Seminars in Ophthalmology最新文献

{"title":"Large Language Models Use in Dry Eye Disease: Perplexity AI versus ChatGPT4.","authors":"Sowmya V Kothandan, Stephanie L Watson, Sayan Basu, Swati Singh","doi":"10.1080/08820538.2025.2547077","DOIUrl":"10.1080/08820538.2025.2547077","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the utility of two large language models (LLM) in dry eye disease (DED) clinics and research.</p><p><strong>Methods: </strong>Trained ocular surface experts generated 12 prompts for queries commonly asked by DED patients (<i>n</i> = 10 questions) and research ideas for DED (<i>n</i> = 2). Responses of two LLM models, ChatGPT4 and Perplexity AI, were graded by them using a standardized grading system (1 = needs improvement, 2 = fair, 3 = good, and 4 = excellent) evaluating the response accuracy, compassion, comprehensiveness, professionalism, humanness, and overall quality of each response. The mean scores of the grades from each expert for each response were compared.</p><p><strong>Results: </strong>The 10 clinical DED prompts received similar overall mean quality grades for the responses with ChatGPT (mean grade score = 2.6) and Perplexity AI (2.7). The mean grade scores for the response characteristics (accuracy, compassion, professionalism, humanness, and succinctness) varied between the experts for each question (range 2.2 to 3.1 for ChatGPT and 2.3 to 3.0 for Perplexity AI). ChatGPT4 generated DED-related research ideas better than Perplexity AI (mean 3.4 vs. 2.6). The source citations for responses by Perplexity AI were from web pages and were not evidence-based. There was slight or poor agreement between the reviewers' ratings for response characteristics generated by both LLMs.</p><p><strong>Conclusion: </strong>Perplexity AI and ChatGPT performed similarly for patient-related queries on DED and could have a role in patient education. These LLMs could have a role in DED clinics for patient counseling but require supervision. The LLMs are not ready to generate dry-eye research ideas or perform literature searches for DED.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-6"},"PeriodicalIF":2.3,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883586","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":"Lacrimal History - Part 46: Doyens of Dacryology Series - James Ware (1756-1815) and His Three Lacrimal Treatises.","authors":"Mohammad Javed Ali","doi":"10.1080/08820538.2025.2547159","DOIUrl":"https://doi.org/10.1080/08820538.2025.2547159","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-8"},"PeriodicalIF":2.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144848984","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":"Chronic Ocular Sequelae of Stevens-Johnson Syndrome: Recent Advances in Understanding of Patho-Physiology and Management.","authors":"Purvasha Narang, Sharon D'Souza","doi":"10.1080/08820538.2025.2545264","DOIUrl":"https://doi.org/10.1080/08820538.2025.2545264","url":null,"abstract":"<p><strong>Background: </strong>Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe mucocutaneous reactions primarily triggered by drugs or infections. Although acute management focuses on systemic stabilization, chronic ocular sequelae remain a significant concern with vision-threatening complications arising in up to 75% of the affected patients. Ocular manifestations range from dry eye disease, lid margin keratinization (LMK), and conjunctival cicatrization to more severe complications like limbal stem cell deficiency (LSCD), cicatricial entropion, symblepharon, corneal perforation and scarring.</p><p><strong>Purpose: </strong>This review aims to summarize the recent advances in understanding the pathophysiology and management strategies for chronic ocular sequelae of SJS.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted using PubMed database, identifying published studies addressing the roles of persistent immune dysregulation, autoantibodies, and microbiome alterations in perpetuating chronic ocular inflammation and scarring. The recent treatment modalities for such sequelae of SJS were also evaluated.</p><p><strong>Conclusion: </strong>Elevated levels of pro-inflammatory cytokines, neutrophil predominance, and aberrant keratinization pathways have been identified as key contributors. Management strategies have evolved to include timely surgical interventions like mucous membrane grafting (MMG) for LMK, scleral lenses for ocular surface protection, and limbal stem cell transplantation for LSCD. The introduction of advanced therapies, such as topical autologous serum, platelet-rich plasma, and recombinant growth factors, has enhanced ocular surface rehabilitation. Emerging treatments, including simple oral mucosal epithelial transplantation (SOMET), cultivated oral mucosal epithelial transplantation (COMET), and keratoprostheses, offer hope for severe cases. Additionally, the integration of artificial intelligence (AI) in prognosis prediction and the development of targeted biologics highlight the potential for personalized care. Despite these advancements, challenges persist in early diagnosis, access to specialized care, and the high cost of novel therapies. Multidisciplinary collaboration and awareness are imperative for optimizing outcomes. Future directions emphasize the need for precision medicine approaches, AI integration, and nationwide registries to facilitate research and enhance patient support. Such comprehensive understanding and management approach aims to mitigate the long-term visual disability associated with chronic ocular sequelae of SJS/TEN, thereby improving quality of life.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-11"},"PeriodicalIF":2.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144848982","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":"Electrophysiological Insights into Neurovisual Dysfunctions in Myopia: A Systematic Review.","authors":"Bruno Ribeiro, Andresa Fernandes, Francisco Miguel Brardo, Maria Vaz Pato, Nuno Pinto","doi":"10.1080/08820538.2025.2546535","DOIUrl":"https://doi.org/10.1080/08820538.2025.2546535","url":null,"abstract":"<p><strong>Introduction: </strong>Myopia is characterized by the unusual convergence of light rays entering the eye, causing them to focus in front of the retina. Electrophysiological tests, largely non-invasive, offer valuable insights into the functionality of retinal and/or visual pathway cells. This systematic review aims to assess whether electrophysiological tests could support the hypothesis that myopia is associated with a significant impairment in neurovisual function.</p><p><strong>Methods: </strong>We included observational or interventional studies involving myopic subjects alongside an age-matched control group. Searches were performed in PubMed, Scopus, and Web of Science, utilising keywords, MeSH terms and expressions. The primary outcomes analysed were the amplitude and latency of the electrophysiological tests considered. A total of 11 studies were included, comprising 340 myopic subjects. The tests evaluated were multifocal electroretinography (mfERG), pattern electroretinography (PERG), flash electroretinography (flash ERG), and visual evoked potentials (VEP).</p><p><strong>Results: </strong>A total of 1271 articles were identified. Of these, 11 met the eligibility criteria and were included in this review. Among the 11 studies, 7 using mfERG, PERG, and flash ERG reported an amplitude reduction in myopic eyes compared to controls. In terms of latency, four studies employing mfERG and PERG reported a delay in myopic eyes. The single included VEP study found both reduced amplitude and delayed latency in myopic eyes.</p><p><strong>Conclusions: </strong>The evidence gathered indicates that myopia is associated with functional neurovisual impairment, detectable through ERG and VEP. These findings reinforce the value of such tests as complementary tools for assessing retinal and visual pathway function in myopic individuals.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-10"},"PeriodicalIF":2.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144848983","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":"Fibrin Glue-Assisted Repair in Recurrent Retinal Detachment Following Post-Viral Retinitis: A Retrospective Analysis of 12 Cases in HIV-Positive Patients.","authors":"Vikas Ambiya, Gaurav Kapoor, Mehak Aggarwal, Vijay K Sharma, Sunandan Bhatta","doi":"10.1080/08820538.2025.2547322","DOIUrl":"https://doi.org/10.1080/08820538.2025.2547322","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the anatomical and functional outcomes of fibrin glue application in the surgical management of recurrent rhegmatogenous retinal detachment (RRD) in patients with healed post-viral retinitis and HIV infection.</p><p><strong>Methods: </strong>A retrospective review was conducted of 40 cases of RRD secondary to viral retinitis in HIV-positive patients. Among these, 12 eyes exhibited recurrent detachment under silicone oil and were managed with silicone oil exchange, using fibrin glue to close persistent retinal breaks. Pre- and postoperative visual acuity, anatomical reattachment, and complications were assessed. The time to fibrin glue resorption and any evidence of epiretinal membrane formation were also recorded.</p><p><strong>Results: </strong>All 12 cases achieved successful retinal reattachment post fibrin glue application. Silicone oil removal was performed between 3 to 4 months postoperatively. Best corrected visual acuity improved in all eyes (mean preoperative LogMAR VA 1.2 ± 0.13 improved to 0.53 ± 0.13, <i>p</i> < .001). There were no pre-operative or post-operative complications. Nineteen of the total 40 cases required concurrent cataract surgery.</p><p><strong>Conclusion: </strong>Fibrin glue is a safe and effective adjunct for managing persistent retinal breaks in recurrent RRD under silicone oil in HIV-positive individuals with resolved viral retinitis. It promotes retinal reattachment and improves visual outcomes with minimal complications.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-5"},"PeriodicalIF":2.3,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822402","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":"Lacrimal History - Part 45: Doyens of Dacryology Series - Samuel Ernest Whitnall (1876-1950) and His Anatomical Work.","authors":"Mohammad Javed Ali","doi":"10.1080/08820538.2025.2545726","DOIUrl":"https://doi.org/10.1080/08820538.2025.2545726","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-5"},"PeriodicalIF":2.3,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804742","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":"Lacrimal History - Part 24: 'Valve of Hasner' Or Should it Be 'Valve of Bianchi-Zinn'?","authors":"Mohammad Javed Ali","doi":"10.1080/08820538.2025.2543222","DOIUrl":"https://doi.org/10.1080/08820538.2025.2543222","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-12"},"PeriodicalIF":2.3,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785196","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":"Insights from the First Five Years of the Prospective Ocular Tumor Study.","authors":"Rachel M Malsch, Rachael B Tessem, Lauren A Dalvin","doi":"10.1080/08820538.2025.2457043","DOIUrl":"10.1080/08820538.2025.2457043","url":null,"abstract":"<p><strong>Purpose: </strong>Standardized data collection is needed to improve research for rare diseases. In this manuscript, we describe our experience establishing the Prospective Ocular Tumor Study (POTS).</p><p><strong>Methods: </strong>The ongoing POTS captures all patients with an ocular tumor seen on the Ocular Oncology Service at Mayo Clinic Rochester and collects patient demographics, tumor features, treatment, and outcomes. This manuscript reports data collected from July 2019-July 2024.</p><p><strong>Results: </strong>During a 5-year time period, 1,766 patients enrolled in the database, with 975 (55%) females, 1,732 (98%) white race, and mean age 61.5 years. The most frequent tumor types were choroidal melanoma (<i>n</i> = 610 [34%]), choroidal nevus (<i>n</i> = 575 [32%]), iris nevus (<i>n</i> = 95 [5.3%]), iris melanoma (<i>n</i> = 46 [2.6%]), and vitreoretinal lymphoma (<i>n</i> = 46 [2.6%]).</p><p><strong>Conclusion: </strong>The POTS is a valuable source of detailed, longitudinal data on rare ocular tumors. Expanding standardized data collection across multiple centers will facilitate improved outcomes research in ocular oncology.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"508-517"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Enucleation for Intraocular Unilateral Retinoblastoma Can Save Life in Lower-Income Settings.","authors":"Mattan Arazi, Jonathan Kfir, Alia Ahmad, Allen Foster, Alona Baum, Andrew W Stacey, Andrey A Yarovoy, Arturo Manuel Zapata López, M Ashwin Reddy, Brianne Brown, Covadonga Bascaran, Deborah Im, Fahmida Huque, Jesse L Berry, Juan Garcia, Lamis Al Harby, Mandeep S Sagoo, Marcia Zondervan, Matthew Burton, Nathalie Cassoux, Nicholas John Astbury, Nir Gomel, Richard Bowman, Riffat Rashid, Rosdali Diaz Coronado, Sadia Sultana, Sadik Taju Sherief, Sharon Blum, Soma Rani Roy, Swathi Kaliki, Tatiana Ushakova, Vera A Yarovaya, Vladimir G Polyakov, Xunda Ji, Ido Didi Fabian","doi":"10.1080/08820538.2024.2447724","DOIUrl":"10.1080/08820538.2024.2447724","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the outcomes of primary enucleation and adjuvant systemic chemotherapy, when deemed appropriate, on a cohort of children with unilateral intraocular Rb (AJCC 8th edition, cT2 and cT3) from diverse economic groupings.</p><p><strong>Methods: </strong>A prospective analysis including treatment-naïve Rb patients were presented to 11 centers from 10 countries from January 1 to December 31, 2019, and were followed-up thereafter. Only children with unilateral intraocular Rb that underwent primary enucleation were included in the present analysis. Systemic metastasis and survival were investigated.</p><p><strong>Results: </strong>Of the 692 children with Rb, 191 (27.6%) were included in the study cohort. Among them, 24 (12.6%) were from low-income countries (LICs), 89 (46.6%) from lower-middle-income countries (LMICs), 59 (30.9%) from upper-middle-income countries (UMICs), and 19 (9.9%) from high-income countries (HICs). High-risk histopathological features were observed in 110 eyes (57.6%) following enucleation, and 102 of these children (92.7%) received adjuvant intravenous chemotherapy. The three-year survival rate for the entire cohort was 95.0%. Stratified by economic grouping, survival rates were 87.5% (LIC), 96.6% (LMIC), 93.2% (UMIC), and 100% (HIC). Children from LICs demonstrated a higher prevalence of HRHF compared to HICs. Residing in a lower-income country was associated with a higher risk of systemic metastasis and poorer outcomes.</p><p><strong>Conclusion: </strong>In the present multinational cohort of children with unilateral intraocular Rb who underwent upfront enucleation coupled with adjuvant chemotherapy as needed, overall survival was favorable, especially for children from low-income countries. Prompting early diagnosis, while the tumor remains intraocular can be life-saving, particularly in low-resource settings where primary enucleation and adjuvant chemotherapy can cure unilateral Rb.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"496-500"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143503854","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":"Immune Checkpoint Inhibitors in the Treatment of Ocular Surface Cancers: A Review.","authors":"Wendy J Li, Wisam Najdawi, Omar Badla, Anat Galor, Carol L Karp","doi":"10.1080/08820538.2025.2458658","DOIUrl":"10.1080/08820538.2025.2458658","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) have transformed cancer therapy by targeting key immune pathways such as PD-1, PD-L1, CTLA-4, and LAG-3 to enhance the immune system's ability to combat malignancies. Their use in treating ocular surface tumors is an emerging area of interest, particularly in conjunctival melanoma (CM) and ocular surface squamous neoplasia (OSSN). Some studies have indicated the potential of ICI's in sebaceous gland carcinoma (SeC), conjunctival lymphoma, and Kaposi sarcoma.</p><p><strong>Purpose: </strong>This review aims to evaluate the role of ICIs in treating ocular surface tumors, focusing on their mechanisms of action, clinical outcomes, and therapeutic potential.</p><p><strong>Methods: </strong>A literature review was conducted by searching Pubmed for studies published between January 2014 and October 2024. Studies included were original research, clinical trials, case reports and series, and reviews.</p><p><strong>Results: </strong>ICIs, including pembrolizumab and nivolumab, have shown promising results in CM, achieving tumor regression and disease stabilization in advanced and metastatic cases. ICIs have also demonstrated efficacy in OSSN, particularly in lesions with high tumor mutational burden, with responses ranging from partial to complete resolution. Although clinical data for SeC and conjunctival lymphoma remain limited to isolated reports, these studies suggest a role for ICIs in managing refractory or advanced disease.</p><p><strong>Conclusion: </strong>ICIs hold transformative potential in improving outcomes for ocular surface malignancies, particularly in cases where conventional treatments fail or pose significant morbidity. Despite their promise, challenges persist, including variable response rates, immune-related adverse events, and the need for reliable predictive biomarkers. Comprehensive prospective studies are necessary to refine the application of ICIs, optimize treatment strategies, and expand therapeutic options for these challenging cancers.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"485-495"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}