AJO International最新文献

{"title":"Outcomes of aqueous shunt surgery in glaucoma secondary to congenital aniridia","authors":"Jeremy C.K. Tan ,&nbsp;Abdus Samad Ansari ,&nbsp;Nicholas G. Strouthidis ,&nbsp;John Brookes ,&nbsp;Peng T Khaw ,&nbsp;Keith Barton ,&nbsp;Renata Puertas","doi":"10.1016/j.ajoint.2025.100114","DOIUrl":"10.1016/j.ajoint.2025.100114","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the safety and efficacy outcomes of aqueous shunt implant with/without intraoperative mitomycin-C (MMC) in glaucoma secondary to congenital Aniridia and risk factors associated with its success.</div></div><div><h3>Design</h3><div>Retrospective study</div></div><div><h3>Subjects</h3><div>Patients with congenital Aniridia who underwent aqueous shunt implantation with/without intraoperative MMC for glaucoma at Moorfields Eye Hospital London between 2012 and 2021 with at least 3 years follow-up.</div></div><div><h3>Methods</h3><div>The primary outcome was success at 3 years defined by intraocular pressure (IOP) reduction ≥ 20 % from baseline and final IOP between 6 and 21 mmHg with/without (overall) or without (complete) medications, without further glaucoma surgery or loss of light perception.</div></div><div><h3>Results</h3><div>Altogether 28 eyes of 23 patients were included, with a mean age of 33.1 (SD 18.3) years. The baseline IOP, medications and visual acuity were 23.4 (SD 8.3), 3.0 (SD 0.9) and 1.6 (SD 0.7) logMAR respectively. Intraoperative MMC was used in 15 (53.6 %) cases. At 3 years the proportion of complete and overall success was 44.0 % and 92.0 % respectively, with a significant reduction in IOP (-11.0, CI -14.0 to -8.0, <em>p</em> &lt; 0.001) and medication use (-1.7, CI -2.3 to -1.2, <em>p</em> &lt; 0.001), and no significant change in VA. There was no significant association between baseline IOP, number of medications and VA, lens status, MMC use, removal of stent suture and surgical success.</div></div><div><h3>Conclusions</h3><div>Aqueous shunt implant is effective at reducing IOP and medication use at 3 years in glaucoma secondary to congenital Aniridia, with no significant change in visual acuity observed post-operatively.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 2","pages":"Article 100114"},"PeriodicalIF":0.0,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of ChatGPT-4 in detecting referable diabetic retinopathy using single fundus images","authors":"Owais Aftab ,&nbsp;Hamza Khan ,&nbsp;Brian L. VanderBeek ,&nbsp;Drew Scoles ,&nbsp;Benjamin J. Kim ,&nbsp;Jonathan C. Tsui","doi":"10.1016/j.ajoint.2025.100111","DOIUrl":"10.1016/j.ajoint.2025.100111","url":null,"abstract":"<div><h3>Purpose</h3><div>Evaluate ChatGPT-4′s ability to identify referable diabetic retinopathy (DR) from single fundus images.</div></div><div><h3>Design</h3><div>A cross-sectional study comparing ChatGPT-4′s versus retina specialists’ identification of more than mild DR (mtmDR) and vision-threatening DR (VTDR).</div></div><div><h3>Methods</h3><div>Images in equal proportions of normal, mild, moderate, and severe nonproliferative DR (NPDR), proliferative DR (PDR), and blurry images with and without suspected PDR were presented to a panel of blinded retina specialists who identified images as readable or unreadable, and potentially as mtmDR or VTDR. These images were also submitted to ChatGPT-4 three times with a standardized prompt regarding mtmDR and VTDR. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for ChatGPT-4′s responses regarding mtmDR and VTDR as compared to the retina specialists majority determination.</div></div><div><h3>Results</h3><div>Retina specialists read 158/180 prompts (87.7 %) with excellent interrater reliability while ChatGPT-4 read 132/180 (73.33 %) of the image prompts. For mtmDR, ChatGPT-4 demonstrated a sensitivity of 96.2 %, specificity of 19.1 %, PPV of 69.1 %, and NPV of 72.7 %. Overall, 90.9 % of prompts read by ChatGPT-4 were labeled as mtmDR. For VTDR, ChatGPT-4 demonstrated a 63.0 % sensitivity, 62.5 % specificity, 71.9 % PPV, and 52.6 % NPV compared to retina specialists. ChatGPT-4 labeled 51.5 % of read images as VTDR. Overall referability was 66.6 % for retina specialists and 93.3 % for ChatGPT-4.</div></div><div><h3>Conclusion</h3><div>While ChatGPT-4 demonstrates promise in identifying moderate-to-severe DR, its limited specificity and tendency to overcall disease reduce its current utility as a screening tool.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 2","pages":"Article 100111"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CERKL-associated retinal degeneration in Portugal: Mutational spectrum and retinal phenotypes","authors":"Catarina Pestana Aguiar ,&nbsp;Lilianne Duarte ,&nbsp;Célia Azevedo Soares ,&nbsp;Pedro Marques-Couto ,&nbsp;Sérgio Estrela-Silva ,&nbsp;Ana Luísa Carvalho ,&nbsp;João Pedro Marques","doi":"10.1016/j.ajoint.2025.100112","DOIUrl":"10.1016/j.ajoint.2025.100112","url":null,"abstract":"<div><h3>Purpose</h3><div>Ceramide kinase-like (CERKL) is a rarely reported gene in association with inherited retinal disease. This study aims to describe the genetic profile and phenotypic spectrum of <em>CERKL</em>-associated Retinal Degeneration (CERKL-RD) in Portugal.</div></div><div><h3>Design</h3><div>Cross-sectional, multicenter cohort study</div></div><div><h3>Methods</h3><div>Genotypic and phenotypic evaluation of 17 patients from 15 families from 3 Portuguese national health system health care providers. All patients were evaluated with multimodal retinal imaging (spectral domain optical coherence tomography, ultra-widefield color fundus photography and fundus autofluorescence). Genetic variants were classified in compliance with the American College of Medical Genetics and Genomics (ACMG) standards and guidelines.</div></div><div><h3>Results</h3><div>The majority of patients were female (76.5 %), with a mean age of 49±17 years. The mean age at molecular diagnosis was 45.6 ± 16.1 years-old. Mean follow-up time was 60.6 ± 60.3 months. Most patients harbored the R257* variant in homozygosity, but with high intra- and interfamilial variability in the retinal phenotype. At the time of diagnosis, 41.2 % patients were already legally blind and this number raised to 52.9 % at the last available follow-up. Early macular involvement was a concerning characteristic observed in almost all cases.</div></div><div><h3>Conclusion</h3><div><em>CERKL</em>-RD in Portugal is predominantly associated with a nonsense variant, highlighting the potential role of nonsens<em>e</em> suppression therapies for this population.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 2","pages":"Article 100112"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual rehabilitation in subconjunctival MIGS versus trabeculectomy and tube shunt surgery","authors":"Jeremy C.K. Tan ,&nbsp;Yohei Hashimoto ,&nbsp;Hamish Dunn ,&nbsp;David Wechsler ,&nbsp;Shweta Kaushik ,&nbsp;Louis Arnould ,&nbsp;Andrew White ,&nbsp;Mitchell Lawlor ,&nbsp;FGB registry","doi":"10.1016/j.ajoint.2025.100108","DOIUrl":"10.1016/j.ajoint.2025.100108","url":null,"abstract":"<div><h3>Background</h3><div>To compare recovery of baseline visual acuity and persistent visual loss at 12-months in standalone subconjunctival minimally invasive glaucoma surgery (MIGS) vs trabeculectomy and tube shunt surgery in manifest and suspect glaucoma.</div></div><div><h3>Design</h3><div>Retrospective international multicenter study</div></div><div><h3>Methods</h3><div>Analysis of 974 eyes (Xen, 359; Trab, 455; Tube 160) of 847 subjects that underwent standalone Xen45 gel stent (Xen, 87 % ab-interno), trabeculectomy (Trab) or tube shunt (Tube) surgery with 12 months of follow-up. The primary outcome was time for visual acuity (VA) to return to within five letters of pre-operative baseline.</div></div><div><h3>Results</h3><div>The baseline glaucoma severity was significantly worse in the Tube group (mean deviation -10.4 vs -12.9 vs -14.4 dB in Xen vs Trab vs Tube, <em>P</em> &lt; 0.001). The proportion of eyes that returned to within 5 letters of baseline VA at 12 months was 93.0 %, 88.6 % and 89.4 % respectively. Compared to the Trab group, the Xen had a significantly shorter median recovery time (9 vs 15 vs 15 days) and higher likelihood of return to baseline VA, including in a subcohort propensity score matched by baseline characteristics (OR 1.48, CI 1.18–1.87, <em>P</em> &lt; 0.001). The Xen group however displayed lower surgical success than the Trab group. There was no significant difference in the rate of VA loss at 12 months (2.5 % vs 2.5 % vs 5 %, <em>P</em> = 0.21).</div></div><div><h3>Conclusions</h3><div>Subconjunctival minimally invasive glaucoma surgery displayed the fastest and a higher likelihood of return to baseline visual acuity compared to Trab and Tube surgery.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 1","pages":"Article 100108"},"PeriodicalIF":0.0,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143526708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical performance analysis and cost-utility analysis of a mobile cataract surgery service in a rural setting in Thailand","authors":"Mantapond Ittarat ,&nbsp;Wanrudee Isaranuwatchai ,&nbsp;Sunee Chansangpetch","doi":"10.1016/j.ajoint.2025.100109","DOIUrl":"10.1016/j.ajoint.2025.100109","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate a clinical performance and cost-effectiveness of a mobile cataract surgery service, specifically and separately for Phacoemulsification (Phaco) and extracapsular cataract extraction (ECCE)</div></div><div><h3>Design</h3><div>A pre-post study with individual-level data</div></div><div><h3>Methods</h3><div>Patients diagnosed with advanced cataracts underwent cataract surgery at a mobile cataract surgery service. Data on corrected distance visual acuity (CDVA), quality of life (QOL) assessed by EQ-5D-5L questionnaire, and cost were prospectively collected at and compared between baseline and 3 months after treatment. Linear regression was used to analyze the clinical performance, and a cost-utility analysis (CUA) was conducted to show the cost-effectiveness of the mobile service.</div></div><div><h3>Results</h3><div>A total of 98 eyes from 98 patients had cataract surgeries, with 53 patients (54 %) undergoing Phaco techniques and 45 patients (46 %) undergoing ECCE techniques. For the total cohort, LogMAR CDVA changed from 1.88±0.59 to 0.23±0.23 (<em>p</em> &lt; 0.001) with only one case of complication. Significant improvements of mobility and usual activities QOL scores, and utility values were demonstrated (all <em>p</em> &lt; 0.001). Separate CUAs by technique with pre-post data showed that patients with Phaco gained 4.93 QALYs and costed approximately THB 18,800 (USD 535) and patients with ECCE gained 5.45 QALYs with the cost of THB 14,400 (USD 412).</div></div><div><h3>Conclusions</h3><div>A mobile cataract surgery service is effective in improving vision and QOL with a low complication rate. The CUAs showed that both Phaco and ECCE could be cost-effective. Implementing such services in rural areas could be a strategy to increase effective cataract surgery coverage.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 1","pages":"Article 100109"},"PeriodicalIF":0.0,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143526709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toxic optic neuropathy from heavy metal exposure: A comprehensive review and case reports","authors":"Mohammed Saeed ,&nbsp;Luai Eldweik","doi":"10.1016/j.ajoint.2025.100107","DOIUrl":"10.1016/j.ajoint.2025.100107","url":null,"abstract":"<div><h3>Purpose</h3><div>This article explores heavy metal toxicity as a significant cause of optic neuropathy, and aims to raise awareness among ophthalmologists evaluating patients affected, to a cause that is often not on their radar. We conducted a comprehensive literature review to highlight the clinical presentations and diagnostic strategies.</div></div><div><h3>Methods</h3><div>We searched for cases of toxic optic neuropathy (TON) secondary to heavy metal exposure in patients seen at the Neuro-Ophthalmology Clinic at Cleveland Clinic Abu Dhabi and identified relevant cases for review. We conducted a literature review of the English-language literature using PubMed to identify published cases of heavy metal-induced optic neuropathy, focusing on keywords including toxic optic neuropathy, heavy metal poisoning, lead, arsenic, mercury, thallium, cadmium, and chromium. Articles were selected based on relevance to clinical presentations and diagnostic findings.</div></div><div><h3>Results</h3><div>We identified four cases of heavy metal-induced optic neuropathy in patients aged 34 to 76. All experienced gradual, painless vision loss over months to years, accompanied by impaired color vision and visual field defects such as cecocentral scotoma and peripheral constriction. Key findings included pale optic discs and thinning of the retinal nerve fiber layer and ganglion cell layer on optical coherence tomography. Despite normal brain imaging and extensive testing to rule out infectious, autoimmune, and nutritional causes, elevated heavy metal levels were identified in all cases. Arsenic toxicity from contaminated water was the cause in three cases, while mercury exposure from workplace inhalation accounted for the fourth. Similar findings have been reported in the literature, where cases ranged from 22 to 75 years of age, affected both sexes, and shared comparable presentations, including optic disc pallor, retinal thinning, and associated neurological symptoms like peripheral neuropathy.</div></div><div><h3>Conclusions</h3><div>Heavy metal toxicity as a cause of optic neuropathy is an uncommon yet critical condition that can often be overlooked in clinical practice. Differentiating optic neuropathy due to heavy metal toxicity from other similar conditions can be challenging, three of the four patients were initially diagnosed with glaucoma and were later referred due to a lack of evidence supporting this diagnosis. Clinical suspicion, thorough history taking, and comprehensive laboratory work-up are essential for accurate diagnosis.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 1","pages":"Article 100107"},"PeriodicalIF":0.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143526707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reach, effectiveness, adoption, implementation and maintenance of a school eye health program in Petauke district, Zambia","authors":"Surenth Priyan Srinivasan ,&nbsp;Amaarah Udat ,&nbsp;Evelyn Ngaanuma ,&nbsp;Ronnie Graham ,&nbsp;Hannah Faal ,&nbsp;Ving Fai Chan","doi":"10.1016/j.ajoint.2025.100106","DOIUrl":"10.1016/j.ajoint.2025.100106","url":null,"abstract":"<div><h3>Purpose</h3><div>This study evaluates the performance of a school eye health program conducted by Vision Action in the Petauke district, Zambia, using the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance).</div></div><div><h3>Design</h3><div>Program evaluation study design.</div></div><div><h3>Methods</h3><div>The program targeted 50,000 learners and 780 teachers across 101 schools. Teachers conducted screenings, with referrals made to mobile eye clinics. Data on knowledge, attitudes, practices (KAP), and children's quality of life (QoL) were collected and analyzed using qualitative and quantitative indicators.</div></div><div><h3>Results</h3><div>A total of 53,353 children (106 % of the target) were screened, with rural students (65 %) and girls (55 %) being the largest beneficiaries. Teachers exhibited the greatest improvement in eye health knowledge and practices. Children's QoL scores significantly improved from a baseline mean of 48.9 (95 % CI: 45.9–51.9) to 70.2 (95 % CI: 64.9–75.5), representing a 51.6 % change (<em>p</em> &lt; 0.001). However, spectacle compliance was low (17 %), and only 59 % of referred children attended the mobile clinic due to barriers like COVID-19 fears and harvest season timing.</div></div><div><h3>Conclusion</h3><div>The program successfully reached over 53,000 children, surpassing its target and improving eye health awareness and QoL. While it demonstrated strong effectiveness, challenges like low spectacle compliance and referral uptake persist. Addressing barriers such as parental fears and community activities is essential. The findings emphasize the importance of sustainable screening practices and integrating community engagement strategies to ensure long-term benefits in resource-limited settings.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 1","pages":"Article 100106"},"PeriodicalIF":0.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143508598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structural and functional clinician-reported outcomes show strong correlations with patient-reported outcomes in Retinitis Pigmentosa","authors":"Sofia Teixeira ,&nbsp;Maria Franca ,&nbsp;Nuno Gouveia ,&nbsp;Bruno Teixeira ,&nbsp;Rufino Silva ,&nbsp;Joaquim Murta ,&nbsp;João Pedro Marques","doi":"10.1016/j.ajoint.2025.100105","DOIUrl":"10.1016/j.ajoint.2025.100105","url":null,"abstract":"<div><h3>Purpose</h3><div>Retinitis Pigmentosa (RP) is the most common inherited retinal disease (IRD). The Michigan Retinal Degeneration Questionnaire (MRDQ) is a validated patient-reported outcome (PRO) measure designed to assess visual function in IRDs. This study aims to explore the association between functional and structural clinician-reported outcomes (CROs) and PROs in RP.</div></div><div><h3>Design</h3><div>Cross-sectional study</div></div><div><h3>Methods</h3><div>Study conducted at a Portuguese IRD referral center, including genetically confirmed RP patients from the IRD-PT registry (retina.com.pt). Collected clinical data encompassed demographics, genetic results, best-corrected visual acuity (BCVA), mean deviation (MD) and foveal sensitivity (FS) from automated static perimetry, ultra-widefield fundus autofluorescence (UW-FAF) patterns, and ellipsoid zone area measurements from spectral-domain optical coherence tomography (SD-OCT). Participants completed the Portuguese version of the MRDQ.</div></div><div><h3>Results</h3><div>The study included 72 RP patients (50% female, mean age 46.96±17.24 years) with disease-causing variants across twelve different genes. Median BCVA of the better-seeing eye was 71.50 (61.00, 80.00) ETDRS letters. A significant negative correlation (p&lt;0.001) was found between BCVA and all MRDQ domains. MD and FS also correlated negatively (p&lt;0.002) with several MRDQ domains. In structural measures, ellipsoid zone (EZ) area showed significant negative correlations with all MRDQ parameters (p&lt;0.05) except scotopic function and photosensitivity. UW-FAF patterns showed a significant association with scotopic (p=0.02) and mesopic peripheral functions (p=0.01).</div></div><div><h3>Conclusion</h3><div>This study reveals a strong correlation between PRO measures and both functional and structural CROs in RP. The MRDQ is a valuable tool for understanding self-perceived visual function in RP and should be used in therapeutic trials and personalized low vision rehabilitation.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 1","pages":"Article 100105"},"PeriodicalIF":0.0,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chat GPT 4o vs residents: French language evaluation in ophthalmology","authors":"Leah Attal ,&nbsp;Elad Shvartz ,&nbsp;Nakhoul Nakhoul ,&nbsp;Daniel Bahir","doi":"10.1016/j.ajoint.2025.100104","DOIUrl":"10.1016/j.ajoint.2025.100104","url":null,"abstract":"<div><h3>Purpose</h3><div>Chatbots capable of answering multiple-choice questions (MCQs) at a level comparable to residents could serve as affordable, 24/7 available educational tools with comprehensive explanations. Their non-judgmental nature could enable residents to freely ask questions without hesitation. Therefore, this study's aim is to evaluate ChatGPT 4o's accuracy to MCQs from the national ophthalmology residency examination in French language, compared to residents and other leading AI chatbots</div></div><div><h3>Methods</h3><div>A set of 600 questions from the national ophthalmology examination was translated into French and submitted to ChatGPT 4o, ChatGPT 4, and Gemini Advanced. The generated responses were compared to official correction grids to evaluate their accuracy. Additionally, variations over time, specialties, and accuracy with both text-based and image-based questions were analysed and compared to residents’ results.</div></div><div><h3>Results</h3><div>ChatGPT 4o achieved an accuracy rate of 67.5 %, outperforming the accuracy of ChatGPT 4 and Gemini Advanced. However, Gemini Advanced exhibited greater sensitivity to the ethical considerations involved in medical advice generation. ChatGPT 4o demonstrated consistent accuracy over time, with particular strength in the fundamentals of ophthalmology, ocular pathologies, and refractive surgery. Its performance in image processing was significantly improved compared to other chatbots, though still inferior to text-based processing.</div></div><div><h3>Conclusion</h3><div>ChatGPT 4o demonstrates sufficient accuracy to pass the ophthalmology national examination, though its performance falls short compared to that of residents. These findings suggest that the use of ChatGPT 4o as an educational tool in ophthalmology residency is promising, even in a non-English language. However, further improvements are needed to enhance its performances.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 1","pages":"Article 100104"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143291832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a novel limbal-rigid contact lens on potential cost savings in Stevens-Johnson syndrome patients from postmarket surveillance","authors":"Kenichi Kimura ,&nbsp;Mayumi Ueta ,&nbsp;Hideki Fukuoka ,&nbsp;Koji Kitazawa ,&nbsp;Tsutomu Inatomi ,&nbsp;Shigeru Kinoshita ,&nbsp;Ryoichi Shiota ,&nbsp;Naoki Yamauchi ,&nbsp;Jiro Miyazaki ,&nbsp;Satomi Sakabayashi ,&nbsp;Satoshi Teramukai ,&nbsp;Kojiro Imai ,&nbsp;Kenji Konomi ,&nbsp;Yuichi Uchino ,&nbsp;Yoko Ogawa ,&nbsp;Takefumi Yamaguchi ,&nbsp;Jun Shimazaki ,&nbsp;Yoshiyuki Satake ,&nbsp;Chie Sotozono","doi":"10.1016/j.ajoint.2025.100101","DOIUrl":"10.1016/j.ajoint.2025.100101","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the safety, efficacy, and potential-cost-savings of a newly-developed limbal-rigid contact lens (CL) via postmarket surveillance (PMS).</div></div><div><h3>Design</h3><div>Postmarket prospective observational use-results surveillance with cost-savings analysis.</div></div><div><h3>Methods</h3><div>We examined 80 eyes of 68 Stevens-Johnson syndrome (SJS) cases using the newly-developed Suncon Kyoto-CS limbal-rigid CL (Sun Contact Lens). CL-wear-associated best-corrected visual acuity (BCVA), objective signs (i.e., bulbar-conjunctival hyperemia, upper-eyelid conjunctival scarring, eye discharge, keratoconjunctival epithelial defect, corneal opacification, and corneal neovascularization), and subjective symptoms (i.e., dryness and eye pain) at baseline and at 6-months of CL use were measured and compared, with adverse events noted. Potential cost savings from improvements in CL-wear-related BCVA were estimated based on the potential for improvements in each patient's visual-impairment-grade under the Japanese Pharmaceuticals and Medical Devices Agency (PMDA) disability pension plan. Main outcome measures were potential cost savings via use of the CL. Secondary outcome measures were CL safety and efficacy via PMS.</div></div><div><h3>Results</h3><div>At 6-months of CL use, the median BCVA in the CL-fitted eyes improved from 1.30 to 0.70 logMAR compared to that of spectacle correction at baseline (<em>P</em> &lt; 0.001), and improvement of bulbar-conjunctival hyperemia, dryness, and eye pain was observed (<em>P</em> &lt; 0.001, <em>P</em> &lt; 0.001, and <em>P</em> &lt; 0.001, respectively). No serious adverse events occurred. Potential-cost-savings analysis showed visual-impairment-grade improvement in 18 (28.6 %) of 63 patients. Considering the financial amount of the PMDA disability pension, estimated total potential cost savings was &gt;6.9-million U.S. dollars.</div></div><div><h3>Conclusion</h3><div>The newly-developed limbal-rigid CL was found safe and effective for treating SJS-associated ocular sequelae, and potentially reduces disability-pension costs.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 1","pages":"Article 100101"},"PeriodicalIF":0.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}