AJO International最新文献

{"title":"Association between screen time and guardian-reported vision difficulty in children and adolescents: A population-based analysis","authors":"Andrew Mihalache ,&nbsp;Panthea Rahmdel ,&nbsp;Ryan S. Huang ,&nbsp;Marko M. Popovic ,&nbsp;Behnam Rahmdel ,&nbsp;Stacey Chong ,&nbsp;Crystal S.Y. Cheung ,&nbsp;Rajeev H. Muni","doi":"10.1016/j.ajoint.2025.100177","DOIUrl":"10.1016/j.ajoint.2025.100177","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate associations between screen time and guardian-reported vision difficulties among paediatric populations in the United States.</div></div><div><h3>Design</h3><div>Retrospective, population-based, cross-sectional study.</div></div><div><h3>Methods</h3><div>Using data from the 2020 and 2022 National Health Interview Survey, this study included participants aged 2-17 years with complete guardian-reported data pertaining to vision status and screen time usage. We performed logistic regressions to explore associations between screen time and vision difficulties, reporting odds ratios (ORs) and 95% confidence intervals (CIs).</div></div><div><h3>Results</h3><div>A total of 5,112 participants (mean age: 10.1 ± 4.7 years) were included in 2020, and 6,473 participants (mean age: 9.9 ± 4.7 years) were included in 2022. In our univariable analysis, children who had a screen time of &gt;2 hours/day had a higher odds of guardian-reported vision difficulty in 2020 (OR=1.53, 95%CI=[1.08, 2.16], p=0.017) and in 2022 (OR=1.38, 95%CI=[1.02, 1.86], p=0.038). These findings were consistent in a subgroup of female children (p=0.002 in 2020 and p=0.014 in 2022). Our multivariable analysis of 2020 data found that the odds of guardian-reported vision difficulty among children with a screen time of &gt;2 hours/day was significantly higher in females (OR=1.73, 95%CI=[1.02, 2.93], p=0.040) and children residing in the Midwest (OR=2.41, 95%CI=[1.11, 5.20], p=0.026). No findings were significant in our adjusted analysis of 2022 data.</div></div><div><h3>Conclusion</h3><div>Screen time was associated with guardian-reported vision difficulties in paediatric populations in the United States in our univariable analysis. However, this association was not consistently observed in adjusted models of 2020 data, and no associations remained significant in the multivariable analysis of 2022 data. Public health initiatives aimed at promoting healthy screen time habits and regular eye care among vulnerable groups of children and adolescents are encouraged.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100177"},"PeriodicalIF":0.0,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-linear association between serum lipid levels and diabetic retinopathy in a nationally representative Korean population","authors":"Seowoong Jun ,&nbsp;Joon Yul Choi ,&nbsp;Tae Keun Yoo","doi":"10.1016/j.ajoint.2025.100176","DOIUrl":"10.1016/j.ajoint.2025.100176","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the associations between serum lipid levels and diabetic retinopathy (DR) in Korean adults with diabetes.</div></div><div><h3>Design</h3><div>Cross-sectional analysis of a nationally representative survey.</div></div><div><h3>Methods</h3><div>We analyzed 1,378 adults with diabetes from the Korea National Health and Nutrition Examination Survey (2008–2011). DR was ascertained from fundus photographs and medical history. Lipids (total cholesterol, HDL, LDL, triglycerides, non-HDL) were modeled by quintiles and with restricted cubic splines. Multivariable logistic regression adjusted for age, sex, systolic blood pressure, hemoglobin A1c, and statin use. Sensitivity analyses used multiple imputation.</div></div><div><h3>Results</h3><div>DR was present in 301/1,378 participants (21.8%). Adjusted models showed no linear trends for cholesterol measures. In quintile analyses, total cholesterol exhibited higher odds of DR at both extremes versus the middle quintile (Q3): Q1 OR 1.63 (95% CI, 1.04–2.57); Q4 OR 1.64 (1.06–2.57); Q5 OR 1.59 (1.03–2.49); P for U-shape = 0.008 (Q2 OR 1.42 [0.90–2.23]). LDL and non-HDL also demonstrated U-shaped patterns (P for U-shape = 0.029 and 0.038). Spline models supported U-shaped association for total cholesterol (P = 0.031), LDL (P = 0.039), and non-HDL (P = 0.014). No consistent nonlinear associations were observed for HDL or triglycerides. Multiple-imputation results were concordant, reinforcing the U-shape for total cholesterol.</div></div><div><h3>Conclusions</h3><div>Total cholesterol, LDL, and non-HDL showed U-shaped nonlinear associations with DR, indicating elevated risk at both low and high concentrations. Maintaining lipids within an intermediate range may support retinal vascular health and refine metabolic risk stratification in diabetes.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100176"},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proportion of eyes with visual-acuity improvement after vitrectomy for post-traumatic endophthalmitis: A meta-analysis","authors":"Muhammad Alfatih ,&nbsp;Ananda Kukuh Adishabri ,&nbsp;Ni Luh Putu Yunia Dewi ,&nbsp;Alfiani Zukhruful Fitri Rifa'i ,&nbsp;Michaela Kemuning ,&nbsp;Dillan Cunha Amaral ,&nbsp;Bruno Fortaleza de Aquino Ferreira ,&nbsp;Ricardo Noguera Louzada ,&nbsp;Ari Djatikusumo ,&nbsp;Hashem Abu Serhan","doi":"10.1016/j.ajoint.2025.100174","DOIUrl":"10.1016/j.ajoint.2025.100174","url":null,"abstract":"<div><h3>Purpose</h3><div>Post-traumatic endophthalmitis (PTE) is a leading cause of irreversible vision loss after ocular trauma; despite widespread vitrectomy, outcomes vary and predictors remain unclear. This study aims to systematically evaluate the proportion of eyes showing the best-corrected visual acuity (BCVA) improvement and final BCVA ≥ 20/200 after vitrectomy for PTE and to investigate potential determinants of outcome using meta-regression.</div></div><div><h3>Design</h3><div>A systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>We conducted a meta-analysis following the PRISMA guidelines and registered the protocol in PROSPERO (CRD42024606195). Eligible studies included ≥80 % of participants undergoing vitrectomy for PTE. The prespecified primary outcome was the proportion with any BCVA improvement; final BCVA ≥20/200 at last follow-up was assessed as an additional outcome. Random-effects meta-analysis was performed, and subgroup and meta-regression analyses were used to explore outcome modifiers. Certainty of evidence was assessed using GRADE.</div></div><div><h3>Results</h3><div>Nine studies (<em>n</em> = 448 eyes) were included. The pooled proportion of eyes with any BCVA improvement was 0.80 (95 % CI 0.63–0.90; I² = 90 %), significantly higher in adults (≥18 years; 0.91) than in children/adolescents (&lt;18 years; 0.65; <em>p</em> &lt; 0.01). Meta-regression suggested higher silicone-oil use and IOFB proportion correlated with BCVA improvement (<em>p</em> = 0.027; <em>p</em> = 0.017), while corneal-entry and baseline retinal detachment were not associated. The proportion achieving final BCVA ≥20/200 was 0.33 (95 % CI 0.23–0.45; I²=67.9 %) with no age difference (<em>p</em> = 0.45). Certainty was low to very low.</div></div><div><h3>Conclusion</h3><div>Vitrectomy for PTE often yielded visual improvement, particularly in adults, while ambulatory vision (≥20/200) was less common. Given the single-arm meta-analysis, substantial heterogeneity, and low-certainty ratings, these estimates should be interpreted cautiously. Multicenter randomized trials are needed to verify these findings and to evaluate the potential role of silicone-oil tamponade.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100174"},"PeriodicalIF":0.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tele-eye care: Perspective and acceptance among patients and eye care practitioners in Benin City","authors":"God’sglory Isoken Braimoh,&nbsp;Faustina Idu,&nbsp;Clinton Ifeanyi Okechukwu","doi":"10.1016/j.ajoint.2025.100172","DOIUrl":"10.1016/j.ajoint.2025.100172","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess awareness, acceptance, and perceived barriers to tele-eye care among patients and eye care practitioners in Benin City, Nigeria.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted over three months among 332 patients attending clinics and 56 licensed eye care practitioners (optometrists and ophthalmologists). A structured questionnaire, adapted from prior studies, was administered via Google Forms. Practitioners received the survey through professional WhatsApp groups, while patients completed it during clinic visits. Data were analyzed using descriptive statistics and inferential tests (chi-square, <em>t</em>-tests, and logistic regression) to assess associations, with significance set at <em>p</em> &lt; 0.05.</div></div><div><h3>Results</h3><div>Awareness of tele-eye care was modest among patients (47.6 %), and prior use was low (25.3 %), yet willingness to adopt mobile-based applications was high (88.6 %). Patients’ main concerns included reduced quality of care (81.3 %), limited personal interaction (53.0 %), and privacy risks (51.5 %). Most practitioners (93 %) were familiar with telemedicine, though only 32 % reported its use in their clinics. While 84 % believed it could expand access to care, concerns included diagnostic accuracy (67.9 %), restricted service applicability (73.2 %), and insufficient practitioner training (75 %).</div></div><div><h3>Conclusion</h3><div>Both patients and practitioners in Benin City expressed strong interest in tele-eye care, though actual use remains limited. Adoption is constrained by service limitations, privacy concerns, and inadequate training. Targeted practitioner education, improved digital infrastructure, and clear regulatory frameworks are needed to facilitate broader integration of tele-eye care into routine practice.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100172"},"PeriodicalIF":0.0,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender differences in faculty rank and salary among ophthalmology subspecialists at U.S. public medical schools","authors":"Emily Sun ,&nbsp;Chen Dun ,&nbsp;Susan K. Burden ,&nbsp;Ambar Faridi ,&nbsp;Laura K. Green ,&nbsp;Andrea L. Kossler ,&nbsp;Christina R. Prescott ,&nbsp;Jamie B. Rosenberg ,&nbsp;Erin M. Shriver ,&nbsp;Grace Sun ,&nbsp;Christina Y. Weng ,&nbsp;Kimberly M. Winges ,&nbsp;Maria A. Woodward ,&nbsp;Fasika A. Woreta","doi":"10.1016/j.ajoint.2025.100173","DOIUrl":"10.1016/j.ajoint.2025.100173","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine gender differences in faculty rank and salary among ophthalmology subspecialists at U.S. medical schools.</div></div><div><h3>Design</h3><div>Retrospective cross-sectional</div></div><div><h3>Methods</h3><div>Gender and academic rank for faculty where state laws mandate public salary disclosure for university employees were collected from department websites. Annual salary was collected from GovSalaries.com. Differences in rank and salary, by gender, were analyzed using Student’s <em>t</em>-test.</div></div><div><h3>Results</h3><div>Salaries were available from 28/122 departments (23 %) from 17 states (538 ophthalmologists, 41.1 % women). A smaller proportion of women were full professors compared to men (25.8 % vs. 46.7 %). A larger proportion were assistant professors (47.1 % vs. 30.1 %) or associate professors (27.1 % vs. 22.7 %). Medical retina, neuro-ophthalmology, and comprehensive ophthalmology had the largest gender disparity among full professors between men and women (15.4 % vs. 61.5 %; 31.3 % vs. 69.0 %; 5.9 % vs. 42.1 % respectively).</div><div>Women had lower salaries compared to men across all subspecialties ($281,718 vs. $364,017, <em>p</em> &lt; 0.0001), including assistant professors ($229,389 vs. $265,974, <em>p</em> = 0.03). There were no significant differences among associate ($280,704 vs. $324,434, <em>p</em> = 0.15) or full professors ($378,264 vs. $447,531, <em>p</em> = 0.08). Among assistant professors, women had lower salaries in comprehensive ophthalmology ($224,755 vs. $441,742 <em>p</em> &lt; 0.0001), cornea ($181,284 vs. $276,121, <em>p</em> = 0.05), and medical retina ($204,057 vs. $393,616, <em>p</em> = 0.03). Overall, women earned significantly less after controlling for subspecialty, VA status, rank, and region ($278,751 vs. $308,629, <em>p</em> = 0.015), and earned significantly less in comprehensive ophthalmology ($230,837 vs. $355,782, <em>p</em> = 0.038) and cornea ($289,211 vs. $360,546, <em>p</em> = 0.018).</div></div><div><h3>Conclusions</h3><div>Significant gender differences in rank and salary exist in several subspecialties. Further research is needed to identify effective strategies for these disparities.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100173"},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blindness and vision impairment in Querétaro, Mexico: A comparison of RAAB surveys conducted in 2015 and 2024","authors":"Bethania López ,&nbsp;Ellery López-Star ,&nbsp;Van C. Lansingh ,&nbsp;João M Furtado","doi":"10.1016/j.ajoint.2025.100171","DOIUrl":"10.1016/j.ajoint.2025.100171","url":null,"abstract":"<div><h3>Purpose</h3><div><strong>:</strong> To estimate the prevalence and causes of vision impairment and blindness among individuals aged ≥50 years in Querétaro, Mexico, and to assess progress in eye health indicators since a prior survey conducted in 2015.</div></div><div><h3>Design</h3><div><strong>:</strong> Population-based cross-sectional study using the Rapid Assessment of Avoidable Blindness (RAAB) version 7 methodology.</div></div><div><h3>Methods</h3><div><strong>:</strong> A total of 6574 individuals were selected via cluster sampling. Trained teams conducted visual acuity testing, lens examination, and ocular assessment using mobile data capture tools. Effective Cataract Surgical Coverage (eCSC) and Effective Refractive Error Coverage (eREC) were calculated. Results were compared with the 2015 RAAB study.</div></div><div><h3>Results</h3><div><strong>:</strong> Of the eligible individuals, 5111 (77.8 %) completed the examination. The prevalence of blindness was 2.3 % (95 % CI: 1.7–3.0 %), and moderate-to-severe vision impairment was 11.4 % (95 % CI: 9.8–13.0 %). Cataract was the leading cause of blindness (49.2 %), while refractive error predominated among milder impairments. The eCSC at the &lt;20/60 threshold was 26.6 % (95 % CI: 20.4–32.8 %), and eREC for distance vision was 37.6 % (95 % CI: 33.8–41.4 %). Compared to 2015, both prevalence of blindness and unmet need for cataract surgery increased. Barriers included cost, fear, and lack of awareness.</div></div><div><h3>Conclusions</h3><div><strong>:</strong> Since 2015, the burden of avoidable blindness and vision impairment in Querétaro has grown. The findings underscore the need for expanded, higher-quality cataract and refractive services integrated into public health strategies to meet the WHO 2030 eye health targets.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100171"},"PeriodicalIF":0.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145096496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suprachoroidal triamcinolone in macular edema for patients with non-infectious uveitis resistant to subtenon triamcinolone","authors":"Mohammed Suhail Najm Al-Salam ,&nbsp;Ahmed shakir Ali Al-Wassiti ,&nbsp;Muthanna Basheer Yasir ,&nbsp;Mohammed Tareq Mutar","doi":"10.1016/j.ajoint.2025.100170","DOIUrl":"10.1016/j.ajoint.2025.100170","url":null,"abstract":"<div><h3>Purpose</h3><div>Uveitic macular edema is a serious complication of uveitis which if not properly managed can cause visual impairment. The study aimed to assess the response of uvetic macular edema to suprachoroidal triamcinolone injections for sub-Tenon triamcinolone acetonide resistant patients. The response was measured by changes in central macular thickness (CMT) and visual acuity (VA), with measurements taken before treatment, one and three months after treatment.</div></div><div><h3>Design</h3><div>Prospective Single Arm Clinical Study</div></div><div><h3>Methods</h3><div>The study included 9 patients with non-infectious uveitis treated with systemic steroids and immunosuppressant therapy. These patients had uveitic macular edema that persisted despite adequate control of intra-ocular inflammation and showed no response to posterior sub-tenon steroids injections. Suprachoroidal triamcinolone acetonide injection was considered for those patients; 4 mg was injected into the suprachoroidal space.</div></div><div><h3>Results</h3><div>The study involved 44.4 % males; the mean age was 35 years. The underlying etiologies included Vogt–Koyanagi–Harada (VKH) syndrome in three patients (33.3 %), pars planitis in four patients (44.5 %), and Behcet disease in two (22.2 %).</div><div>The mean central macular thickness CMT decreased from 556 µm to 270 µm, and LogMAR visual acuity improved from 0.876 to 0.470 over three months. Over three months, 8 patients showed a 40 % reduction in CMT, with &gt;60 % decline in 3 patients. In terms of VA, 6 patients gained 2 lines and 2 patients gained 4 lines.</div></div><div><h3>Conclusion</h3><div>Suprachoroidal triamcinolone demonstrated a significant improvement in visual acuity and a reduction in CMT at one and three months in patients with non-infectious uveitis.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100170"},"PeriodicalIF":0.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145096495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of intracameral antibiotics in reducing postoperative endophthalmitis risk after cataract surgery: A meta-analysis","authors":"Hashem Abu Serhan ,&nbsp;Hamad A. Alkorbi ,&nbsp;Elhassan Mahmoud ,&nbsp;Muhammad Zain Kaleem ,&nbsp;Omar Abousaad ,&nbsp;Mohamed Nasser Elshabrawi ,&nbsp;Ibrahim M. Alrawi ,&nbsp;Abdulrahman Nasir Al Khatib ,&nbsp;Ahmed E. Habib ,&nbsp;Ayman G. Elnahry","doi":"10.1016/j.ajoint.2025.100168","DOIUrl":"10.1016/j.ajoint.2025.100168","url":null,"abstract":"<div><h3>Purpose</h3><div>Postoperative endophthalmitis is a rare but serious complication following cataract surgery, often leading to severe vision loss and increased healthcare burden. This systematic review and meta-analysis aimed to evaluate the effectiveness of intracameral antibiotic prophylaxis in reducing the risk of postoperative endophthalmitis.</div></div><div><h3>Design</h3><div>A systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted across PubMed, Cochrane Library, Scopus, and EMBASE up to September 18, 2024. Studies were included if they compared intracameral antibiotic prophylaxis with no prophylaxis in patients undergoing cataract surgery. The primary outcome was the odds of developing postoperative endophthalmitis. Random-effects and quality-effects models were used for meta-analysis, with heterogeneity assessed via the I² statistic. Subgroup analyses were conducted based on antibiotic type, study design, and geographic region.</div></div><div><h3>Results</h3><div>A total of 25 studies involving 5665,621 participants were included. The pooled odds ratio (OR) for the risk of endophthalmitis with intracameral antibiotics was 0.31 (95 % CI: 0.15–0.61), indicating a 69 % reduction in risk compared to no prophylaxis. Subgroup analysis revealed significant differences in efficacy based on antibiotic type, with moxifloxacin (OR: 0.24, 95 % CI: 0.20–0.29) and vancomycin (OR: 0.11, 95 % CI: 0.04–0.30) showing the greatest protective effects. Sensitivity analyses confirmed the robustness of results, though publication bias was suggested by funnel and Doi plots asymmetry.</div></div><div><h3>Conclusions</h3><div>Intracameral antibiotic prophylaxis significantly reduces the risk of postoperative endophthalmitis following cataract surgery, with moxifloxacin and vancomycin showing the strongest protective effects. Given the variability in efficacy across antibiotic types, further randomized controlled trials are needed to optimize prophylactic strategies. These findings support broader adoption of intracameral antibiotics to enhance patient safety and reduce the global burden of post-cataract endophthalmitis.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100168"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a deep learning model to classify choroidal melanoma risk factors based on color fundus photographs","authors":"Huzaifa Suri ,&nbsp;P. Connor Lentz ,&nbsp;David A. Leske ,&nbsp;Mostafa Mousavi ,&nbsp;Haley S. D’Souza ,&nbsp;Muhammad B. Qureshi ,&nbsp;Raymond Iezzi ,&nbsp;Yogatheesan Varatharajah ,&nbsp;Lauren A. Dalvin","doi":"10.1016/j.ajoint.2025.100167","DOIUrl":"10.1016/j.ajoint.2025.100167","url":null,"abstract":"<div><div>Choroidal melanoma is the most common malignant primary intraocular tumor and can develop either de novo or from a preexisting choroidal nevus, a benign pigmented lesion. Key risk factors for the transformation of choroidal nevus into melanoma include tumor diameter &gt; 5 mm, tumor thickness &gt; 2 mm, orange pigment, subretinal fluid, and low internal reflectivity on ultrasound. However, the assessment of many of these risk factors requires multimodal imaging equipment and skilled subspecialists, only available at tertiary referral centers. In this study, we developed and validated a deep learning approach to identifying these risk factors based solely on fundus images of choroidal nevi. Results indicate acceptable to excellent predictive performance for detection of all five risk factors. These findings suggest that deep learning models may be valuable tools for identifying high-risk choroidal nevi, particularly in resource-limited settings.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100167"},"PeriodicalIF":0.0,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging gaps in ophthalmology education through large language models","authors":"Shahrzad Gholami ,&nbsp;Beth Wilson ,&nbsp;Sarah Page ,&nbsp;Daniel B. Mummert ,&nbsp;Joseph Carr ,&nbsp;Robert R. McNabb ,&nbsp;Rahul Dodhia ,&nbsp;Juan M. Lavista Ferres ,&nbsp;William B. Weeks ,&nbsp;Dale E. Fajardo ,&nbsp;Karine D. Bojikian","doi":"10.1016/j.ajoint.2025.100166","DOIUrl":"10.1016/j.ajoint.2025.100166","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the performance of general-domain large language models (LLMs), particularly OpenAI’s Generative Pre-trained Transformer (GPT) models, within the American Academy of Ophthalmology (AAO) Self-Assessment Program, which is based on AAO’s Basic and Clinical Science Course.</div></div><div><h3>Methods</h3><div>We input 3357 questions into GPT-4o, GPT-4-Turbo, o1 and o3-mini via Microsoft’s Azure OpenAI Service using zero-shot and chain-of-thought (CoT) prompting. Questions with images were analyzed using the multimodal version of GPT-4o and GPT-4.1. The performance of the LLMs was compared to 1371 unique residents who had previously participated in the program. Additionally, we compared the performance on 1399 questions, including information on 3 question types: recall, interpretation, and decision-making or clinical management. Average accuracy rates were used to evaluate performance and compare statistical significance across categories.</div></div><div><h3>Results</h3><div>o1 (CoT) was the most accurate model (95% confidence interval [CI]: 90.3%–92.1%) with performance ranging from 95.17% (general medicine) to 86.9% (cornea) and 91.1% accuracy on a synthesized sample test. It also outperformed residents in recall-type, interpretation-type, and decision-making or clinical management questions (95.7%, 85.3%, and 90.8%, respectively, <em>P</em> &lt; 0.001). Third-year residents were more accurate than first-year or second-year residents (78.2%, 68.3%, 74.9%, respectively). On multimodal inputs, adding images improved the model’s accuracy but all models still underperformed compared to residents.</div></div><div><h3>Conclusions</h3><div>The accuracy of the LLMs models continues to improve, with o1 (CoT) showing the highest overall performance. Multimodal inputs can enhance model accuracy, but current models still need improvement. LLMs shows great potential in democratizing access to high-quality medical knowledge.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 4","pages":"Article 100166"},"PeriodicalIF":0.0,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144917789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}