Seminars in Ophthalmology最新文献

{"title":"Large Language Models in Ophthalmology: Potential and Pitfalls.","authors":"Antonio Yaghy, Maria Yaghy, Jerry A Shields, Carol L Shields","doi":"10.1080/08820538.2023.2300808","DOIUrl":"10.1080/08820538.2023.2300808","url":null,"abstract":"<p><p>Large language models (LLMs) show great promise in assisting clinicians in general, and ophthalmology in particular, through knowledge synthesis, decision support, accelerating research, enhancing education, and improving patient interactions. Specifically, LLMs can rapidly summarize the latest literature to keep clinicians up-to-date. They can also analyze patient data to highlight crucial insights and recommend appropriate tests or referrals. LLMs can automate tedious research tasks like data cleaning and literature reviews. As AI tutors, LLMs can fill knowledge gaps and assess competency in trainees. As chatbots, they can provide empathetic, personalized responses to patient inquiries and improve satisfaction. The visual capabilities of LLMs like GPT-4 allow assisting the visually impaired by describing environments. However, there are significant ethical, technical, and legal challenges around the use of LLMs that should be addressed regarding privacy, fairness, robustness, attribution, and regulation. Ongoing oversight and refinement of models is critical to realize benefits while minimizing risks and upholding responsible AI principles. If carefully implemented, LLMs hold immense potential to push the boundaries of care, discovery, and quality of life for ophthalmology patients.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"289-293"},"PeriodicalIF":1.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139098632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Choroidal Perfusion Changes After Vitrectomy for Myopic Traction Maculopathy.","authors":"Miguel A Quiroz-Reyes, Erick A Quiroz-Gonzalez, Miguel A Quiroz-Gonzalez, Virgilio Lima-Gomez","doi":"10.1080/08820538.2023.2283029","DOIUrl":"10.1080/08820538.2023.2283029","url":null,"abstract":"<p><strong>Background: </strong>The choroidal vasculature supplies the outer retina and is altered in many retinal diseases, including myopic traction maculopathy (MTM). Choroid health is typically assessed by measuring the choroidal thickness; however, this method has substantial limitations. The choroidal vascularity index (CVI) was recently introduced to provide quantitative information on the vascular flow in the choroid. This index has been evaluated in a wide range of diseases but has not been extensively used to characterize MTM.</p><p><strong>Aim: </strong>This study aimed to investigate the CVI across different stages of MTM and the influence of macular surgery on choroidal perfusion markers in different surgically resolved MTM stages.</p><p><strong>Methods: </strong>Eighteen healthy myopic eyes in the control group and forty-six MTM eyes in the surgical group were evaluated using enhanced optical coherence tomography (OCT) imaging. Binarized OCT images were processed to obtain the luminal choroidal area (LCA) and stromal choroidal area (SCA), which were used to calculate CVI in the form of a percentage ratio. CVI data were collected at baseline, one and four months postoperatively, and at the final clinical visit. MTM eyes were divided into four stages based on disease severity. The choriocapillaris flow area (CFA) and central subfield thickness (CSFT) were measured along side the CVI.</p><p><strong>Results: </strong>No significant differences were observed between the two groups at baseline, except for visual acuity (<i>p</i>  < 0.0001). Surgery significantly improved vision at all postoperative time points (<i>p</i>  < 0.0001). At baseline, there were no significant differences in CVI, CFA, or CSFT scores between the control and surgical groups. However, all three measurements were lower at the final visit in the surgical group (<i>p</i> ≤0.0001). No significant differences were found in any of the parameters among the four stages of MTM (<i>p</i>  > 0.05). Ultimately, correlation and multivariate linear regression analyses did not reveal any significant association between CVI and visual acuity.</p><p><strong>Conclusions: </strong>This study did not find significant preoperative differences in CVI between healthy myopic eyes and eyes with MTM. However, the postoperative CVI and CFA values were significantly lower than those of the control eyes. Thus, CVI may not be a good biomarker for surgical outcomes, as the correlation between CVI and visual acuity was not statistically significant.The CVI and CFA decreased after surgery, providing evidence of choroidal changes after surgical management.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"261-270"},"PeriodicalIF":1.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138291742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TGF-β1 Mediates the EndoMt in High Glucose-Treated Human Retinal Microvascular Endothelial Cells.","authors":"Jia Ying, Peipei Wang, Xiao Jin, Li Luo, Keshuang Lai, Jun Li","doi":"10.1080/08820538.2023.2300806","DOIUrl":"10.1080/08820538.2023.2300806","url":null,"abstract":"<p><p>The purpose of our study was to investigate the role of TGF-β1 in the endothelial-to-mesenchymal transition (EndoMT) and fibrosis in high glucose (HG)-treated human retinal microvascular endothelial cells (HRMECs). HRMECs were cultured not only under normal glucose (NG) conditions with or without TGF-β1, but also under HG conditions with or without the TGF-β1 inhibitor SB431542. The expression of TGF-β1 was detected by real time-PCR and enzyme-linked immunosorbent assay. Morphological changes and migration of the HRMECs were observed using electron microscopy and scratch-wound assay. Endothelial markers, such as CD31 and vascular endothelial (VE)-cadherin, and the acquisition of fibrotic markers, such as alpha smooth muscle actin (α-SMA) and fibroblast-specific protein-1 (FSP-1), were determined by immunofluorescent staining and western blot. The level of TGF-β1 was significantly upregulated in HG-treated HRMECs. And HG stimulation promoted obvious morphological changes and the migration ability in HRMECs. Our results also demonstrated increased expression of α-SMA and FSP-1, and decreased expression of CD31 and VE-cadherin, in HG-treated HRMECs. These EndoMT-related changes were promoted by TGF-β1 and abrogated by SB431542. The results of this study demonstrated the important role of TGF-β1 in HG-induced vitreoretinal fibrosis. EndoMT is likely to be involved in the associated effects.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"312-319"},"PeriodicalIF":1.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139404275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of Brolucizumab in the Treatment of Diabetic Macular Edema and Diabetic Retinopathy: A Systematic Review and Meta-Analysis.","authors":"Hashem Abu Serhan, Mohammad J J Taha, Mohammad T Abuawwad, Abdelaziz Abdelaal, Sara Irshaidat, Leen Abu Serhan, Qusai Faisal Abu Salim, Nour Awamleh, Basel Abdelazeem, Ayman G Elnahry","doi":"10.1080/08820538.2023.2271095","DOIUrl":"10.1080/08820538.2023.2271095","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the efficacy and safety of brolucizumab in diabetic macular edema (DME) and diabetic retinopathy (DR).</p><p><strong>Methods: </strong>In this systematic review and meta-analysis, an electronic search was done to acquire all articles describing brolucizumab use in patients with DME and DR. The review was prospectively registered on PROSPERO (CRD42022382625). Collected articles were filtered through two stages by independent reviewers. Data were extracted from the included articles and then analyzed accordingly.</p><p><strong>Results: </strong>Brolucizumab induced significant improvement in best-corrected visual acuity and was either better or non-inferior to other types of anti-VEGF (MD -0.64 mu, 95% CI [-1.15, -0.13], <i>P</i> = .01); the same observation was noted with regards to central subfield macular thickness (CSMT) (MD -138.6 mu, 95% CI [-151.9, -125.3], <i>P</i> = .00001). Brolucizumab was reported to be relatively safe for use in diabetic patients, with few adverse events observed, with a higher frequency of adverse events in relation to the 3 mg dose compared to the 6 mg dose.</p><p><strong>Conclusion: </strong>Brolucizumab is a new drug that has potential advantages in efficacy over other anti-VEGF agents in the treatment of DME and DR. It showed significant improvement in BCVA and CSMT with the possibility of a lower dosing schedule compared to other agents. Although observed in low frequency, sight-threatening adverse effects appear to occur more frequently compared to other anti-VEGF agents. The main observed adverse event was retinal vasculitis which was seen more commonly with the 3 mg dose versus the 6 mg dose.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"251-260"},"PeriodicalIF":1.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41238345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics of m.11778G>A Leber Hereditary Optic Neuropathy with Favorable Outcomes.","authors":"Ungsoo Samuel Kim, Jeong Seop Yun","doi":"10.1080/08820538.2024.2323114","DOIUrl":"10.1080/08820538.2024.2323114","url":null,"abstract":"<p><p>The prognosis of 11,778 mitochondrial mutations in Leber hereditary optic neuropathy (LHON) is poor. Patients with favorable outcomes (visual acuity better than 20/100) who could be observed for more than 6 months were analyzed. Among 74 patients (57 male, 17 female), 6 (8.1%) showed improvement in visual acuity of 20/100 or higher. The patients with favorable outcomes have better visual acuity at nadir (logMAR 0.98 ± 0.69 in the favorable patients and logMAR 2.32 ± 0.93 in the unfavorable patients, <i>p</i> = .003). Among the favorable group, four patients (36, 32, 19, and 7 years of age at onset) took idebenone within 6 months of onset. However, fifty-one percent of the patients with unfavorable outcomes took idebenone (<i>p</i> = .008). Although the age at onset in the favorable patients is relatively younger than that of the unfavorable patients (20.3 ± 10.8 versus 28.8 ± 12.8 years), a significant difference was not found (<i>p</i> = .138). In conclusion, better visual acuity in nadir and administration of idebenone may affect vision recovery.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"320-323"},"PeriodicalIF":1.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Canaliculocoele: A Case Series and Review of Literature.","authors":"Nisar Sonam Poonam, Avriel Isaac Gudkar, Md Shahid Alam","doi":"10.1080/08820538.2024.2345285","DOIUrl":"https://doi.org/10.1080/08820538.2024.2345285","url":null,"abstract":"<p><strong>Aim: </strong>To report a case series on canaliculocoele and to review the existing literature.</p><p><strong>Methods and materials: </strong>A retrospective analysis of the case records of all patients diagnosed with canaliculocoele between January 1^st, 2018, and December 31^st, 2019, was conducted. Only histopathologically proven cases of canaliculocoele with a minimum follow-up of 6 weeks were included.</p><p><strong>Results: </strong>Five cases of canaliculocoele that presented over 2 years were included. The mean age was 58.8 ± 9.63 years, with a female preponderance. The mean duration of symptoms was 22.2 ± 22.71 months. All patients had medial cystic swelling, either at the upper or lower lid. Four patients had gross stenosis of the punctum, while the punctum was absent in one patient. Ultrasound biomicroscopy showed canalicular cystic distension with intra-lesional hyper-reflective echoes. All patients were managed with a complete cystectomy, except for one where a marsupialization was done. Adjunctive mini-Monoka intubation was done in two patients. The histopathological diagnosis of all cases was consistent with canaliculocoele. The mean follow-up was 3.82 ± 2.77 months.</p><p><strong>Conclusion: </strong>Canaliculocoele is mostly unilateral and seen in middle-aged women. A good clinical evaluation supported by diagnostic imaging along with an affirmative histopathology can confirm the diagnosis.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-5"},"PeriodicalIF":1.7,"publicationDate":"2024-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Punctal Atresia As a Clinical Indicator of Systemic Genetic Anomalies","authors":"Daphna Landau-Prat, Rayna Marshall, Alanna Strong, James A. Katowitz, William R. Katowitz","doi":"10.1080/08820538.2024.2345291","DOIUrl":"https://doi.org/10.1080/08820538.2024.2345291","url":null,"abstract":"Punctal atresia or agenesis (PA) is a rare congenital anomaly characterized by the absence or closure of the tear duct puncta, potentially linked to systemic genetic anomalies. The necessity of a g...","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":"6 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140637184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tear Protein Markers for Diabetic Retinopathy and Diabetic Macular Edema – Towards an Early Diagnosis and Better Prognosis","authors":"Sarmeela Sharma, Akash Belenje, Brijesh Takkar, Ritesh Narula, Varsha M Rathi, Mudit Tyagi, Padmaja Kumari Rani, Raja Narayanan, Inderjeet Kaur","doi":"10.1080/08820538.2024.2342266","DOIUrl":"https://doi.org/10.1080/08820538.2024.2342266","url":null,"abstract":"Diabetic eye disease is a highly prevalent and sight-threatening disorder. It is a disease of neuro-vascular unit of the retina, if left untreated can cause blindness. Therapeutic approaches follow...","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":"39 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140625720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Optical Coherence Tomography Angiography in Glaucoma","authors":"Maximilian Braun, Chhavi Saini, Jessica A. Sun, Lucy Q. Shen","doi":"10.1080/08820538.2024.2343049","DOIUrl":"https://doi.org/10.1080/08820538.2024.2343049","url":null,"abstract":"Glaucoma is the leading cause of irreversible vision loss and comprises a group of chronic optic neuropathies characterized by progressive retinal ganglion cell (RGC) loss. Various etiologies, incl...","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":"131 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140629515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tear Film Dynamics in Visual Display Terminal Users: A Review of Impact on Goblet Cells, Lacrimal and Meibomian Gland Function","authors":"Moumi Maity, Anat Galor, Sayan Basu, Swati Singh","doi":"10.1080/08820538.2024.2332355","DOIUrl":"https://doi.org/10.1080/08820538.2024.2332355","url":null,"abstract":"The prevalence of dry eye disease (DED) is rising among visual display terminal (VDT) users, a trend that correlates with the growing use of digital devices. The prevalence of VDT-associated DED is...","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":"50 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140617825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}