalmic antiseptic formulations, povidone-iodine (PVI) 0.6% and chlorhexidine (CLX) 0.02%, before ocular surgery. DESIGN Randomized controlled trial. METHODS Seventy adult patients undergoing intraocular surgery (phacoemulsification) were randomized to receive in the index eye PVI (group A) 4 times a day for 3 days or CLX (group B) 4 times a day for 3 days before surgery. The untreated eye was used as control. A conjunctival swab was taken in both eyes before (T0) and after (T1) therapy. Microbial DNA was quantified with real-time polymerase chain reaction (PCR) analysis. The Mick algorithm was used to compare the abundance of each genus/genera against the distribution of abundances from the reference. At T1, patients filled a questionnaire to evaluate therapy-induced symptoms. Primary outcome was the reduction of bacterial DNA at T1 (microbial load), vs control arm, expressed as mean number of real-time PCR cycle times (CTs). Secondary outcomes were taxonomic composition, differential abundance, and therapy-induced ocular symptoms. RESULTS The T0-T1 difference in CT was significant in group B, but not in group A (mean [95% CI], 0.99 [0.33] vs 0.26 [0.15], P < .001, and 0.65 [0.3] vs 0.45 [0.41], P = .09, respectively). The taxonomic composition, alpha, and beta diversity remained consistent at all time points in both groups. The rate of patients reporting therapy-induced ocular symptoms and the mean discomfort grade were greater in group A than in group B (97% vs 26% and 4.97±2.48 vs 0.66±1.53, respectively). CONCLUSIONS Compared with PVI 0.6%, CLX 0.02% induced a greater reduction of ocular surface bacterial load, with no significant alterations of the taxonomic composition. Moreover, CLX was better tolerated than PVI.
Collapse
Affiliation(s)
- Vito Romano
- From the Eye Unit, ASST Spedali Civili di Brescia (V.R., F.S.), Brescia, Italy; Eye Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia (V.R., Fr.G., F.S.), Brescia, Italy
| | | | - Francesca Gatti
- Eye Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia (V.R., Fr.G., F.S.), Brescia, Italy
| | - Matteo Airaldi
- Department of Molecular and Translational Medicine, Università degli Studi di Brescia (M.A.), Brescia, Italy; St. Paul's Eye Unit, Royal Liverpool University Hospital (M.A.), Liverpool, United Kingdom
| | - Davide Borroni
- Eyemetagenomics Ltd, Covent Garden (D.B., C.R.-d.-l.), London, United Kingdom
| | - Emanuela Aragona
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute (E.A.), Milan, Italy
| | - Carlos Rocha-de-Lossada
- Eyemetagenomics Ltd, Covent Garden (D.B., C.R.-d.-l.), London, United Kingdom; Ophthalmology Department, QVision, Vithas Almería (C.R.-d.-l.), Almeria, Spain; Ophthalmology Department, Hospital Regional Universitario Málaga (C.R.-d.-l.), Malaga, Spain
| | - Federico Gabrielli
- Biolab SRL, Laboratorio di Genetica e Genomica Molecolare (Fe.G., F.T.P.), Ascoli Piceno, Italy
| | - Filomena Tiziana Papa
- Biolab SRL, Laboratorio di Genetica e Genomica Molecolare (Fe.G., F.T.P.), Ascoli Piceno, Italy
| | - Mario R Romano
- Department of Biomedical Sciences, Humanitas University (M.R.R.), Milan, Italy; Department of Ophthalmology, Humanitas Gavazzeni-Castelli (M.R.R.), Bergamo, Italy
| | - Stefano Calza
- Unit of Biostatistics and Bioinformatics, Department of Molecular and Translational Medicine, University of Brescia (S.C.), Brescia, Italy
| | - Francesco Semeraro
- From the Eye Unit, ASST Spedali Civili di Brescia (V.R., F.S.), Brescia, Italy; Eye Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia (V.R., Fr.G., F.S.), Brescia, Italy
| |
Collapse
|
6
|
Phuljhele S. Biases which begin at the end. Indian J Ophthalmol 2024; 72:S333-S334. [PMID: 38648450 DOI: 10.4103/ijo.ijo_863_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Affiliation(s)
- Swati Phuljhele
- Dr. R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
7
|
Iurescia A, Iribarren R, Lanca C, Grzybowski A. Accommodative-vergence disorders in a paediatric ophthalmology clinical setting in Argentina. Acta Ophthalmol 2024; 102:e346-e351. [PMID: 37775962 DOI: 10.1111/aos.15785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 09/17/2023] [Accepted: 09/19/2023] [Indexed: 10/01/2023]
Abstract
PURPOSE To determine the frequency of potential non-strabismic accommodative-vergence anomalies (NSAVA) and investigate associations between NSAVA, refractive errors and age among children attending a paediatric ophthalmology clinic. METHODS This study included children and adolescents aged 5-19 years attending an ophthalmology clinic with at least two follow-up visits. At their first visit, children had a comprehensive ophthalmic examination, including refractive error measurement by cycloplegic autorefraction and spectacles were prescribed if necessary. At the second visit, children had an examination of best-corrected visual acuity, convergence and accommodation to identify potential NSAVA. The relationship between age, sex, heterophoria and refractive error and potential NSAVA was assessed by a multivariable logistic regression model. RESULTS A total of 384 children and adolescents were evaluated. Their mean age was 10.97 ± 3.07 years and 58.9% were females. Forty-two per cent of children failed the NSAVA tests and 34.1% had myopia (≤-0.50 D). Children who failed NSAVA tests self-reported a higher proportion of reading problems (73.7%) compared to those who passed the tests (26.3%; p < 0.001). Children with self-reported reading problems were more likely to have accommodative infacility (57.9%) compared with children without (42.1%; p < 0.001). Refractive error and age were not associated with failure in NSAVA tests (p > 0.05). CONCLUSIONS NSAVA was a frequent cause of vision problems found in a sample of children from an ophthalmology paediatric clinic. Thus, further research is necessary to understand the potential of public health policies to prevent, refer, diagnose and treat those conditions.
Collapse
Affiliation(s)
| | | | - Carla Lanca
- Escola Superior de Tecnologia da Saúde de Lisboa (ESTeSL), Instituto Politécnico de Lisboa, Lisboa, Portugal
- Comprehensive Health Research Center (CHRC), Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland
- Institute for Research in Ophthalmology, Poznań, Poland
| |
Collapse
|
8
|
Yamadera K, Kimura A, Okita Y, Mochizuki Y, Gomi F. Comparison of head tilt test between sagging eye syndrome and acquired unilateral trochlear nerve palsy. Graefes Arch Clin Exp Ophthalmol 2024; 262:1641-1646. [PMID: 38141057 PMCID: PMC11031610 DOI: 10.1007/s00417-023-06347-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 11/26/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023] Open
Abstract
PURPOSE To investigate the distinction between sagging eye syndrome (SES group) and acquired unilateral trochlear nerve palsy (Trochlear group) in the Bielschowsky head tilt test (BHTT). METHODS Fifteen patients in the SES group (mean age 74.6 ± 5.2 years) and 14 patients in the Trochlear group (55.2 ± 15.9 years) visited the Department of Ophthalmology, Hyogo Medical University Hospital between November 2016 and October 2022 for treatment of their diplopia. Eye position was measured with the alternate prism cover test, and values for fixation of the dominant eye, or unaffected eye, were used. Cyclodeviation was measured with the synoptophore and the Glaucoma Module Premium Edition of the SPECTRALIS optical coherence tomography. In the BHTT, eye position was measured in three head postures: primary position (PP), head tilt to the side with hypertropia (Hyper), and head tilt to the side with hypotropia (Hypo). The differences in vertical deviation between PP and Hyper (Hyper - PP), PP and Hypo (PP - Hypo) and Hyper - Hypo were measured and compared. RESULTS Vertical deviation in primary position was 7.3 ± 4.5 PD in the SES group and significantly larger (17.1 ± 8.4 PD) in the Trochlear group (p = 0.002). The vertical deviation in Hyper was significantly larger in the Trochlear group with 7.7 ± 4.7 PD and 22.1 ± 9.4 PD, respectively (p < 0.001), whereas the that in Hypo was not significantly different between the two groups with 6.5 ± 3.4 PD and 8.4 ± 6.6 PD, respectively (p = 0.725). The SES group showed no significant difference according to the 3 head postures (p = 0.311), while the Trochlear group showed a significantly different with smaller mean values in vertical deviation in Hypo (p < 0.001). The difference in the vertical deviation for the 3 head postures was the largest in Hyper - Hypo (1.7 ± 2.1 PD and 13.6 ± 7.1 PD, respectively), and the accuracy of SES was at the cutoff value of 6 PD, and it was considered not to be SES if the value was 6PD or higher. The accuracy of SES determination was 100% sensitivity and 100% specificity, and the area under the curve was 1.0. CONCLUSION The difference in Hyper - Hypo in the BHTT may be the most useful index in differentiating SES from acquired unilateral trochlear nerve palsy; if the difference was more than 6 PD, the probability of SES was very low.
Collapse
Affiliation(s)
- Katsuhide Yamadera
- Department of Ophthalmology, Hyogo Medical University, 1-1, Mukogawa-Cho, Nishinomiya-City, Hyogo, Japan.
| | - Akiko Kimura
- Department of Ophthalmology, Hyogo Medical University, 1-1, Mukogawa-Cho, Nishinomiya-City, Hyogo, Japan
| | - Yoichi Okita
- Department of Ophthalmology, Hyogo Medical University, 1-1, Mukogawa-Cho, Nishinomiya-City, Hyogo, Japan
| | - Yoshihito Mochizuki
- Department of Ophthalmology, Hyogo Medical University, 1-1, Mukogawa-Cho, Nishinomiya-City, Hyogo, Japan
| | - Fumi Gomi
- Department of Ophthalmology, Hyogo Medical University, 1-1, Mukogawa-Cho, Nishinomiya-City, Hyogo, Japan
| |
Collapse
|
9
|
Wright BA, De Andrade LM, Dumitrescu AV, Larson SA, Weiner RL, Kemp PS. A new vision: Integration of ophthalmology services into an interdisciplinary pediatric cystic fibrosis clinic model. Pediatr Pulmonol 2024; 59:1502-1504. [PMID: 38353399 DOI: 10.1002/ppul.26912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 12/22/2023] [Accepted: 01/31/2024] [Indexed: 04/30/2024]
Affiliation(s)
| | | | | | - Scott A Larson
- University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | | | - Pavlina S Kemp
- University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| |
Collapse
|
10
|
Gilson A, Chen Q, Adelman RA. Ophthalmic care may not align with patient need: An analysis on state-wide patient needs and provider density between 2008 and 2022. Int J Med Inform 2024; 185:105411. [PMID: 38492409 PMCID: PMC11047060 DOI: 10.1016/j.ijmedinf.2024.105411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 03/07/2024] [Accepted: 03/08/2024] [Indexed: 03/18/2024]
Abstract
PURPOSE This study aims to assess the extent to which the demand for ophthalmologic care among patients at the state level is reflected in Google Trends data, serving as an indicator of patient desire in ophthalmology. METHODS For each state, patient interest in ophthalmologic care was estimated using the Google Trends resource measuring web search and YouTube search rates for multiple ophthalmologic terms. We compared the change in search for ophthalmologic terms over time and used ordinary least squares regression to evaluate whether search interest for ophthalmologic terms was able to predict the rate of practicing ophthalmologists in each state. We also compare the changing rates of searches across the web and YouTube to evaluate the resources patients are most likely to utilize. RESULTS From 2008 to 2022, web search rates for general ophthalmology related terms increased by 43.98%, while search interest for retinal specific terms increased by 19.51%. YouTube specific results for general ophthalmology terms increased by 55.83% while search for retinal terms fell by 58.48%. Ophthalmologic and retinal specific search interest was not significantly associated with either outcome. CONCLUSIONS Our findings suggest that patient information needs, demographic elements, and the educational backgrounds of residents and fellows - those important factors - are surprisingly poorly correlated with ophthalmology provider density. Furthermore, we observed no noteworthy correlation between the search interest in ophthalmology and the overall density of ophthalmologists or retinal specialists. This implies that there is a pressing need to explore and implement strategies aimed at better aligning these influencing factors the choices made by ophthalmologists in selecting their practice locations to bridge the gap between healthcare availability and public interest.
Collapse
Affiliation(s)
- Aidan Gilson
- Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, USA.
| | - Qingyu Chen
- Section of Biomedical Informatics & Data Science, Yale School of Medicine, New Haven, USA
| | - Ron A Adelman
- Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, USA
| |
Collapse
|
11
|
Kedia N, Sanjeev S, Ong J, Chhablani J. ChatGPT and Beyond: An overview of the growing field of large language models and their use in ophthalmology. Eye (Lond) 2024; 38:1252-1261. [PMID: 38172581 PMCID: PMC11076576 DOI: 10.1038/s41433-023-02915-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 11/23/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024] Open
Abstract
ChatGPT, an artificial intelligence (AI) chatbot built on large language models (LLMs), has rapidly gained popularity. The benefits and limitations of this transformative technology have been discussed across various fields, including medicine. The widespread availability of ChatGPT has enabled clinicians to study how these tools could be used for a variety of tasks such as generating differential diagnosis lists, organizing patient notes, and synthesizing literature for scientific research. LLMs have shown promising capabilities in ophthalmology by performing well on the Ophthalmic Knowledge Assessment Program, providing fairly accurate responses to questions about retinal diseases, and in generating differential diagnoses list. There are current limitations to this technology, including the propensity of LLMs to "hallucinate", or confidently generate false information; their potential role in perpetuating biases in medicine; and the challenges in incorporating LLMs into research without allowing "AI-plagiarism" or publication of false information. In this paper, we provide a balanced overview of what LLMs are and introduce some of the LLMs that have been generated in the past few years. We discuss recent literature evaluating the role of these language models in medicine with a focus on ChatGPT. The field of AI is fast-paced, and new applications based on LLMs are being generated rapidly; therefore, it is important for ophthalmologists to be aware of how this technology works and how it may impact patient care. Here, we discuss the benefits, limitations, and future advancements of LLMs in patient care and research.
Collapse
Affiliation(s)
- Nikita Kedia
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Joshua Ong
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, MI, USA
| | - Jay Chhablani
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| |
Collapse
|
12
|
Kaarniranta K, Pawlikowska-Łagód K, Jääskeläinen JE, Grzybowski AE. Acta Ophthalmologica 100 years-Overview of selected articles during Acta Ophthalmologica history. Acta Ophthalmol 2024; 102:367-373. [PMID: 38233882 DOI: 10.1111/aos.16628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/05/2024] [Indexed: 01/19/2024]
Abstract
We selected and discussed 10 articles in Acta Ophthalmologica since 1923 that changed clinical ophthalmology and treatment protocols, or provided novel findings and perspectives. We are aware that the selection of articles may be debatable and we invite readers to suggest other significant Acta articles. For historians, the article archive of Acta Ophthalmologica is located in Copenhagen.
Collapse
Affiliation(s)
- Kai Kaarniranta
- Department of Ophthalmology, University of Eastern Finland, Kuopio, Finland
- Department of Ophthalmology, Kuopio University Hospital, Kuopio, Finland
- Department of Molecular Genetics, University of Lodz, Lodz, Poland
| | | | - Juha E Jääskeläinen
- Department of Ophthalmology, Kuopio University Hospital, Kuopio, Finland
- Department of Neurosurgery, University of Eastern Finland, Kuopio, Finland
| | - Andrzej E Grzybowski
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznań, Poland
| |
Collapse
|
13
|
González-Martín-Moro J, Fernández Hortelano A, Cobo Soriano R. Reflections on the mandatory and urgent need to update the official formative program of the specialty in ophthalmology. Arch Soc Esp Oftalmol (Engl Ed) 2024; 99:185-186. [PMID: 38016598 DOI: 10.1016/j.oftale.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 11/30/2023]
Affiliation(s)
- J González-Martín-Moro
- Departamento de Oftalmología, Hospital Universitario del Henares, Coslada, Madrid, Spain; Facultad de Ciencias de la Salud, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain.
| | - A Fernández Hortelano
- Departamento de Oftalmología, Hospital Universitario del Henares, Coslada, Madrid, Spain; Facultad de Ciencias de la Salud, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain; Universidad Francisco de Vitoria-Medicina Postgrado, Aula-UFV-Johnson&Johnson, Pozuelo de Alarcón, Madrid, Spain
| | - R Cobo Soriano
- Departamento de Oftalmología, Hospital Universitario del Henares, Coslada, Madrid, Spain; Facultad de Ciencias de la Salud, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain; Universidad Francisco de Vitoria-Medicina Postgrado, Aula-UFV-Johnson&Johnson, Pozuelo de Alarcón, Madrid, Spain
| |
Collapse
|
14
|
Patel S, Ong WH, Cobb C, Gillan S. Patient information videos via QR codes: An innovative and sustainable approach in ophthalmology. Scott Med J 2024; 69:45-52. [PMID: 38425262 DOI: 10.1177/00369330241236945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
BACKGROUND We explore an innovative approach by transforming patient information leaflet (PILs) into Quick Response (QR) code linked patient information videos (PIVs) in ophthalmology. Our objectives are to assess the subjective utility of a PIV on glaucoma and analyse the use of QR codes as a delivery method. METHODS A prospective study was conducted in Ninewells Hospital, NHS Tayside. A glaucoma PIV was created and linked to a QR code provided to 130 glaucoma patients. Pre- and post-video questionnaires evaluated the patients' perception of using a QR code and subjective improvement in their understanding of glaucoma. RESULTS Out of 102 responses collected, 55% of patients had no prior experience with QR codes. However, 81% of patients were able to watch the PIV. The average view duration of the video was 3:26, with 82.5% view retention. Statistically significant improvement in glaucoma knowledge was observed across all six areas questioned (p < 0.001) using a 5-point Likert scale. Overall, 70% of patients preferred PIVs over PILs, and 77% acknowledged that PIVs could be a sustainable alternative. CONCLUSION QR codes for delivering PIVs were well-received, with patients finding them easy to use. Our PIV on glaucoma effectively enhanced patients' understanding of the condition.
Collapse
Affiliation(s)
- Sirjhun Patel
- NHS Tayside, Department of Ophthalmology, Ninewells Hospital, Dundee, UK
| | - Wei Han Ong
- NHS Tayside, Department of Ophthalmology, Ninewells Hospital, Dundee, UK
| | - Caroline Cobb
- NHS Tayside, Department of Ophthalmology, Ninewells Hospital, Dundee, UK
| | - Stewart Gillan
- NHS Tayside, Department of Ophthalmology, Ninewells Hospital, Dundee, UK
| |
Collapse
|
15
|
Abiona O, Haywood P, Yu S, Hall J, Fiebig DG, van Gool K. Physician responses to insurance benefit restrictions: The case of ophthalmology. Health Econ 2024; 33:911-928. [PMID: 38251043 DOI: 10.1002/hec.4799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 10/04/2023] [Accepted: 01/01/2024] [Indexed: 01/23/2024]
Abstract
This study examines the impact of social insurance benefit restrictions on physician behaviour, using ophthalmologists as a case study. We examine whether ophthalmologists use their market power to alter their fees and rebates across services to compensate for potential policy-induced income losses. The results show that ophthalmologists substantially reduced their fees and rebates for services directly targeted by the benefit restriction compared to other medical specialists' fees and rebates. There is also some evidence that they increased their fees for services that were not targeted. High-fee charging ophthalmologists exhibited larger fee and rebate responses while the low-fee charging group raise their rebates to match the reference price provided by the policy environment.
Collapse
Affiliation(s)
- Olukorede Abiona
- Macquarie University Centre for the Health Economy (MUCHE), Macquarie University Business School (MQBS) and Australian Institute of Health Innovation (AIHI), Macquarie University, Sydney, New South Wales, Australia
- Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney, Sydney, New South Wales, Australia
| | - Phil Haywood
- Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney, Sydney, New South Wales, Australia
| | - Serena Yu
- Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney, Sydney, New South Wales, Australia
| | - Jane Hall
- Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney, Sydney, New South Wales, Australia
| | - Denzil G Fiebig
- Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney, Sydney, New South Wales, Australia
- School of Economics, UNSW Business School, University of New South Wales, Sydney, New South Wales, Australia
| | - Kees van Gool
- Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
16
|
Chaluvadi UD. Re: Margolis et al.: Six myths of the anterior segment: misunderstandings and critical thinking in ophthalmology (Ophthalmology. 2023;130:783-785). Ophthalmology 2024; 131:e21. [PMID: 38340110 DOI: 10.1016/j.ophtha.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/29/2023] [Accepted: 12/07/2023] [Indexed: 02/12/2024] Open
Affiliation(s)
- Uma D Chaluvadi
- Department of Ophthalmology, Maui Memorial Medical Center, Maui, Hawaii.
| |
Collapse
|
17
|
Cardona G, Herrera A. Gender distribution in publishing in five leading optometry journals. Ophthalmic Physiol Opt 2024; 44:634-640. [PMID: 38321803 DOI: 10.1111/opo.13283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 01/13/2024] [Accepted: 01/24/2024] [Indexed: 02/08/2024]
Abstract
PURPOSE To explore gender distribution in authorship and citation parameters of articles published in five optometry journals included in the Ophthalmology category of Journal Citation Reports. METHODS The Scopus database was used to retrieve all citable articles published in 2011 and 2021 in Optometry and Vision Science, Ophthalmic and Physiological Optics, Clinical Experimental Optometry, Contact Lens and Anterior Eye, and Eye and Contact Lens. Gender of the first, last and single authors of all articles, and citation parameters of articles published in 2011 up to May 2023 were determined. Gender of the editor-in-chief and members of the editorial board of these journals was investigated (May 2023). RESULTS Only one journal had a female editor-in-chief and three journals had more males than females in their editorial board. In 2011 and 2021, respectively, 40.1% and 48.0% of articles had female as the first authors (χ 1 , 948 2 = 5.77; p = 0.02), and 32.7% and 39.6% had female as the last authors (χ 1 , 948 2 = 4.61; p = 0.03). Gender parity was observed in one journal for the first author and none for the last author in 2011, and in three journals for the first author and one for the last author in 2021. Regarding combinations of male (M) and female (F) first and last authorship positions, the authors of articles in 2011 were MM (44.5%), FM (22.8%), FF (17.3%) and MF (15.4%), and MM (34.6%), FM (25.8%), FF (22.1%) and MF (17.5%) in 2021. Differences between 2011 and 2021 were statistically significant (χ 3 , 948 2 = 9.80; p = 0.02). The proportion of authorship combinations did not show statistically significant differences among journals in 2011 or in 2021. Neither citation nor self-citation were influenced by gender. CONCLUSIONS Gender disparities persist in optometry journals, with females being under-represented in senior and leadership positions. Increasing the awareness of gender disparity in authorship is a necessary step towards ensuring fairness in science in general, and optometry in particular.
Collapse
Affiliation(s)
- Genis Cardona
- Applied Optics and Image Processing Group (GOAPI), School of Optics and Optometry of Terrassa, Universitat Politècnica de Catalunya (UPC), Terrassa, Spain
| | - Aitor Herrera
- School of Optics and Optometry of Terrassa, Universitat Politècnica de Catalunya (UPC), Terrassa, Spain
| |
Collapse
|
18
|
Cappellani F, Card KR, Shields CL, Pulido JS, Haller JA. Reliability and accuracy of artificial intelligence ChatGPT in providing information on ophthalmic diseases and management to patients. Eye (Lond) 2024; 38:1368-1373. [PMID: 38245622 PMCID: PMC11076805 DOI: 10.1038/s41433-023-02906-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 12/05/2023] [Accepted: 12/13/2023] [Indexed: 01/22/2024] Open
Abstract
PURPOSE To assess the accuracy of ophthalmic information provided by an artificial intelligence chatbot (ChatGPT). METHODS Five diseases from 8 subspecialties of Ophthalmology were assessed by ChatGPT version 3.5. Three questions were asked to ChatGPT for each disease: what is x?; how is x diagnosed?; how is x treated? (x = name of the disease). Responses were graded by comparing them to the American Academy of Ophthalmology (AAO) guidelines for patients, with scores ranging from -3 (unvalidated and potentially harmful to a patient's health or well-being if they pursue such a suggestion) to 2 (correct and complete). MAIN OUTCOMES Accuracy of responses from ChatGPT in response to prompts related to ophthalmic health information in the form of scores on a scale from -3 to 2. RESULTS Of the 120 questions, 93 (77.5%) scored ≥ 1. 27. (22.5%) scored ≤ -1; among these, 9 (7.5%) obtained a score of -3. The overall median score amongst all subspecialties was 2 for the question "What is x", 1.5 for "How is x diagnosed", and 1 for "How is x treated", though this did not achieve significance by Kruskal-Wallis testing. CONCLUSIONS Despite the positive scores, ChatGPT on its own still provides incomplete, incorrect, and potentially harmful information about common ophthalmic conditions, defined as the recommendation of invasive procedures or other interventions with potential for adverse sequelae which are not supported by the AAO for the disease in question. ChatGPT may be a valuable adjunct to patient education, but currently, it is not sufficient without concomitant human medical supervision.
Collapse
Affiliation(s)
- Francesco Cappellani
- Retina Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, USA
| | - Kevin R Card
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, USA
| | - Carol L Shields
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, USA
| | - Jose S Pulido
- Retina Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, USA
| | - Julia A Haller
- Retina Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, USA.
| |
Collapse
|
19
|
Malcolm J, Dodd A, Shaikh M, Cassels-Brown A, Buchan JC. Reducing the carbon footprint of cataract surgery: co-creating solutions with a departmental Delphi process. Eye (Lond) 2024; 38:1349-1354. [PMID: 38155328 PMCID: PMC11076634 DOI: 10.1038/s41433-023-02902-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 12/05/2023] [Accepted: 12/12/2023] [Indexed: 12/30/2023] Open
Abstract
BACKGROUND Climate change is arguably the greatest threat to global health of the 21st century. Although cataract surgery is a major contributor to global greenhouse gas emissions, recent literature review identified a paucity of evidence-based strategies for improving the environmental impact of cataract services. Our study aimed to assess the effectiveness of a departmental Delphi process for improving cataract services' environmental sustainability. METHODS All members of ophthalmology theatre teams in a UK teaching hospital were invited to participate in a three-stage Delphi process. Team members were surveyed for suggestions for reducing the department's environmental impact. Suggested interventions were refined during a plenary face-to-face discussion and ranked. The highest ranked interventions were combined into a mutually agreed action plan. Data on the economic and environmental cost of cataract services was collected prior to and six months after the Delphi process using the Eyefficiency mobile application. RESULTS Twenty-three interventions were suggested by a range of staff cadres. Interventions were ranked by 24 team members. The 2nd, 4th, 5th, 8th and 11th ranked interventions were combined into an "Eco-packs" project in collaboration with suppliers (Bausch + Lomb), saving 675 kg of waste and 350 kg of CO2 equivalent annually. CONCLUSIONS The Delphi process is an effective method for provoking departmental engagement with the sustainability agenda that we would encourage all ophthalmology departments to consider utilising. The baseline per case CO2 equivalent measured in our department was reproducible and could serve as a maximum benchmark to be improved upon.
Collapse
Affiliation(s)
- Jonathan Malcolm
- Leeds Teaching Hospitals NHS Trust, Beckett Street, Leeds, LS9 7TF, UK.
| | - Amy Dodd
- Leeds Teaching Hospitals NHS Trust, Beckett Street, Leeds, LS9 7TF, UK
| | - Mohammad Shaikh
- Leeds Teaching Hospitals NHS Trust, Beckett Street, Leeds, LS9 7TF, UK
| | | | - John C Buchan
- Leeds Teaching Hospitals NHS Trust, Beckett Street, Leeds, LS9 7TF, UK
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
- Royal College of Ophthalmologists' National Ophthalmology Database, 18 Stephenson Way, London, NW1 2HD, UK
| |
Collapse
|
20
|
Dychiao RGK, Alberto IRI, Artiaga JCM, Salongcay RP, Celi LA. Large language model integration in Philippine ophthalmology: early challenges and steps forward. Lancet Digit Health 2024; 6:e308. [PMID: 38670739 DOI: 10.1016/s2589-7500(24)00064-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 02/27/2024] [Accepted: 03/14/2024] [Indexed: 04/28/2024]
Affiliation(s)
| | | | - Jose Carlo M Artiaga
- Department of Ophthalmology and Visual Sciences, Philippine General Hospital, Manila, Philippines
| | | | - Leo Anthony Celi
- Institute for Medical Engineering & Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
| |
Collapse
|
21
|
Liu R, Sule AA, Shannon CS, Ravilla T, Taylor H, Rojas-Carabali W, Khanna RC, Mishra C, Sen A, Khatri A, Tan ACS, Sobrin L, Agrawal R. A practical model for effective eye care delivery in Southeast Asian rural communities: A proposal built based on experts' recommendations. Indian J Ophthalmol 2024; 72:S473-S481. [PMID: 38648455 DOI: 10.4103/ijo.ijo_2196_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 01/03/2024] [Indexed: 04/25/2024] Open
Abstract
PURPOSE To evaluate rural community-based eye care models from the perspective of community ophthalmology experts and suggest sustainable technological solutions for enhancing rural eye care delivery. METHODS A semi-structured descriptive survey, using close-ended and open-ended questions, was administered to the experts in community ophthalmology sourced through purposive sampling. The survey was self-administered and was facilitated through online platforms or in-person meetings. Uniform questions were presented to all participants, irrespective of their roles. RESULTS Surveyed participants (n = 22 with 15 from India and 7 from Nepal) in high-volume tertiary eye hospitals faced challenges with resources and rural outreach. Participants had mixed satisfaction with pre-operative screening and theatre resources. Delayed presentations and inexperienced surgeons contributed to the surgery complications. Barriers to rural eye care included resource scarcity, funding disparities, and limited infrastructure. In rural/peri-urban areas 87% of participants agreed with providing primary eye care services, with more than 60% of the experts not in agreement with the makeshift center model of eye care delivery. Key components for an effective eye care model are sustainability, accessibility, affordability, and quality. These can be bolstered through a healthcare management platform and a human-chain supply distribution system. CONCLUSION Tailored interventions are crucial for rural eye care, emphasizing the need for stronger human resources, optimized funding, and community awareness. Addressing challenges pertinent to delayed presentation and surgical training is vital to minimizing complications, especially with advanced cataracts. Enhancements in rural eye care demand a comprehensive approach prioritizing accessibility, affordability, and consistent quality.
Collapse
Affiliation(s)
- Renee Liu
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Schepens Eye Research Institute, Boston, Massachusetts, USA
| | - Ashita A Sule
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Choo Sheriel Shannon
- Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
| | | | - Hugh Taylor
- Indigenous Eye Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - William Rojas-Carabali
- Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
- Lee Kong Chian School of Medicine, Singapore
| | - Rohit C Khanna
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | | | - Alok Sen
- Sadguru Netra Chikatsalaya, Sri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, India
| | | | - Anna C S Tan
- Singapore National Eye Centre, Singapore
- Singapore Eye Research Institute, The Academia, Singapore, Singapore
- Department of Ophthalmology and Visual Sciences, Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Lucia Sobrin
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Schepens Eye Research Institute, Boston, Massachusetts, USA
| | - Rupesh Agrawal
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
- Singapore Eye Research Institute, The Academia, Singapore, Singapore
- Department of Ophthalmology and Visual Sciences, Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Lee Kong Chian School of Medicine, Singapore
- Moorfields Eye Hospital, NHS Foundation Trust, London, UK
| |
Collapse
|
22
|
Biswas S, Davies LN, Sheppard AL, Logan NS, Wolffsohn JS. Utility of artificial intelligence-based large language models in ophthalmic care. Ophthalmic Physiol Opt 2024; 44:641-671. [PMID: 38404172 DOI: 10.1111/opo.13284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 02/27/2024]
Abstract
PURPOSE With the introduction of ChatGPT, artificial intelligence (AI)-based large language models (LLMs) are rapidly becoming popular within the scientific community. They use natural language processing to generate human-like responses to queries. However, the application of LLMs and comparison of the abilities among different LLMs with their human counterparts in ophthalmic care remain under-reported. RECENT FINDINGS Hitherto, studies in eye care have demonstrated the utility of ChatGPT in generating patient information, clinical diagnosis and passing ophthalmology question-based examinations, among others. LLMs' performance (median accuracy, %) is influenced by factors such as the iteration, prompts utilised and the domain. Human expert (86%) demonstrated the highest proficiency in disease diagnosis, while ChatGPT-4 outperformed others in ophthalmology examinations (75.9%), symptom triaging (98%) and providing information and answering questions (84.6%). LLMs exhibited superior performance in general ophthalmology but reduced accuracy in ophthalmic subspecialties. Although AI-based LLMs like ChatGPT are deemed more efficient than their human counterparts, these AIs are constrained by their nonspecific and outdated training, no access to current knowledge, generation of plausible-sounding 'fake' responses or hallucinations, inability to process images, lack of critical literature analysis and ethical and copyright issues. A comprehensive evaluation of recently published studies is crucial to deepen understanding of LLMs and the potential of these AI-based LLMs. SUMMARY Ophthalmic care professionals should undertake a conservative approach when using AI, as human judgement remains essential for clinical decision-making and monitoring the accuracy of information. This review identified the ophthalmic applications and potential usages which need further exploration. With the advancement of LLMs, setting standards for benchmarking and promoting best practices is crucial. Potential clinical deployment requires the evaluation of these LLMs to move away from artificial settings, delve into clinical trials and determine their usefulness in the real world.
Collapse
Affiliation(s)
- Sayantan Biswas
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Leon N Davies
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Amy L Sheppard
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Nicola S Logan
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - James S Wolffsohn
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
| |
Collapse
|
23
|
Pan AA, Pham AT, Appelo B, Legault GL, Woreta FA, Justin GA. Utilizing a composite citation index for evaluating clinical ophthalmology research: insights into gender, nationality, and self-citation among top ophthalmology researchers. Eye (Lond) 2024; 38:1380-1385. [PMID: 38172579 PMCID: PMC11076492 DOI: 10.1038/s41433-023-02912-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 12/01/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVES To compare the performance of a composite citation score (c-score) and its six constituent citation indices, including H-index, in predicting winners of the Weisenfeld Award in ophthalmologic research. Secondary objectives were to explore career and demographic characteristics of the most highly cited researchers in ophthalmology. METHODS A publicly available database was accessed to compile a set of top researchers in the field of clinical ophthalmology and optometry based on Scopus data from 1996 to 2021. Each citation index was used to construct a multivariable model adjusted for author demographic characteristics. Using area under the receiver operating curve (AUC) analysis, each index's model was evaluated for its ability to predict winners of the Weisenfeld Award in Ophthalmology, a research distinction presented by the Association for Research in Vision and Ophthalmology (ARVO). Secondary analyses investigated authors' self-citation rates, career length, gender, and country affiliation over time. RESULTS Approximately one thousand unique authors publishing primarily in clinical ophthalmology/optometry were analyzed. The c-score outperformed all other citation indices at predicting Weisenfeld Awardees, with an AUC of 0.99 (95% CI: 0.97-1.0). The H-index had an AUC of 0.89 (95% CI: 0.83-0.96). Authors with higher c-scores tended to have longer career lengths and similar self-citation rates compared to other authors. Sixteen percent of authors in the database were identified as female, and 64% were affiliated with the United States of America. CONCLUSION The c-score is an effective metric for assessing research impact in ophthalmology, as seen through its ability to predict Weisenfeld Awardees.
Collapse
Affiliation(s)
- Annabelle A Pan
- Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Alex T Pham
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ben Appelo
- Department of Ophthalmology, Wilford Hall Eye Center, San Antonio, TX, USA
| | - Gary L Legault
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | | | - Grant A Justin
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- Department of Ophthalmology, Walter Reed National Military Medical Center, Bethesda, MD, USA
| |
Collapse
|
24
|
Muñoz-Negrete FJ, Villegas-Pérez MP. About the need to update the official program of ophthalmology specialty in Spain. Arch Soc Esp Oftalmol (Engl Ed) 2024; 99:225-226. [PMID: 38309661 DOI: 10.1016/j.oftale.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 12/23/2023] [Indexed: 02/05/2024]
Affiliation(s)
- F J Muñoz-Negrete
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, IRYCIS, Madrid, Spain; Presidente de la Comisión Nacional de la Especialidad de Oftalmología.
| | - M P Villegas-Pérez
- Hospital General Universitario Reina Sofía, Universidad de Murcia, Murcia, Spain; Vicepresidente de la Comisión Nacional de la Especialidad de Oftalmología
| |
Collapse
|
25
|
Schweitzer M, Ostheimer P, Lins A, Romano V, Steger B, Baumgarten D, Augustin M. Transforming Tele- Ophthalmology: Utilizing Cloud Computing for Remote Eye Care. Stud Health Technol Inform 2024; 313:215-220. [PMID: 38682533 DOI: 10.3233/shti240040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
BACKGROUND Tele-ophthalmology is gaining recognition for its role in improving eye care accessibility via cloud-based solutions. The Google Cloud Platform (GCP) Healthcare API enables secure and efficient management of medical image data such as high-resolution ophthalmic images. OBJECTIVES This study investigates cloud-based solutions' effectiveness in tele-ophthalmology, with a focus on GCP's role in data management, annotation, and integration for a novel imaging device. METHODS Leveraging the Integrating the Healthcare Enterprise (IHE) Eye Care profile, the cloud platform was utilized as a PACS and integrated with the Open Health Imaging Foundation (OHIF) Viewer for image display and annotation capabilities for ophthalmic images. RESULTS The setup of a GCP DICOM storage and the OHIF Viewer facilitated remote image data analytics. Prolonged loading times and relatively large individual image file sizes indicated system challenges. CONCLUSION Cloud platforms have the potential to ease distributed data analytics, as needed for efficient tele-ophthalmology scenarios in research and clinical practice, by providing scalable and secure image management solutions.
Collapse
Affiliation(s)
- Marco Schweitzer
- Division for Digital Health and Telemedicine, UMIT TIROL - Private University For Health Sciences and Health Technology, Hall in Tyrol, Austria
- Institute of Electrical and Biomedical Engineering, UMIT TIROL - Private University For Health Sciences and Health Technology, Hall in Tyrol, Austria
| | - Philipp Ostheimer
- Institute of Electrical and Biomedical Engineering, UMIT TIROL - Private University For Health Sciences and Health Technology, Hall in Tyrol, Austria
| | | | - Vito Romano
- Eye Unit, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Bernhard Steger
- Department of Ophthalmology, Medical University of Innsbruck, Innsbruck, Austria
| | - Daniel Baumgarten
- Institute of Electrical and Biomedical Engineering, UMIT TIROL - Private University For Health Sciences and Health Technology, Hall in Tyrol, Austria
| | | |
Collapse
|
26
|
Jansook P, Loftsson T, Stefánsson E. Drug-like properties of tyrosine kinase inhibitors in ophthalmology: Formulation and topical availability. Int J Pharm 2024; 655:124018. [PMID: 38508428 DOI: 10.1016/j.ijpharm.2024.124018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 03/11/2024] [Accepted: 03/17/2024] [Indexed: 03/22/2024]
Abstract
Tyrosine kinase inhibitors (TKIs) can inhibit edema and neovascularization, such as in age-related macular degeneration and diabetic retinopathy. However, their topical administration in ophthalmology is limited by their toxicity and poor aqueous solubility. There are multiple types of TKIs, and each TKI has an affinity to more than one type of receptor. Studies have shown that ocular toxicity can be addressed by selecting TKIs that have a high affinity for specific vascular endothelial growth factor receptors (VEGFRs) but a low affinity for epidermal growth factor receptors (EGFRs). Drugs permeate from the aqueous tear fluid into the eye via passive diffusion. Thus, a sustained high concentration of the dissolved drug in the aqueous tear fluid is essential for a successful delivery to posterior tissues such as the retina. Unfortunately, the aqueous solubility of the TKIs that have the most favorable VEGFR/EGFR affinity ratio, that is, axitinib and cabozantinib, is well below 1 µg/mL, making their topical delivery very challenging. This is a review of the drug-like properties of TKIs that are currently being evaluated or have been evaluated as ophthalmic drugs. These properties include their solubilization, cyclodextrin complexation, and ability to permeate from the aqueous tear fluid to the posterior eye segment.
Collapse
Affiliation(s)
- Phatsawee Jansook
- Faculty of Pharmaceutical Sciences, Chulalongkorn University, 254 Payathai Road, Pathumwan, Bangkok, 10330, Thailand; Cyclodextrin Application and Nanotechnology-Based Delivery Systems Research Unit, Chulalongkorn University, Bangkok 10330, Thailand.
| | - Thorsteinn Loftsson
- Faculty of Pharmaceutical Sciences, University of Iceland, Hofsvallagata 53, IS-107, Reykjavik, Iceland
| | - Einar Stefánsson
- Department of Ophthalmology, Landspitali University Hospital, IS-101 Reykjavik, Iceland
| |
Collapse
|
27
|
Sharma M, Huertas L, Shah S, Gil A, Bitrian E, Chang TC. Compliance with web content accessibility guidelines in ophthalmology social media posts. Sci Rep 2024; 14:9142. [PMID: 38644414 PMCID: PMC11033289 DOI: 10.1038/s41598-024-59838-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 04/16/2024] [Indexed: 04/23/2024] Open
Abstract
This is a cross-sectional exploratory analysis of publicly available Internet data to examine compliance to web content accessibility guidelines (WCAG) on patient education social media posts in ophthalmology. WCAG ensures web content accessibility for those with disabilities (including visual impairment). A total of 100 social media posts were sampled from ten ophthalmology patient education social media pages and ten non-ophthalmology (cardiopulmonary) pages as the comparison group. Three independent graders evaluated the selected posts based on the WCAG 2 checklist by WebAIM, a non-profit affiliated with Utah State University, after its adaptation for social media posts. Validated accessibility standard labels: "0" for not meeting any standards, "1" or "A" for meeting bare minimum accessibility requirements, "2" or "AA" for meeting legal accessibility requirements, or "3" or "AAA" for exceeding accessibility requirements. There was not enough evidence to detect a difference in WCAG scores between ophthalmology and non-ophthalmology posts (p = 0.80). Forty-nine percent of scores for ophthalmology social media posts showed no compliance with any WCAG. The most common reasons that ophthalmology posts failed to meet criteria were due to color and contrast issues (39%). Most ophthalmology social media posts had low WCAG scores, indicating poor compliance to WCAG. Because social media is highly visual, reduced compliance to WCAG may create barriers for low vision individuals to successfully access patient education social media content.
Collapse
Affiliation(s)
- Meghan Sharma
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, FL, 33136, USA
| | - Laura Huertas
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, FL, 33136, USA
| | - Serena Shah
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, FL, 33136, USA
| | - Alexandra Gil
- Florida International University, 11200 SW 8th St, Miami, FL, 33199, USA
| | - Elena Bitrian
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, FL, 33136, USA
| | - Ta C Chang
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, FL, 33136, USA.
| |
Collapse
|
28
|
Kanclerz P, Przewłócka K, Mimouni M. Does the introduction of streamlight decrease refractive surgery operating time? Int Ophthalmol 2024; 44:185. [PMID: 38634955 PMCID: PMC11026198 DOI: 10.1007/s10792-024-03093-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 03/05/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE The aim of the study was to analyze the time-savings associated with introduction of Streamlight™ (Alcon Laboratories, Fort Worth, TX, USA) transepithelial photorefractive keratectomy (PRK) in surface corneal ablations. METHODS All refractive surgeries were performed using the Alcon WaveLight® EX500 at the ArtLife Clinic, Gdańsk, Poland. The study included patients treated for refractive errors with transepithelial PRK between April 2019 and October 2021, who were matched with patients treated with alcohol-assisted PRK during the same period. Only results for the left eye were analyzed. RESULTS One-hundred-five patients underwent transepithelial PRK (age 33.42 ± 8.67 years) and were matched with 105 patients that underwent alcohol-assisted PRK (age 33.05 ± 10.16 years; p = 0.11). The mean preoperative spherical equivalent refraction was - 2.04 ± 2.28 D, and - 1.9 ± 1.71 D for the transepithelial and alcohol-assisted PRK group, respectively (p = 0.20). The total surgery time was non-significantly shorter in transepithelial PRK (349.46 ± 47.83 s) than in alcohol-assisted PRK (354.93 ± 137.63 s; p = 0.7); however, the variance of surgical time was significantly lower in transepithelial PRK (p < 0.001). The laser treatment duration was greater in transepithelial PRK (41.78 ± 17.2 s) than in alcohol-assisted PRK (8.48 ± 6.12 s; p < 0.001), and so was the number of breaks during the laser treatment (0.95 ± 0.63 vs. 0.53 ± 0.88, respectively; p < 0.001). CONCLUSION The introduction of transepithelial PRK did not bring significant time-associated savings into the refractive surgery suite.
Collapse
Affiliation(s)
- Piotr Kanclerz
- ArtLife Ophthalmological Center, ul. Obrońców Wybrzeża 23, 80-398, Gdańsk, Poland.
- Department of Ophthalmology, Hygeia Clinic, Gdańsk, Poland.
- Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland.
| | | | - Michael Mimouni
- Department of Ophthalmology, Rambam Health Care Campus Affiliated with the Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| |
Collapse
|
29
|
Cheng Y, Cai S, Wu H, Pan J, Su M, Wei X, Ye J, Ke L, Liu G, Chu C. Revolutionizing eye care: the game-changing applications of nano-antioxidants in ophthalmology. Nanoscale 2024; 16:7307-7322. [PMID: 38533621 DOI: 10.1039/d4nr00611a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Since the theory of free radical-induced aging was proposed in 1956, it has been constantly proven that reactive oxygen species (ROS) produced by oxidative stress play a vital role in the occurrence and progression of eye diseases. However, the inherent limitations of traditional drug therapy hindered the development of ophthalmic disease treatment. In recent years, great achievements have been made in the research of nanomedicine, which promotes the rapid development of safe theranostics in ophthalmology. In this review, we focus on the applications of antioxidant nanomedicine in the treatment of ophthalmology. The eye diseases were mainly classified into two categories: ocular surface diseases and posterior eye diseases. In each part, we first introduced the pathology of specific diseases about oxidative stress, and then presented the representative application examples of nano-antioxidants in eye disease therapy. Meanwhile, the nanocarriers that were used, the mechanism of function, and the therapeutic effect were also presented. Finally, we summarized the latest research progress and limitations of antioxidant nanomedicine for eye disease treatment and put forward the prospects of future development.
Collapse
Affiliation(s)
- Yuhang Cheng
- Shen Zhen Research Institute of Xiamen University, Shenzhen 518057, China.
- Xiamen University affiliated Xiamen Eye Center, Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, School of Medicine, Xiamen University, Xiamen, 361102, China
| | - Shundong Cai
- Shen Zhen Research Institute of Xiamen University, Shenzhen 518057, China.
- Xiamen University affiliated Xiamen Eye Center, Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, School of Medicine, Xiamen University, Xiamen, 361102, China
| | - Han Wu
- Xiamen University affiliated Xiamen Eye Center, Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, School of Medicine, Xiamen University, Xiamen, 361102, China
| | - Jintao Pan
- Shen Zhen Research Institute of Xiamen University, Shenzhen 518057, China.
| | - Min Su
- Department of Pharmacy, Xiamen Medical College, Xiamen 361023, China.
| | - Xingyuan Wei
- Shen Zhen Research Institute of Xiamen University, Shenzhen 518057, China.
- Xiamen University affiliated Xiamen Eye Center, Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, School of Medicine, Xiamen University, Xiamen, 361102, China
| | - Jinfa Ye
- Xiamen University affiliated Xiamen Eye Center, Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, School of Medicine, Xiamen University, Xiamen, 361102, China
| | - Lang Ke
- Xiamen University affiliated Xiamen Eye Center, Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, School of Medicine, Xiamen University, Xiamen, 361102, China
| | - Gang Liu
- Shen Zhen Research Institute of Xiamen University, Shenzhen 518057, China.
| | - Chengchao Chu
- Shen Zhen Research Institute of Xiamen University, Shenzhen 518057, China.
- Xiamen University affiliated Xiamen Eye Center, Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, School of Medicine, Xiamen University, Xiamen, 361102, China
| |
Collapse
|
30
|
Lin SR, Jiao YH, Cheng JJ, Liu LZ, Hu JP. [A comparative study of rigid gas permeable corneal contact lenses versus frame glasses for refractive correction of postoperative aphakic eyes after congenital cataract surgery in infants and children]. Zhonghua Yan Ke Za Zhi 2024; 60:343-351. [PMID: 38583058 DOI: 10.3760/cma.j.cn112142-20231211-00283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/08/2024]
Abstract
Objective: The aim of this paper is to compare the refractive correction effects of rigid gas permeable contact lenses (RGPCL) and spectacle correction in children with aphakia after congenital cataract surgery. Methods: This was a prospective non-randomized controlled trial. Children with aphakic eyes after congenital cataract surgery, who underwent vision correction in the Strabismus and Pediatric Ophthalmology Clinic of Beijing Tongren Hospital affiliated with Capital Medical University from April 2012 to November 2019, were continuously collected. Those who voluntarily chose to wear RGPCL for refractive correction were included in the experimental group. Patients with monocular disease were in trial group 1, and patients with binocular disease were in trial group 2. Patients who chose to wear frame glasses for refractive correction were included in the control group. Patients with monocular disease were in control group 1, and patients with binocular disease were in control group 2. Regional origin, medical history, and family information were collected at the first diagnosis. During the follow-up, adverse reactions occurring during the process of wearing glasses were recorded. The Teller acuity card was used for visual examination to obtain the best-corrected visual acuity and convert it into the logarithm of the minimum resolution angle. The degree of nystagmus was determined according to the amplitude and frequency of nystagmus. Treatment cost, treatment compliance, and the reasons for adopting or not adopting RGPCL were analyzed through a questionnaire completed by the parents of children with RGPCL. Results: A total of 203 children (344 eyes) who underwent congenital cataract surgery were included, including 124 males (210 eyes) and 79 females (134 eyes). The age range was 3 to 36 months. There were 28 cases in the experimental group, including 19 cases in trial group 1 and 9 cases in trial group 2. There were 175 cases in the control group, including 43 cases in control group 1 and 132 cases in control group 2. Except for 6 months of age, the visual acuity of the experimental group was better than that of the control group, and the differences were statistically significant (P<0.05). The visual acuity of children in trial group 1 was better than that of children in control group 1 at the same age. Among them, at 12 months of age [1.54 (1.27, 1.97), 1.84 (0.97, 2.12)], 18 months of age [1.27 (0.97, 1.84), 1.84 (0.97, 2.12)], 24 months of age [1.54 (1.27, 1.84), 1.84 (0.97, 2.12)], and 30 months old [0.97 (0.66, 1.27), 1.54 (0.66, 2.12)], the difference was statistically significant (P<0.001). The visual acuity of children in trial group 2 was better than that in control group 2 at the same age. Among them, at 18 months old [1.27 (0.97, 1.54), 1.27 (0.66, 2.12)], 24 months old [0.97 (0.66, 1.27), 1.27 (0.66, 2.12)], and 30 months old [1.27 (0.66, 2.12)], the difference was statistically significant (P<0.05). The remission rate of nystagmus in the experimental group was 8/9 (8 cases), the remission rate of nystagmus in the control group was 34.40% (32 cases), and the exacerbation rate was 29.03% (27 cases). The average annual cost of the experimental group was 25 125 yuan, and that of the control group was 2 511 yuan. Conclusions: RGPCL is a well-tolerated, safe, and effective treatment for infants and young children. The visual acuity and degree of nystagmus were significantly improved in children who wore RGPCL for aphakia refractive correction after congenital cataract surgery compared with spectacle correction.
Collapse
Affiliation(s)
- S R Lin
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing 100730, China Lin Sairou was a graduate student,and is now working at the Department of Ophthalmology, Beijing Tsinghua Changgung Hospital affiliated to Tsinghua University, Beijing 102218, China
| | - Y H Jiao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing 100730, China Lin Sairou was a graduate student,and is now working at the Department of Ophthalmology, Beijing Tsinghua Changgung Hospital affiliated to Tsinghua University, Beijing 102218, China
| | - J J Cheng
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing 100730, China Lin Sairou was a graduate student,and is now working at the Department of Ophthalmology, Beijing Tsinghua Changgung Hospital affiliated to Tsinghua University, Beijing 102218, China
| | - L Z Liu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing 100730, China Lin Sairou was a graduate student,and is now working at the Department of Ophthalmology, Beijing Tsinghua Changgung Hospital affiliated to Tsinghua University, Beijing 102218, China
| | - J P Hu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing 100730, China Lin Sairou was a graduate student,and is now working at the Department of Ophthalmology, Beijing Tsinghua Changgung Hospital affiliated to Tsinghua University, Beijing 102218, China
| |
Collapse
|
31
|
Britten A, Matten P, Nienhaus J, Masch JM, Dettelbacher K, Roodaki H, Hecker-Denschlag N, Leitgeb RA, Drexler W, Pollreisz A, Schmoll T. Visualization of Cataract Surgery Steps With 4D Microscope-Integrated Swept-Source Optical Coherence Tomography in Ex Vivo Porcine Eyes. Transl Vis Sci Technol 2024; 13:18. [PMID: 38607633 PMCID: PMC11019595 DOI: 10.1167/tvst.13.4.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/19/2024] [Indexed: 04/13/2024] Open
Abstract
Purpose To investigate the visualization capabilities of high-speed swept-source optical coherence tomography (SS-OCT) in cataract surgery. Methods Cataract surgery was simulated in wet labs with ex vivo porcine eyes. Each phase of the surgery was visualized with a novel surgical microscope-integrated SS-OCT with a variable imaging speed of over 1 million A-scans per second. It was designed to provide four-dimensional (4D) live-volumetric videos, live B-scans, and volume capture scans. Results Four-dimensional videos, B-scans, and volume capture scans of corneal incision, ophthalmic viscosurgical device injection, capsulorrhexis, phacoemulsification, intraocular lens (IOL) injection, and position of unfolded IOL in the capsular bag were recorded. The flexibility of the SS-OCT system allowed us to tailor the scanning parameters to meet the specific demands of dynamic surgical steps and static pauses. The entire length of the eye was recorded in a single scan, and unfolding of the IOL was visualized dynamically. Conclusions The presented novel visualization method for fast ophthalmic surgical microscope-integrated intraoperative OCT imaging in cataract surgery allowed the visualization of all major steps of the procedure by achieving large imaging depths covering the entire eye and high acquisition speeds enabling live volumetric 4D-OCT imaging. This promising technology may become an integral part of routine and advanced robotic-assisted cataract surgery in the future. Translational Relevance We demonstrate the visualization capabilities of a cutting edge swept-source OCT system integrated into an ophthalmic surgical microscope during cataract surgery.
Collapse
Affiliation(s)
- Anja Britten
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | | | - Jonas Nienhaus
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | | | - Katharina Dettelbacher
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | | | | | - Rainer A. Leitgeb
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Drexler
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Andreas Pollreisz
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
| | - Tilman Schmoll
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
- Carl Zeiss Meditec, Inc., Dublin, CA, USA
| |
Collapse
|
32
|
Yap BP, Kelvin LZ, Toh EQ, Low KY, Rani SK, Goh EJH, Hui VYC, Ng BK, Lim TH. Generalizability of Deep Neural Networks for Vertical Cup-to-Disc Ratio Estimation in Ultra-Widefield and Smartphone-Based Fundus Images. Transl Vis Sci Technol 2024; 13:6. [PMID: 38568608 PMCID: PMC10996969 DOI: 10.1167/tvst.13.4.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 02/19/2024] [Indexed: 04/05/2024] Open
Abstract
Purpose To develop and validate a deep learning system (DLS) for estimation of vertical cup-to-disc ratio (vCDR) in ultra-widefield (UWF) and smartphone-based fundus images. Methods A DLS consisting of two sequential convolutional neural networks (CNNs) to delineate optic disc (OD) and optic cup (OC) boundaries was developed using 800 standard fundus images from the public REFUGE data set. The CNNs were tested on 400 test images from the REFUGE data set and 296 UWF and 300 smartphone-based images from a teleophthalmology clinic. vCDRs derived from the delineated OD/OC boundaries were compared with optometrists' annotations using mean absolute error (MAE). Subgroup analysis was conducted to study the impact of peripapillary atrophy (PPA), and correlation study was performed to investigate potential correlations between sectoral CDR (sCDR) and retinal nerve fiber layer (RNFL) thickness. Results The system achieved MAEs of 0.040 (95% CI, 0.037-0.043) in the REFUGE test images, 0.068 (95% CI, 0.061-0.075) in the UWF images, and 0.084 (95% CI, 0.075-0.092) in the smartphone-based images. There was no statistical significance in differences between PPA and non-PPA images. Weak correlation (r = -0.4046, P < 0.05) between sCDR and RNFL thickness was found only in the superior sector. Conclusions We developed a deep learning system that estimates vCDR from standard, UWF, and smartphone-based images. We also described anatomic peripapillary adversarial lesion and its potential impact on OD/OC delineation. Translational Relevance Artificial intelligence can estimate vCDR from different types of fundus images and may be used as a general and interpretable screening tool to improve community reach for diagnosis and management of glaucoma.
Collapse
Affiliation(s)
- Boon Peng Yap
- School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore, Singapore
| | - Li Zhenghao Kelvin
- Department of Ophthalmology, Tan Tock Seng Hospital, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- National Healthcare Group Eye Institute, Singapore, Singapore
| | - En Qi Toh
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Kok Yao Low
- Department of Ophthalmology, Tan Tock Seng Hospital, Singapore, Singapore
- National Healthcare Group Eye Institute, Singapore, Singapore
| | - Sumaya Khan Rani
- Department of Ophthalmology, Tan Tock Seng Hospital, Singapore, Singapore
- National Healthcare Group Eye Institute, Singapore, Singapore
| | - Eunice Jin Hui Goh
- Department of Ophthalmology, Tan Tock Seng Hospital, Singapore, Singapore
- National Healthcare Group Eye Institute, Singapore, Singapore
| | - Vivien Yip Cherng Hui
- Department of Ophthalmology, Tan Tock Seng Hospital, Singapore, Singapore
- National Healthcare Group Eye Institute, Singapore, Singapore
| | - Beng Koon Ng
- School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore, Singapore
| | - Tock Han Lim
- Department of Ophthalmology, Tan Tock Seng Hospital, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- National Healthcare Group Eye Institute, Singapore, Singapore
| |
Collapse
|
33
|
Paramo R, Zong AM, Barmettler A. Socioeconomic Disparities Associated with Access to Oculofacial Plastic Surgeons: A Cross-Sectional Analysis of US County Demographics. Ophthalmology 2024; 131:492-498. [PMID: 37852418 DOI: 10.1016/j.ophtha.2023.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/25/2023] [Accepted: 10/03/2023] [Indexed: 10/20/2023] Open
Abstract
PURPOSE To compare population demographics with the geographic distribution of oculofacial plastic surgeons (OPSs) in the United States. DESIGN A cross-sectional study design was used to investigate demographic differences between counties with 1 or more OPSs and counties with zero OPSs. PARTICIPANTS The number of OPSs were identified in each US county using online public databases: American Society of Ophthalmic Plastic and Reconstructive Surgeons and American Academy of Ophthalmology. Counties were categorized into 2 groups: 1 or more OPSs and zero OPSs. Demographic characteristics at the county level were obtained from the 2021 US Census Bureau Population Estimates and the American Community Survey. Cost of living was collected from the 2022 Economic Policy Institute Family Budget Calculator. MAIN OUTCOME MEASURES Socioeconomic demographics of the US population as related to geographic OPS distribution. RESULTS A total of 1238 OPSs were identified. States with the most OPSs per million were Hawaii (6.2), D.C. (6.0), Connecticut (5.8), Utah (5.1), and Maryland (5.0). Among 3143 counties, 2725 (86.7%) had zero OPSs and 418 (13.3%) had 1 or more OPSs. Counties with 1 or more OPSs had a higher median (standard deviation) household income versus counties with zero OPSs ($72 471 [$19 152] vs. $56 152 [$13 675]; difference $16 319; 95% confidence interval [CI], $14 300-$18 338; P < 0.001). The annual cost of living per person (standard deviation) was higher in counties with 1 or more OPSs versus counties with zero OPSs ($39 238 [$6992] vs. $36 227 [$3516]; difference $3011; 95% CI, $2328-$3694; P < 0.001). Counties with zero OPSs versus counties with 1 or more OPSs had higher proportions of persons with only Medicaid (15.6% vs. 13.6%; difference 2.0%; 95% CI, 1.4%-2.5%; P < 0.001), no health insurance (9.9% vs. 8.0%; difference 1.9%; 95% CI, 1.5%-2.4%; P < 0.001), no household internet access (17.2% vs. 9.6%; difference 7.6%; 95% CI, 7.1%-8.0%; P < 0.001), and higher proportions of persons aged 65 years or older (20.0% vs. 17.0%; difference 3.0%; 95% CI, 2.5%-3.5%; P < 0.001). CONCLUSIONS This cross-sectional analysis of all US counties revealed socioeconomic disparities associated with access to OPSs. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Collapse
Affiliation(s)
- Ricky Paramo
- Montefiore Medical Center, Department of Ophthalmology and Visual Sciences, Bronx, New York
| | - Amanda M Zong
- Albert Einstein College of Medicine, Bronx, New York
| | - Anne Barmettler
- Montefiore Medical Center, Department of Ophthalmology and Visual Sciences, Bronx, New York.
| |
Collapse
|
34
|
Schlote T, Chan E, Germann U. [Ophthalmic agents during pregnancy]. Ophthalmologie 2024; 121:333-348. [PMID: 38587538 DOI: 10.1007/s00347-024-02025-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/08/2024] [Indexed: 04/09/2024]
Abstract
The use of ophthalmic agents during pregnancy and breastfeeding always represents an off-label use. Therefore, the use of drugs must be particularly carefully assessed with respect to the risk-benefit assessment. In this overview the literature databank of the PubMed library, pharmaceutical lists (Red List, Swiss pharmaceutical compendium), guidelines of the specialist societies the German Society of Ophthalmology (DOG), the Swiss Society of Ophthalmology (SOG), the European Glaucoma Society (EGS), the American Academy of Ophthalmology (AAO) and internet portals (embryotox, reprotox) were inspected and recommendations for the use of ophthalmic agents during pregnancy and breastfeeding were derived. More attention should be dedicated to this topic in the specialist societies.
Collapse
Affiliation(s)
- Torsten Schlote
- Tagesklinik Ambimed, Klingentalstr. 9, 40457, Basel, Schweiz.
| | | | | |
Collapse
|
35
|
|
36
|
Gupta U, Maatouk CM, Markle JC, Talcott KE, Singh RP, Rachitskaya AV. Characterizing the Journey of Geographic Atrophy Patients in Routine Ophthalmic Practice. Ophthalmic Surg Lasers Imaging Retina 2024; 55:204-210. [PMID: 38319056 DOI: 10.3928/23258160-20240123-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
BACKGROUND AND OBJECTIVE Geographic atrophy (GA) is a form of late-stage age-related macular degeneration (AMD). This study aims to characterize the journey of patients with GA in real-world ophthalmology practice. PATIENTS AND METHODS This is a retrospective cohort study of 100 patients with GA and 100 with intermediate AMD (iAMD). RESULTS Approximately one-third of GA patients' eyes had GA at the time of their initial AMD diagnosis, and nearly half of the iAMD patients' eyes had iAMD at that time. When holding confounders constant, GA patients experienced significantly worse visual acuity outcomes, and a significantly higher proportion required referrals for low vision evaluation, needed assistance for activities of daily living, failed to meet driving standards, and met criteria for legal blindness when compared to iAMD controls. CONCLUSIONS Many patients have already progressed to GA by the time they receive an AMD diagnosis, emphasizing the importance of providing early detection and intervention, especially considering novel treatment options. [Ophthalmic Surg Lasers Imaging Retina 2024;55:204-210.].
Collapse
|
37
|
Yoo SH, Archer DKL, Caro JA, Monterrey R. Words matter in strabismus surgery too: on terminology used for adjustable strabismus surgery. J AAPOS 2024; 28:103872. [PMID: 38461967 DOI: 10.1016/j.jaapos.2024.103872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 02/06/2024] [Indexed: 03/12/2024]
Affiliation(s)
- Sylvia H Yoo
- Department of Ophthalmology, Tufts Medical Center, Boston, Massachusetts; Tufts University School of Medicine, Boston, Massachusetts
| | - Damian K L Archer
- Office for Multicultural Affairs, Tufts University School of Medicine, Boston, Massachusetts
| | - José A Caro
- Office for Multicultural Affairs, Tufts University School of Medicine, Boston, Massachusetts; Department of Medicine, Tufts Medical Center, Boston, Massachusetts
| | - Rodrigo Monterrey
- Center for Diversity Equity Inclusion, Tufts Medicine, Burlington, Massachusetts
| |
Collapse
|
38
|
Mandal P, Shah C, Shah S. Developing ophthalmology in Cambodia. Eye (Lond) 2024; 38:1084-1090. [PMID: 38135774 PMCID: PMC11009286 DOI: 10.1038/s41433-023-02846-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/29/2023] [Accepted: 11/13/2023] [Indexed: 12/24/2023] Open
Abstract
Over 180,000 Cambodian people are blind and a further 10,000 suffer avoidable blindness each year. Ninety percent of this blindness is avoidable, 79% is curable and 11% is preventable. Three-quarters of this blindness is due to cataracts and the remainder is due to uncorrected vision, glaucoma, corneal scarring and pterygium. The Khmer Sight Foundation (KSF) is a charity reincarnated by Professor Sunil Shah and Sean Ngu. Its mission is to deliver a sustainable eye care model for the country. KSF takes a three pronged approach to this. It is working to develop sustainable eye-care within the country through building physical infrastructure. The second approach is to impact the current cataract backlog of over 300,000 patients with the aid of international support. Thirdly, KSF is paving the way for the next generation through the development of an optometry education programme and training of Cambodian ophthalmologists. Here we present the workings of KSF, clinical cases we have encountered and elaborate upon the future goals of this charity.
Collapse
Affiliation(s)
- Priyanka Mandal
- Department of Ophthalmology, University Hospitals of Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Camrun Shah
- University of Exeter Medical School, Exeter, UK
| | - Sunil Shah
- College of Health and Life Sciences, Aston University, Birmingham, UK.
- Midland Eye, Solihull, UK.
| |
Collapse
|
39
|
Chen JJ, McNussen PJ, Lee AG, Subramanian PS. Re: Pakravan et al.: Demographics, practice analysis and geographic distribution of neuro-ophthalmologists in the United States in 2023 (Ophthalmology. 2024;131:333-340). Ophthalmology 2024; 131:e17-e18. [PMID: 38189696 DOI: 10.1016/j.ophtha.2023.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 11/22/2023] [Indexed: 01/09/2024] Open
Affiliation(s)
- John J Chen
- Departments of Ophthalmology and Neurology, Mayo Clinic, Rochester, Minnesota.
| | | | - Andrew G Lee
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; Departments of Neurology, Neurosurgery, and Ophthalmology, Weill Cornell Medicine, New York, New York; Department of Ophthalmology, University of Texas Medical Branch, Galveston, Texas; Department of Ophthalmology, University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Ophthalmology, Texas A&M University College of Medicine, Houston, Texas; Baylor College of Medicine and Center for Space Medicine, Houston, Texas; University of Iowa Hospitals and Clinics, Iowa City, Iowa; University of Buffalo, Buffalo, New York
| | - Prem S Subramanian
- Department of Ophthalmology, University of Colorado School of Medicine and Sue Anschutz-Rodgers UC Health Eye Center, Aurora, Colorado
| |
Collapse
|
40
|
Amescua G, Ahmad S, Cheung AY, Choi DS, Jhanji V, Lin A, Mian SI, Rhee MK, Viriya ET, Mah FS, Varu DM. Dry Eye Syndrome Preferred Practice Pattern®. Ophthalmology 2024; 131:P1-P49. [PMID: 38349301 DOI: 10.1016/j.ophtha.2023.12.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 12/28/2023] [Indexed: 03/24/2024] Open
Affiliation(s)
- Guillermo Amescua
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Sumayya Ahmad
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York
| | - Albert Y Cheung
- Virginia Eye Consultants, Norfolk, Virginia, Assistant Professor, Department of Ophthalmology, Eastern Virginia Medical School, Norfolk, Virginia
| | - Daniel S Choi
- Cataract and Vision Center of Hawaii, Honolulu, Hawaii
| | - Vishal Jhanji
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Amy Lin
- John A. Moran Eye Center, University of Utah, Salt Lake City, Utah
| | - Shahzad I Mian
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan
| | - Michelle K Rhee
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, Elmhurst Hospital, Mount Sinai Services, Elmhurst, New York
| | - Elizabeth T Viriya
- Department of Ophthalmology, Lincoln Hospital/NYC Health+ Hospitals, Bronx, New York
| | - Francis S Mah
- Departments of Cornea and External Diseases, Scripps Clinic Torrey Pines, La Jolla, California
| | | |
Collapse
|
41
|
Heilenbach N, Ogunsola T, Elgin C, Fry D, Iskander M, Abazah Y, Aboseria A, Alshamah R, Alshamah J, Mooney SJ, Maestre G, Lovasi GS, Patel V, Al-Aswad LA. Novel Methods of Identifying Individual and Neighborhood Risk Factors for Loss to Follow-Up After Ophthalmic Screening. J Glaucoma 2024; 33:288-296. [PMID: 37974319 PMCID: PMC10954411 DOI: 10.1097/ijg.0000000000002328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 10/09/2023] [Indexed: 11/19/2023]
Abstract
PRCIS Residence in a middle-class neighborhood correlated with lower follow-up compared with residence in more affluent neighborhoods. The most common explanations for not following up were the process of making an appointment and lack of symptoms. PURPOSE To explore which individual-level and neighborhood-level factors influence follow-up as recommended after positive ophthalmic and primary care screening in a vulnerable population using novel methodologies. PARTICIPANTS AND METHODS From 2017 to 2018, 957 participants were screened for ophthalmic disease and cardiovascular risk factors as part of the Real-Time Mobile Teleophthalmology study. Individuals who screened positive for either ophthalmic or cardiovascular risk factors were contacted to determine whether or not they followed up with a health care provider. Data from the Social Vulnerability Index, a novel virtual auditing system, and personal demographics were collected for each participant. A multivariate logistic regression was performed to determine which factors significantly differed between participants who followed up and those who did not. RESULTS As a whole, the study population was more socioeconomically vulnerable than the national average (mean summary Social Vulnerability Index score=0.81). Participants whose neighborhoods fell in the middle of the national per capita income distribution had a lower likelihood of follow-up compared with those who resided in the most affluent neighborhoods (relative risk ratio=0.21, P -value<0.01). Participants cited the complicated process of making an eye care appointment and lack of symptoms as the most common reasons for not following up as instructed within 4 months. CONCLUSIONS Residence in a middle-class neighborhood, difficulty accessing eye care appointments, and low health literacy may influence follow-up among vulnerable populations.
Collapse
Affiliation(s)
- Noah Heilenbach
- New York University, Grossman School of Medicine, Department of Ophthalmology
| | | | | | - Dustin Fry
- Drexel University, Dornsife School of Public Health, Urban Health Collaborative
| | - Mina Iskander
- University of Miami, Miller School of Medicine, Department of Medicine
| | - Yara Abazah
- New York University, Grossman School of Medicine, Department of Ophthalmology
| | - Ahmed Aboseria
- State University of New York, Downstate Health Sciences University College of Medicine
| | - Rahm Alshamah
- New York University, Grossman School of Medicine, Department of Ophthalmology
| | - Jad Alshamah
- New York University, Grossman School of Medicine, Department of Ophthalmology
| | | | - Gladys Maestre
- University of Texas, Rio Grande Valley School of Medicine
| | - Gina S. Lovasi
- Drexel University, Dornsife School of Public Health, Urban Health Collaborative
| | - Vipul Patel
- New York University, Grossman School of Medicine, Department of Ophthalmology
| | - Lama A. Al-Aswad
- University of Pennsylvania, Scheie Eye Institute, Department of Ophthalmology
| |
Collapse
|
42
|
Salimi A, Saed Aldien A, ElHawary H, Ambikkumar A, Kapusta MA. Canadian legal cases in ophthalmology: a closer look at 40 years' worth of data. Can J Ophthalmol 2024; 59:83-88. [PMID: 36931321 DOI: 10.1016/j.jcjo.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 02/06/2023] [Accepted: 02/23/2023] [Indexed: 03/15/2023]
Abstract
OBJECTIVE To assess the characteristics of malpractice lawsuits against Canadian ophthalmologists and the predisposing factors leading to claims. DESIGN Retrospective case series. METHODS A systematic search of the 2 largest Canadian online legal databases, LexisNexis Canada and Westlaw Canada, was performed to collect cases against ophthalmologists in Canadian courts from 1977 to 2021. RESULTS This study comprised 68 legal cases, including 52 lawsuits, 14 cases appealed once, and 2 cases appealed twice. Most cases concerned surgical procedures (46.2%), followed by misdiagnoses or lack thereof (32.7%) and nonsurgical procedures (21.2%). Half the cases (n = 26) were immediately dismissed by the judge in favour of the ophthalmologist, though among the remaining half that proceeded to trial the majority (88.5%) were won by the patients. All appeals by patients were dismissed by the judge. The median monetary value of damages awarded was $308,202. CONCLUSIONS This study is the first to report on ophthalmology-involved medical litigation cases in Canada. Most cases were ruled in favour of the ophthalmologist, but most of those that were not immediately dismissed by the judge were ruled in favour of the plaintiff. Notably, a plurality of these cases argued for a lack of informed consent, and every case in which a lack was successfully pleaded was ruled in favour of the plaintiff, highlighting the importance of appropriate informed consent. The findings of this study give Canadian ophthalmologists insight into areas of practice that commonly lead to litigation and can aid in improving clinical practice and risk management.
Collapse
Affiliation(s)
- Ali Salimi
- Department of Ophthalmology, McGill University, Montreal, QC.
| | - Ammar Saed Aldien
- School of Law, New York University, New York, NY; Faculty of Medicine and Health Sciences, McGill University, Montreal, QC
| | - Hassan ElHawary
- Division of Plastic and Reconstructive Surgery, McGill University, Montreal, QC
| | | | | |
Collapse
|
43
|
Rohrbach JM. [Still room for dispute: on shaken baby syndrome and abusive head trauma (AHT)]. Ophthalmologie 2024; 121:328-330. [PMID: 38443493 DOI: 10.1007/s00347-024-01999-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 03/07/2024]
Affiliation(s)
- Jens Martin Rohrbach
- Ophthalmopathologisches Labor/Forschungsbereich "Geschichte der Augenheilkunde", Universitäts-Augenklinik Tübingen, Elfriede-Aulhorn-Str. 7, 72076, Tübingen, Deutschland.
| |
Collapse
|
44
|
Tillmann A, Ceklic L, Dysli C, Munk MR. Gender differences in retinal diseases: A review. Clin Exp Ophthalmol 2024; 52:317-333. [PMID: 38348562 DOI: 10.1111/ceo.14364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 01/05/2024] [Accepted: 01/26/2024] [Indexed: 04/18/2024]
Abstract
Gender medicine is a medical specialty that addresses gender differences in health and disease. Traditionally, medical research and clinical practice have often been focused on male subjects and patients. As a result, gender differences in medicine have been overlooked. Gender medicine considers the biological, psychological, and social differences between the genders and how these differences affect the development, diagnosis, treatment, and prevention of disease. For ophthalmological diseases epidemiological differences are known. However, there are not yet any gender-based ophthalmic treatment approaches for women and men. This review provides an overview of gender differences in retinal diseases. It is intended to make ophthalmologists, especially retinologists, more sensitive to the topic of gender medicine. The goal is to enhance comprehension of these aspects by highlighting fundamental gender differences. Integrating gender medicine into ophthalmological practice helps promote personalized and gender-responsive health care and makes medical research more accurate and relevant to the entire population.
Collapse
Affiliation(s)
- Anne Tillmann
- Augenarzt-Praxisgemeinschaft Gutblick, Pfäffikon, Switzerland
| | - Lala Ceklic
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Bern Photographic Reading Center, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Chantal Dysli
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Bern Photographic Reading Center, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Marion R Munk
- Augenarzt-Praxisgemeinschaft Gutblick, Pfäffikon, Switzerland
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Bern Photographic Reading Center, Inselspital, University Hospital Bern, Bern, Switzerland
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| |
Collapse
|
45
|
Young BK, Zhao PY. Large Language Models and the Shoreline of Ophthalmology. JAMA Ophthalmol 2024; 142:375-376. [PMID: 38386327 DOI: 10.1001/jamaophthalmol.2023.6937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Affiliation(s)
- Benjamin K Young
- Casey Eye Institute, Oregon Health & Sciences University, Portland
| | - Peter Y Zhao
- New England Eye Center, Tufts University School of Medicine, Boston, Massachusetts
| |
Collapse
|
46
|
Liu G, Zhou M, Wang W. Re: Sit et al.: Ophthalmic Technology Assessment: corneal hysteresis for the diagnosis of glaucoma and assessment of progression risk: a report by the American Academy of Ophthalmology (Ophthalmology. 2023;130:433-442). Ophthalmology 2024; 131:e16. [PMID: 38189698 DOI: 10.1016/j.ophtha.2023.11.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 11/22/2023] [Indexed: 01/09/2024] Open
Affiliation(s)
- Guangsen Liu
- Department of Ophthalmology, Zhengda Guangming Eye Group, Yantai Zhengda Guangming Eye Hospital, Yantai, Shandong, China; Zhengda Guangming International Eye Reserch Center, Qingdao University, Qingdao, China
| | - Minghui Zhou
- Department of Nursing, Yantai Yuhuangding Hospital, Yantai, Shandong, China
| | - Wei Wang
- Department of Nursing, Yantai Yuhuangding Hospital, Yantai, Shandong, China.
| |
Collapse
|
47
|
Zweifel S. Editorial. Klin Monbl Augenheilkd 2024; 241:343. [PMID: 38653262 DOI: 10.1055/a-2209-7169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
|
48
|
Wang N, Han S, Liu X, Ren Y. Application of process optimization in perioperative nursing of ophthalmic day surgery patients. Minerva Surg 2024; 79:263-265. [PMID: 37851012 DOI: 10.23736/s2724-5691.23.10053-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Affiliation(s)
- Nan Wang
- Operating Room, Tianjin Eye Hospital, Tianjin, China
| | - Sai Han
- Operating Room, Tianjin Eye Hospital, Tianjin, China
| | - Xuyao Liu
- Operating Room, Tianjin Eye Hospital, Tianjin, China
| | - Yongxia Ren
- Department of Nursing, Tianjin Eye Hospital, Tianjin, China -
| |
Collapse
|
49
|
Novack GD. Pipeline: Ocular biostatistics: Proper use of proportions. Ocul Surf 2024; 32:120-122. [PMID: 38387782 DOI: 10.1016/j.jtos.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Affiliation(s)
- Gary D Novack
- Department of Ophthalmology & Visual Sciences, University of California, Davis, USA; PharmaLogic Development Inc., San Rafael CA, USA; Department of Ophthalmology, USA.
| |
Collapse
|
50
|
Kuo A, Yazji I, Abbass N, Chong DD, Fane L, Örge FH. Lack of racial and ethnic diversity in pediatric ophthalmology clinical trials from 2000 to 2022. J AAPOS 2024; 28:103870. [PMID: 38460595 DOI: 10.1016/j.jaapos.2024.103870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 12/26/2023] [Accepted: 01/16/2024] [Indexed: 03/11/2024]
Abstract
PURPOSE To examine the prevalence of and factors associated with racial and ethnic reporting and trends in such reporting and to assess whether categories of race and ethnicity have been under- or over-represented in pediatric ophthalmology randomized control trials (RCTs) in the United States. METHODS We systematically searched the literature on pediatric ophthalmology RCTs in high-impact factor ophthalmology journals published between 2000 and 2022. Logistic regression was used to assess parameters linked to race/ethnicity reporting; linear regression, to gauge the relationship between publication year and race/ethnicity reporting. The racial and ethnic composition of RCTs was contrasted with 2010 US census data by calculating percentage difference. RESULTS Of 170 eligible articles, 89 (52.4%) included race/ethnicity data. Multivariable analysis showed that academic (OR = 12.19; 95% CI, 3.34-44.44) and government (OR = 3.91; 95% CI, 1.20-12.72) funding was linked to data reporting. During the study period, publication year and race/ethnicity reporting had a nonstatistically significant 1.0% annual increase (r = 0.29, P = 0.18). White participants were over-represented, with a percentage difference of 16.7% (95% CI, 11.8%-21.7%), whereas Hispanic individuals were under-represented, with a percentage difference of -7.6% (95% CI, -11.2% to -4.1%) compared to the 2010 US census data. CONCLUSIONS Our results indicate a gradual rise in reported race and/or ethnicity in published pediatric ophthalmology RCTs, though not statistically significant, both in the United States and globally. Notably, under-representation of Hispanic, over-representation of White, and proportional representation of Black and Asian individuals were observed in US-based studies.
Collapse
Affiliation(s)
- Andy Kuo
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Isabella Yazji
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Nadia Abbass
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - David D Chong
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Lauren Fane
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Faruk H Örge
- Case Western Reserve University School of Medicine, Cleveland, Ohio; Center for Pediatric Ophthalmology and Adult Strabismus, Rainbow Babies and Children's Hospital, University Hospitals Cleveland Medical Center, Cleveland, Ohio.
| |
Collapse
|