Graefe's Archive for Clinical and Experimental Ophthalmology最新文献

{"title":"MicroRNA expression profiling in tears and blood as predictive biomarkers for anti-VEGF treatment response in wet age-related macular degeneration","authors":"","doi":"10.1007/s00417-024-06478-x","DOIUrl":"https://doi.org/10.1007/s00417-024-06478-x","url":null,"abstract":"<h3>Abstract</h3> <span> <h3>Purpose</h3> <p>This study aimed to investigate the potential of microRNAs (miRNAs) in tears, blood, and aqueous humor as biomarkers for predicting treatment response in wet age-related macular degeneration (AMD) patients undergoing anti-vascular endothelial growth factor (anti-VEGF) therapy.</p> </span> <span> <h3>Methods</h3> <p>In a single-center prospective cohort study, treatment-naïve wet AMD patients and age-matched controls were enrolled. Clinical data and miRNA levels (miR-199a-3p, miR-365-3p, miR-200b-3p, miR-195-5p, miR-335-5p, and miR-185-5p) in tears, blood, and aqueous humor were collected. Treatment response was categorized into responders and non-responders based on visual acuity and central subfield thickness. MiRNA levels were quantified using reverse-transcription PCR. Statistical analyses were performed, including ROC analysis, to evaluate predictive accuracy.</p> </span> <span> <h3>Results</h3> <p>Dysregulated miRNA profiles were observed in wet AMD tears and blood compared to controls. Specifically, miR-199a-3p, miR-195-5p, and miR-185-5p were upregulated, while miR-200b-3p was downregulated in tears. All six miRNAs were elevated in wet AMD blood samples. Notably, responders showed higher tear expression of miR-195-5p and miR-185-5p. Combining these miRNAs yielded the highest predictive power (AUC = 0.878, <em>p</em> = 0.006) for anti-VEGF responders.</p> </span> <span> <h3>Conclusions</h3> <p>Dysregulated miRNA profiles in tears and blood suggest their potential as biomarkers for wet AMD. MiR-195-5p and miR-185-5p in tears demonstrate predictive value for anti-VEGF treatment responders. This study underscores the non-invasive prediction potential of miRNA tear analysis in wet AMD treatment responses.</p> </span>","PeriodicalId":12748,"journal":{"name":"Graefe's Archive for Clinical and Experimental Ophthalmology","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588314","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":"Factors associated with early hydroxychloroquine-induced retinal toxicity in patients with systemic lupus erythematosus","authors":"Olga Araújo, Halbert Hernández-Negrín, Ricardo P. Casaroli-Marano, José Hernández-Rodríguez, Alfredo Adán, Gerard Espinosa, Laura Pelegrín, Ricard Cervera","doi":"10.1007/s00417-024-06461-6","DOIUrl":"https://doi.org/10.1007/s00417-024-06461-6","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Hydroxychloroquine is currently recommended for the treatment of systemic lupus erythematosus (SLE), but it can cause irreversible retinal toxicity. This study aimed to identify factors associated with early hydroxychloroquine-induced retinal toxicity in patients with SLE from a single centre for 20 years.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>SLE patients diagnosed between 1998 and 2017 and followed up for at least 1 year were included. Demographic, clinical, laboratory and therapeutic data were collected from the electronic medical records and retrospectively analysed. Early hydroxychloroquine-induced retinal toxicity was defined as the development of macular toxicity within the first 5 years of hydroxychloroquine treatment.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>A total of 345 patients followed for a median of 15 years were analysed; 337 (97.7%) patients received hydroxychloroquine, 38 (11.3%) of them presented with retinal toxicity, and 10 (3%) developed early retinal toxicity. These patients had a mean treatment duration of 3.3 years with a mean cumulative dose of 241 g. Patients were diagnosed by visual field (VF) and fundoscopy, and two were also assessed using spectral domain optical coherence tomography (SD-OCT). The median (IQR) age of patients with early toxicity was 56 (51–66) years, and 80% were female. Factors independently associated with early hydroxychloroquine-induced retinal toxicity were lupus anticoagulant positivity (OR 4.2; 95% CI 1.2–15.5) and hypercholesterolaemia (OR 5.6; 95% CI 1.5–21.5).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Our results suggest that lupus anticoagulant positivity and hypercholesterolaemia among SLE patients may be risk factors for early hydroxychloroquine-induced retinal toxicity, regardless of the dose or duration of treatment.</p>","PeriodicalId":12748,"journal":{"name":"Graefe's Archive for Clinical and Experimental Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588935","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":"Following prevalence of myopia in a large Swiss military cohort over the last decade: where is the European “myopia boom”?","authors":"","doi":"10.1007/s00417-024-06467-0","DOIUrl":"https://doi.org/10.1007/s00417-024-06467-0","url":null,"abstract":"<h3>Abstract</h3> <span> <h3>Purpose</h3> <p>Myopia prevalence is increasing globally, with the highest rates found in Asia. Data from European countries is scarce. We aimed to investigate whether the prevalence of myopia is rising in our meridians.</p> </span> <span> <h3>Methods</h3> <p>Data from male military conscripts for the recruitment period of 2008–2017 were retrospectively analyzed. Year of recruitment, conscripts’ birth year, visual acuity, refractive status (spherical equivalent), and spectacle wear (yes/no) were available.</p> </span> <span> <h3>Results</h3> <p>The dataset contained data of a total of 355,657 male conscripts, who had been recruited in the years 2008 to 2017. The mean number of conscripts per year was 35,566 (MD = 35,440, SD = 1249), reaching a minimum number of 33,998 conscripts in 2017 and a maximum of 37,594 in 2011. Mean age at recruitment was 19.7 years (MD = 19.0 years, SD = 1.1 years). Overall, the number of conscripts wearing spectacles remained stable over the observation time; on average 29.6% (<em>n</em> = 10,540; MD = 10,472; SD = 492) of conscripts wore glasses at recruitment. Of 21.8% (<em>n</em> = 77,698) of conscripts, data on the refractive status was available: The mean spherical equivalent for both right and left eyes was -2.3D (MD = -2 D, SD = 2.4 D). No decrease in mean spherical equivalent per recruitment year was noted over the observation period. Estimated myopia prevalence reached an average of 27.5% (SD = 0.8%) and did not increase during the observation period.</p> </span> <span> <h3>Conclusion</h3> <p>In summary, no change in spherical equivalent refractive errors of male Swiss army conscripts was found for the years 2008–2017. Equally, the percentage of spectacle wearers (MN = 29.6%) and estimated myopia prevalence (MN = 27.5%) did not significantly increase during the observation time.</p> <p><strong>Trial registration</strong>: BASEC 2019-00060 (18/01/2019)</p> <p><span> <span> <img alt=\"\" src=\"https://static-content.springer.com/image/MediaObjects/417_2024_6467_Figa_HTML.png\"/> </span> </span></p> </span>","PeriodicalId":12748,"journal":{"name":"Graefe's Archive for Clinical and Experimental Ophthalmology","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588390","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":"Rehabilitation of amblyopia using a digital platform for visual training combined with patching in children: a prospective study","authors":"Carlos J. Hernández-Rodríguez, Patricia Ferrer-Soldevila, Alberto Artola-Roig, David P. Piñero","doi":"10.1007/s00417-024-06475-0","DOIUrl":"https://doi.org/10.1007/s00417-024-06475-0","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>To assess the possible benefits of the use of perceptual learning and dichoptic therapy combined with patching in children with amblyopia over the use of only patching.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Quasi-experimental multicentric study including 52 amblyopic children. Patients who improved their visual acuity (VA) by combining spectacles and patching were included in patching group (PG: 20 subjects), whereas those that did not improved with patching performed visual training (perceptual learning + dichoptic therapy) combined with patching, being assigned to the visual treatment group (VT: 32 subjects). Changes in VA, contrast sensitivity (CS), and stereopsis were monitored during a 6-month follow-up in each group.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Significant improvements in VA were found in both groups at 1 month (<i>p</i> &lt; 0.01). The total improvement of VA was 0.18 ± 0.16 and 0.31 ± 0.35 logMAR in PG and VT groups, respectively (<i>p</i> = 0.317). The Wilcoxon effect size was slightly higher in VT (0.48 vs. 0.54) at 6 months. An enhancement in CS was observed in the amblyopic eye of the VT group for all spatial frequencies at 1 month (<i>p</i> &lt; 0.001). Likewise, the binocular function score also increased significantly in VT group (<i>p</i> = 0.002). A prediction equation of VA improvement at 1 month in VT group was obtained by multiple linear regression analysis (<i>p</i> &lt; 0.001, <i>R</i>² = 0.747).</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>A combined treatment of visual training and patching is effective for obtaining a predictable improvement of VA, CS, and binocularity in patching-resistant amblyopic children.</p>","PeriodicalId":12748,"journal":{"name":"Graefe's Archive for Clinical and Experimental Ophthalmology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588641","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":"Safety, structure and function five years after hESC-RPE patch transplantation in acute neovascular AMD with submacular haemorrhage","authors":"Taha Soomro, Odysseus Georgiadis, Peter J. Coffey, Lyndon da Cruz","doi":"10.1007/s00417-024-06463-4","DOIUrl":"https://doi.org/10.1007/s00417-024-06463-4","url":null,"abstract":"","PeriodicalId":12748,"journal":{"name":"Graefe's Archive for Clinical and Experimental Ophthalmology","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588414","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":"Prognostic impact of hyperreflective foci in nonsyndromic retinitis pigmentosa","authors":"Raquel Félix, Nuno Gouveia, João Bernardes, Rufino Silva, Joaquim Murta, João Pedro Marques","doi":"10.1007/s00417-024-06474-1","DOIUrl":"https://doi.org/10.1007/s00417-024-06474-1","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>To evaluate the prognostic impact of hyperreflective foci (HRF) on spectral-domain optical coherence tomography (SD-OCT) in nonsyndromic retinitis pigmentosa (RP).</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Retrospective, single-center cohort study including genetically-tested RP patients with a minimum follow-up of 24 months. Clinical data including demographics, genetic results and best-corrected visual acuity (BCVA) at baseline and follow-up were collected. Horizontal and vertical SD-OCT scans were analyzed by 2 independent graders. Outer nuclear layer (ONL) thickness and ellipsoid zone (EZ) width were manually measured in horizontal and vertical scans. HRF were classified according to location: outer retinal layers within the central 3mm (central-HRF), outer retinal layers beyond the central 3mm (perifoveal-HRF), and choroid (choroidal-HRF). Central macular thickness (CMT), central point thickness (CPT) and choroidal thickness (CT) at baseline and follow-up were also recorded.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>A total of 175 eyes from 94 RP patients (47.9% female, mean age 50.7±15.5 years) were included, with a mean follow-up of 29.24±7.17 months. Mean ETDRS (early treatment diabetic retinopathy study) BCVA decreased from 61.09±23.54 to 56.09±26.65 (<i>p</i>=0.082). At baseline, 72 eyes (41.1%) showed central-HRF, 110 eyes (62.9%) had perifoveal-HRF and 149 eyes (85.1%) exhibited choroidal-HRF. Central-HRF and perifoveal-HRF were associated with worse final BCVA, as well as greater BCVA deterioration (all <i>p</i>&lt;0.0029). Only central-HRF were associated with a worse final CMT (<i>p</i>&lt;0.001). Shorter EZ widths were associated with all types of HRF (<i>p</i>&lt;0.05). Perifoveal and choroidal-HRF predicted smaller final EZ areas (<i>p</i>&lt;0.01).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>HRF are highly prevalent in RP patients and appear to have a negative prognostic impact in visual function and EZ area.</p>","PeriodicalId":12748,"journal":{"name":"Graefe's Archive for Clinical and Experimental Ophthalmology","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588525","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":"Bilateral vitrectomy in patients with proliferative diabetic retinopathy—characteristics and surgical outcomes","authors":"Yun Hsia, Chung-May Yang","doi":"10.1007/s00417-024-06462-5","DOIUrl":"https://doi.org/10.1007/s00417-024-06462-5","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Comparing characteristics and outcomes of patients with bilateral proliferative diabetic retinopathy (PDR) undergoing concurrent and sequential vitrectomy.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Patients having bilateral vitrectomy were classified into concurrent (requiring bilateral surgery simultaneously) and sequential (indicating vitrectomy in one eye later) groups. Clinical characteristics and outcomes were compared, and correlation between the first and second-operated eyes was analyzed.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>One hundred eight and 126 eyes were in the concurrent and sequential groups, respectively. The sequential group was older (50 vs. 45 years, <i>P</i> = 0.017), had less retinal detachment (54 vs. 77%, <i>P</i> &lt; 0.001), and better visual outcomes (0.79 vs. 1.30, <i>P</i> = 0.021), especially the second-operated eyes. The concurrent group had weaker correlations of disease severity (phi coefficient: 0.36 vs. 0.61) and post-operative visual acuity (<i>r</i>: 0.12 vs. 0.34) between the first- and second-operated eyes than the sequential group. Prior intravitreal injection of anti-vascular endothelial growth factor (odds ratio [OR] 0.37, 95% confidence interval [CI] 0.15–0.86, <i>P</i> = 0.025) predicted better outcomes, while post-operative neovascular glaucoma predicted worse outcomes (OR 6.5, 95% CI 1.7–27.9, <i>P</i> = 0.008).</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>PDR patients requiring surgery concurrently were younger and had more severe diseases and worse outcomes. However, poor outcomes in the first eye did not predict similar outcomes in the second eye.</p>","PeriodicalId":12748,"journal":{"name":"Graefe's Archive for Clinical and Experimental Ophthalmology","volume":"371 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588928","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":"Changes in intraocular pressure following intravitreal dexamethasone implant in patients with history of glaucoma filtration surgery","authors":"Dong Kyu Lee, Joo Yong Lee, Se Joon Woo, Yong Sok Ji, Christopher Seungkyu Lee","doi":"10.1007/s00417-024-06468-z","DOIUrl":"https://doi.org/10.1007/s00417-024-06468-z","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>This study aimed to evaluate changes in intraocular pressure following intravitreal dexamethasone implant injection, specifically in patients undergoing glaucoma filtration surgery.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>The degree of increase in intraocular pressure was compared retrospectively among three groups. Group 1 comprised patients who underwent prior glaucoma filtration surgery (54 eyes). Group 2 included patients with or suspected glaucoma without such surgical history (20 eyes). Group 3 included patients without glaucoma (33 eyes). Pressure measurements were taken before the injection and at 1, 2, 3, and 6 months post-injection. A subgroup analysis was performed for pressure &gt; 35 mmHg, &gt; 30 mmHg, &gt; 25 mmHg, and a difference &gt; 10 mmHg between the peak and baseline pressure.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Group 1 consistently displayed lower pressures compared with Group 2, with significant difference at both 1- and 6-month post-injections (15.09 mmHg vs. 18.10 mmHg, <i>P</i> = 0.042 and 13.91 mg vs. 17.25 mmHg, <i>P</i> = 0.040). The proportion of patients in Group 1 and Group 3 with pressures &gt; 25 mmHg, &gt; 30 mmHg, and a difference &gt; 10 mmHg did not significantly differ (15.6% vs. 9.5%, <i>P</i> = 0.231; 3.1% vs. 2.3%, <i>P</i> = 0.867; and 17.1% vs. 7.1%, <i>P</i> = 0.231). Notably, Group 2 exhibited a significantly higher proportion within each category (&gt; 25 mmHg, 24.0%; &gt; 30 mmHg, 20.0%; &gt; 10 mmHg difference, 28.0%).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Intravitreal dexamethasone implant did not increase the risk of elevated intraocular pressure in patients with a history of glaucoma filtration surgery compared with patients with suspected glaucoma; the risk was similar to those without glaucoma.</p>\u0000","PeriodicalId":12748,"journal":{"name":"Graefe's Archive for Clinical and Experimental Ophthalmology","volume":"2016 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588392","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":"ESASO classification relevance in the diagnosis and evolution in diabetic macular edema patients after dexamethasone implant treatment","authors":"Almudena Moreno-Martínez, Cristina Blanco-Marchite, Fernando Andres-Pretel, Francisco López-Martínez, Antonio Donate-Tercero, Eva González-Aquino, Carlos Cava-Valenciano, Giacomo Panozzo, Sergio Copete","doi":"10.1007/s00417-024-06473-2","DOIUrl":"https://doi.org/10.1007/s00417-024-06473-2","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>To assess the clinical relevance of The European School for Advanced Studies in Ophthalmology (ESASO) classification in patients with diabetic macular edema (DME) after their first dexamethasone implant (DEXI) treatment.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Retrospective real-world study conducted on consecutive DME patients who underwent DEXI treatment and were controlled at month-2. Subjects were initially classified according to the ESASO classification stages. The outcomes were anatomical biomarkers with spectral-domain optical coherence tomography (SD-OCT) and best-corrected visual acuity (BCVA).</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>A total of 128 patients were classified according to ESASO classification stages as early (7; 5.5%), advanced (100; 78.1%), and severe (21; 16.4%). At baseline, there were significant differences between stages in BCVA, central macular thickness (CMT), and tomography anatomical biomarkers (<i>p</i> &lt; 0.05). Initial BCVA (logMAR) was 0.33 ± 0.10, 0.58 ± 0.34, and 0.71 ± 0.35 in the early, advanced, and severe stages, respectively (<i>p</i> &lt; 0.05). At month-2, BCVA was 0.17 ± 0.15, 0.46 ± 0.29, and 0.69 ± 0.27 in those classified as early, advanced, and severe stages, respectively. At month-2, DME was resolved or improved in 6 (85.7%), 60 (60%), and 12 (60%) patients classified as early, advanced, and severe stages, respectively.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>There was a good correlation between BCVA and ESASO classification stages. Patients in the severe stage did not achieve visual acuity improvement over the study period.</p>","PeriodicalId":12748,"journal":{"name":"Graefe's Archive for Clinical and Experimental Ophthalmology","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588385","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":"Large language models as assistance for glaucoma surgical cases: a ChatGPT vs. Google Gemini comparison","authors":"Matteo Mario Carlà, Gloria Gambini, Antonio Baldascino, Francesco Boselli, Federico Giannuzzi, Fabio Margollicci, Stanislao Rizzo","doi":"10.1007/s00417-024-06470-5","DOIUrl":"https://doi.org/10.1007/s00417-024-06470-5","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>The aim of this study was to define the capability of ChatGPT-4 and Google Gemini in analyzing detailed glaucoma case descriptions and suggesting an accurate surgical plan.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Retrospective analysis of 60 medical records of surgical glaucoma was divided into “ordinary” (<i>n</i> = 40) and “challenging” (<i>n</i> = 20) scenarios. Case descriptions were entered into ChatGPT and Bard’s interfaces with the question “What kind of surgery would you perform?” and repeated three times to analyze the answers’ consistency. After collecting the answers, we assessed the level of agreement with the unified opinion of three glaucoma surgeons. Moreover, we graded the quality of the responses with scores from 1 (poor quality) to 5 (excellent quality), according to the Global Quality Score (GQS) and compared the results.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>ChatGPT surgical choice was consistent with those of glaucoma specialists in 35/60 cases (58%), compared to 19/60 (32%) of Gemini (<i>p</i> = 0.0001). Gemini was not able to complete the task in 16 cases (27%). Trabeculectomy was the most frequent choice for both chatbots (53% and 50% for ChatGPT and Gemini, respectively). In “challenging” cases, ChatGPT agreed with specialists in 9/20 choices (45%), outperforming Google Gemini performances (4/20, 20%). Overall, GQS scores were 3.5 ± 1.2 and 2.1 ± 1.5 for ChatGPT and Gemini (<i>p</i> = 0.002). This difference was even more marked if focusing only on “challenging” cases (1.5 ± 1.4 vs. 3.0 ± 1.5, <i>p</i> = 0.001).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>ChatGPT-4 showed a good analysis performance for glaucoma surgical cases, either ordinary or challenging. On the other side, Google Gemini showed strong limitations in this setting, presenting high rates of unprecise or missed answers.</p>","PeriodicalId":12748,"journal":{"name":"Graefe's Archive for Clinical and Experimental Ophthalmology","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588393","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}