Eye最新文献

{"title":"Leveraging large language models to improve patient education on dry eye disease.","authors":"Qais A Dihan, Andrew D Brown, Muhammad Z Chauhan, Ahmad F Alzein, Seif E Abdelnaem, Sean D Kelso, Dania A Rahal, Royce Park, Mohammadali Ashraf, Amr Azzam, Mahmoud Morsi, David B Warner, Ahmed B Sallam, Hajirah N Saeed, Abdelrahman M Elhusseiny","doi":"10.1038/s41433-024-03476-5","DOIUrl":"https://doi.org/10.1038/s41433-024-03476-5","url":null,"abstract":"<p><strong>Background/objectives: </strong>Dry eye disease (DED) is an exceedingly common diagnosis in patients, yet recent analyses have demonstrated patient education materials (PEMs) on DED to be of low quality and readability. Our study evaluated the utility and performance of three large language models (LLMs) in enhancing and generating new patient education materials (PEMs) on dry eye disease (DED).</p><p><strong>Subjects/methods: </strong>We evaluated PEMs generated by ChatGPT-3.5, ChatGPT-4, Gemini Advanced, using three separate prompts. Prompts A and B requested they generate PEMs on DED, with Prompt B specifying a 6th-grade reading level, using the SMOG (Simple Measure of Gobbledygook) readability formula. Prompt C asked for a rewrite of existing PEMs at a 6th-grade reading level. Each PEM was assessed on readability (SMOG, FKGL: Flesch-Kincaid Grade Level), quality (PEMAT: Patient Education Materials Assessment Tool, DISCERN), and accuracy (Likert Misinformation scale).</p><p><strong>Results: </strong>All LLM-generated PEMs in response to Prompt A and B were of high quality (median DISCERN = 4), understandable (PEMAT understandability ≥70%) and accurate (Likert Score=1). LLM-generated PEMs were not actionable (PEMAT Actionability <70%). ChatGPT-4 and Gemini Advanced rewrote existing PEMs (Prompt C) from a baseline readability level (FKGL: 8.0 ± 2.4, SMOG: 7.9 ± 1.7) to targeted 6th-grade reading level; rewrites contained little to no misinformation (median Likert misinformation=1 (range: 1-2)). However, only ChatGPT-4 rewrote PEMs while maintaining high quality and reliability (median DISCERN = 4).</p><p><strong>Conclusion: </strong>LLMs (notably ChatGPT-4) were able to generate and rewrite PEMs on DED that were readable, accurate, and high quality. Our study underscores the value of leveraging LLMs as supplementary tools to improving PEMs.</p>","PeriodicalId":12125,"journal":{"name":"Eye","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinoblastoma vitreous seeding underestimation on ophthalmoscopy.","authors":"Fatma Shakarchi, Florin Grigorian","doi":"10.1038/s41433-024-03536-w","DOIUrl":"https://doi.org/10.1038/s41433-024-03536-w","url":null,"abstract":"","PeriodicalId":12125,"journal":{"name":"Eye","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of methotrexate in the treatment of proliferative vitreoretinopathy: a systematic review.","authors":"Vanessa Ting Ru Toh, Gheslynn Gerard, Zhi Quan Tay, Jianping Chen, Grace Wei Min Chew, Chin Sheng Teoh","doi":"10.1038/s41433-024-03503-5","DOIUrl":"https://doi.org/10.1038/s41433-024-03503-5","url":null,"abstract":"<p><p>Proliferative Vitreoretinopathy (PVR) is a major complication of surgical repair for Rhegmatogenous Retinal Detachment (RRD). Methotrexate (MTX), a folate antimetabolite, has shown promise in targeting the pathological processes involved in PVR, such as cell proliferation inhibition, fibrosis and anti-inflammation. Systematic review examines the use of MTX in PVR by analysing different administration methods and outcomes. A review of relevant studies from PubMed, EMBASE, and Open Access databases was conducted, focusing on studies investigating the role of MTX in PVR. Study characteristics, patient demographics, dosages, administration frequency, and patient outcomes were extracted. Vitrectomy with various additional procedures such as laser photocoagulation, scleral buckling, gas tamponade and membranectomy were performed during primary and repeated surgery. Among the 180 eyes studied, those receiving MTX through intravitreal injection or intraoperative infusion showed promising outcomes, with retinal reattachment rates ranging from 74 to 92%. Eyes that received MTX infusion intraoperatively had an average retinal reattachment rate of 85%. Improvement in Best Corrected Visual Acuity was also observed in all eyes receiving MTX, with low rates of adverse events reported. Re-operation rates for repeated retinal detachment is significantly lower at 18% for eyes that received MTX treatment compared to those who did not receive MTX at initial surgery. Despite positive findings, further research is needed due to limitations such as small number of studies, low quality of evidence, and heterogeneity in treatment regimens. While MTX shows potential as an adjunctive treatment for PVR in RRD, more robust studies are necessary to confirm its efficacy.</p>","PeriodicalId":12125,"journal":{"name":"Eye","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of audiologic side effects with teprotumumab treatment for thyroid eye disease: propensity matched analysis.","authors":"Jonathan C Markle, Anil Johanis, Jacqueline K Shaia, Daniel Benito, Katherine E Talcott, Rishi P Singh","doi":"10.1038/s41433-024-03531-1","DOIUrl":"https://doi.org/10.1038/s41433-024-03531-1","url":null,"abstract":"<p><strong>Background/objectives: </strong>Patients with thyroid eye disease (TED) taking teprotumumab have reported audiologic symptoms as a side effect; however, limited real world data and large sample sizes have been utilized to evaluate this relationship.</p><p><strong>Methods: </strong>A retrospective cohort study was created in TriNetX to identify patients with TED utilizing ICD-10, CPT, and Healthcare Common Procedure coding systems. TED patients with and without teprotumumab treatment were analysed with greedy one-to-one propensity matching. Appearance of one or more new ICD-10 codes corresponding to audiologic outcomes of interest (tinnitus, sensorineural hearing loss, hypoacusis, hyperacusis, autophony, Eustachian tube dysfunction) served as the outcome of interest. Patients with a history of hearing impairment were also evaluated for worsening hearing loss after initiation of teprotumumab.</p><p><strong>Results: </strong>Within the entire TriNetX cohort, 88 out of 441 patients with a diagnosis code for TED treated with teprotumumab had new appearance of an audiologic outcome within TriNetX. After matching, the relative risk for TED patients who were exposed to teprotumumab for new audiologic symptoms was increased with a risk ratio (RR) of 2.85 [95% CI 1.94, 4.20] compared to TED patients not exposed to teprotumumab. Of 51 patients with a history of hearing impairment and TED, 14 had record of new audiologic testing after teprotumumab administration (RR = 1.90 [0.96, 3.78]) compared to unexposed patients.</p><p><strong>Conclusions: </strong>This study affirms previous research stating that TED patients receiving teprotumumab are at an increased risk of new audiologic side effects when compared to TED patients not using teprotumumab.</p>","PeriodicalId":12125,"journal":{"name":"Eye","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age distribution of retinoblastoma tumours in familial disease.","authors":"Jessica Katie Walker, Devika Nair, Ann-Marie Mongan, Manoj Parulekar, Trevor Cole, Joseph Abbott","doi":"10.1038/s41433-024-03499-y","DOIUrl":"https://doi.org/10.1038/s41433-024-03499-y","url":null,"abstract":"<p><strong>Background: </strong>40% of children with retinoblastoma have an RB1 gene mutation identified, known as heritable retinoblastoma. It is important to undertake active surveillance (screening) of relatives of those with identified RB1 gene mutations and ensure ongoing surveillance to monitor for new tumour formation or recurrences. Current guidance is to screen patients up to the age of 7 years old. With advancements in treatment methods and survival rates of retinoblastoma being 98%, it has become increasingly important to plan a surveillance programme that is both safe and cost effective. van Hoefen Wijsard et al. proposed that surveillance could be concluded at the age of 4 years.</p><p><strong>Method: </strong>We conducted a retrospective analysis of all patients with familial retinoblastoma known to our service presenting from 1995 to 2020. 52 patients were eligible for analysis. 47 out of 50 had more than 4 years of follow up (median 129 months).</p><p><strong>Results: </strong>In this cohort, the oldest age for new tumour occurrence was 47 months; if patients were screened from an appropriate age according to protocol, the latest age for new tumour occurrence was 28 months. Furthermore, the average age for tumour recurrence was 15 months; the oldest patient with an identified tumour recurrence was 56 months old.</p><p><strong>Conclusion: </strong>This supports the notion that it may be safe to reduce the length of surveillance for new tumours in familial retinoblastoma from 7 years of age.</p>","PeriodicalId":12125,"journal":{"name":"Eye","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinal fluid quantification using a novel deep learning algorithm in patients treated with faricimab in the TRUCKEE study.","authors":"Aamir A Aziz, Arshad M Khanani, Hannah Khan, Eileen Lauer, Ibrahim Khanani, Ohidul Mojumder, Zoha A Khanani, Huma Khan, Greggory M Gahn, J Taylor Graff, Ashkan M Abbey, David R P Almeida, Mark R Barakat, Giulia Corradetti, Jordan M Graff, Sara J Haug, Jared S Nielsen, Veeral S Sheth, SriniVas R Sadda, Ilan Hadas, Gidi Benyamini, Kester Nahen, Nishant Mohan","doi":"10.1038/s41433-024-03532-0","DOIUrl":"https://doi.org/10.1038/s41433-024-03532-0","url":null,"abstract":"<p><strong>Background: </strong>Investigate retinal fluid changes via a novel deep-learning algorithm in real-world patients receiving faricimab for the treatment of neovascular age-related macular degeneration (nAMD).</p><p><strong>Methods: </strong>Multicenter, retrospective chart review and optical coherence tomography (OCT) image upload from participating sites was conducted on patients treated with faricimab for nAMD from February 2022 to January 2024. The Notal OCT Analyzer (NOA) algorithm provided intraretinal, subretinal and total retinal fluid for each scan. Results were segregated based on treatment history and fluid compartments, allowing for multiple cross-sections of evaluation.</p><p><strong>Results: </strong>A total of 521 eyes were included at baseline. The previous treatments prior to faricimab were aflibercept, ranibizumab, bevacizumab, or treatment-naive for 52.3%, 21.0%, 13.3%, and 11.2% of the eyes, respectively. Of all 521 eyes, 49.9% demonstrated fluid reduction after one injection of faricimab. The mean fluid reduction after one injection was -60.7nL. The proportion of eyes that saw reduction in fluid compared to baseline after second, third, fourth and fifth faricimab injections were 54.4%, 51.9%, 51.4% and 52.2%, respectively. The mean (SD) retreatment interval after second, third, fourth and fifth faricimab injection were 53.4 (34.3), 56.6 (36.0), 57.1 (35.3) and 61.5 (40.2) days, respectively.</p><p><strong>Conclusion: </strong>Deep-learning algorithms provide a novel tool for evaluating precise quantification of retinal fluid after treatment of nAMD with faricimab. Faricimab demonstrates reduction of retinal fluid in multiple groups after just one injection and sustains this response after multiple treatments, along with providing increases in treatment intervals between subsequent injections.</p>","PeriodicalId":12125,"journal":{"name":"Eye","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic and environmental factors associated with glaucoma in an African Ancestry Population: findings from the Primary Open-Angle African American Glaucoma Genetics (POAAGG) study.","authors":"Anusha Mamidipaka, Amy Shi, Roy Lee, Yan Zhu, Yineng Chen, Isabel Di Rosa, Rebecca Salowe, Gui-Shuang Ying, Joan M O'Brien","doi":"10.1038/s41433-024-03470-x","DOIUrl":"https://doi.org/10.1038/s41433-024-03470-x","url":null,"abstract":"<p><strong>Background/objectives: </strong>Glaucoma is the leading cause of irreversible blindness, disproportionately affecting individuals of African ancestry. Limited research has examined the impact of neighbourhood quality and socioeconomic factors on primary open-angle glaucoma (POAG) risk in this population. This study aims to address these gaps by evaluating associations between ocular health and neighbourhood characteristics using geospatial data.</p><p><strong>Subjects/methods: </strong>We conducted a case-control study with 5192 African ancestry individuals from the Philadelphia area using data from the Primary Open-Angle African American Glaucoma Genetics (POAAGG) study. Geocoded U.S. Census data were merged with individual-level demographics and neighbourhood-level measures, including air quality, food accessibility, and socioeconomic indicators, to assess their association with glaucoma risk and severity.</p><p><strong>Results: </strong>The study included 3039 controls (58.5%) and 2153 POAG cases (41.5%). Higher POAG risk was associated with older age (OR 1.72 per 10-year increase, p < 0.001), male gender (OR 2.04, p < 0.001), lower BMI (OR 0.87 per 10 kg/m² increase, p = 0.003), and nonuse of alcohol (OR 0.56 for alcohol use, p < 0.001). Low food access was more common in controls (OR 0.86, p = 0.03), and severe POAG cases were associated with lower homeownership rates (OR 0.95 per 10% increase, p = 0.049). However, most socioeconomic and environmental factors (air quality, education, income, occupation, family structure) were not significantly linked to POAG risk or severity.</p><p><strong>Conclusion: </strong>Socioeconomic status did not significantly protect against POAG in African ancestry individuals. Individual factors were more influential, suggesting neighbourhood and socioeconomic factors may have a lesser impact than previously hypothesised.</p>","PeriodicalId":12125,"journal":{"name":"Eye","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitreous opacities and retinal deposits in Gaucher disease type I.","authors":"Bangtao Yao, Yan Yu, Yuhua Ding","doi":"10.1038/s41433-024-03509-z","DOIUrl":"https://doi.org/10.1038/s41433-024-03509-z","url":null,"abstract":"","PeriodicalId":12125,"journal":{"name":"Eye","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual and anatomical failure of anti-VEGF therapy for retinal vascular diseases: a survival analysis of real-world data.","authors":"Dun Jack Fu, Amit V Mishra, Chrystie Quek, Konstantinos Balaskas, Nikolas Pontikos, Dawn Sim, Sobha Sivaprasad, Livia Faes","doi":"10.1038/s41433-024-03529-9","DOIUrl":"10.1038/s41433-024-03529-9","url":null,"abstract":"<p><strong>Importance: </strong>Predicting undesirable outcomes following anti-VEGF initiation in macular oedema is critical for effective clinical decision-making and optimised care.</p><p><strong>Objective: </strong>To estimate the time to undesirable events in diabetic macular oedema (DMO), central and branch vein occlusions (CRVO and BRVO) after appropriate loading doses with either ranibizumab or aflibercept and identified baseline predictors of negative outcome.</p><p><strong>Design, setting, participants: </strong>A retrospective cohort study of 3277 patients (N = 2107 in DMO, N = 413 in CRVO and N = 757 in BRVO) collected over a 10-year period, in a large UK tertiary centre. Only one eye was included per patient. Inclusion criteria pre-specified a minimum of two clinic visits with one being at least 6 months post treatment.</p><p><strong>Main outcome and measures: </strong>The main outcome measure was absence of visual acuity (VA) improvement due to macular oedema failure of anti-VEGF therapy (defined as VA gain <5 ETDRS letters and CST increase of 50 µm or CST > 325 µm) modelled using time-event analyzes of appropriately loaded patients. Secondary outcomes included survival curves by individual condition (DMO, CRVO, BRVO) and factors associated with negative outcomes.</p><p><strong>Results: </strong>After starting anti-VEGF, there was a 50% chance of undesirable outcomes at 2.3, 5.24 and 6.16 years for DMO, CRVO and BRVO, respectively. Cox proportional hazards modelling identified presenting age, intraretinal (IRF) volume, presence of DMO and VA as predictors of negative outcomes, whilst South East Asian ethnicity conferred an independent protective effect.</p><p><strong>Conclusion: </strong>Real-world data suggest that undesirable events following anti-VEGF injections is likely to in 50% of patients by the third year of treatment in spite of appropriate loading. The definition of undesirable treatment events captured nearly all patients who were escalated to another therapy, but this proportion represented a small percentage of our definition of failed response.</p>","PeriodicalId":12125,"journal":{"name":"Eye","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between socioeconomic status and open globe injury.","authors":"Marlow Schulz, Alyssa C Bonnell, Yewlin E Chee, Shu Feng, Philip P Chen, Karine D Bojikian","doi":"10.1038/s41433-024-03537-9","DOIUrl":"https://doi.org/10.1038/s41433-024-03537-9","url":null,"abstract":"<p><strong>Objective: </strong>To examine associations between socioeconomic status (SES), as evaluated by the Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry Social Vulnerability Index (SVI) and Distressed Communities Index (DCI), and the characteristics of open globe injury (OGI).</p><p><strong>Subjects/methods: </strong>Retrospective review of electronic medical records for patients treated for OGI at an academic Level I trauma centre between May 2009 and March 2021. Patient data included age, date of injury, mechanism of injury, visual acuity at presentation, concomitant orbital wall fracture, and ocular trauma score (OTS). The SVI and DCI scores were obtained based on the patient's home zip code. Patients were classified based on individual mechanisms of injury and grouped into non-accidental vs. accidental cases.</p><p><strong>Results: </strong>899 patients (75.0% male) were included. Average ± SD age (years), SVI, and DCI scores were 44.8 ± 22.7, 0.418 ± 0.207, and 37.9 ± 24.0, respectively. Younger age was associated with higher DCI and lower OTS score (p ≤ 0.002). Non-accidental trauma patients had lower OTS and higher SVI and DCI scores compared to accidental trauma (p < 0.001); firearm-associated ocular injuries (FAOIs) were associated with higher SVI and DCI scores (p < 0.001 and p = 0.040, respectively); domestic violence/assault was associated with worse OTS and higher DCI (p < 001). Falls and sports-related injuries correlated with lower DCI scores (p ≤ 0.031).</p><p><strong>Conclusions: </strong>In our region, among patients with OGIs, lower SES scores were associated with younger age, FAOIs, and non-accidental injuries, including domestic violence/assault. Therefore, lower SES may be considered a risk factor for several distinct mechanisms of OGI.</p>","PeriodicalId":12125,"journal":{"name":"Eye","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}