Retina-The Journal of Retinal and Vitreous Diseases最新文献_第5页

Adjunct 0.025% Povidone-Iodine Irrigation at Time of Vitrectomy for Management of Infectious Endophthalmitis: A Multicenter Single-Intervention Study. 玻璃体切除术时辅助0.025%聚维酮碘冲洗治疗感染性眼内炎：一项多中心单干预研究。

IF 2.1 2区医学

Retina-The Journal of Retinal and Vitreous Diseases Pub Date : 2026-08-31 DOI: 10.1097/IAE.0000000000005006

Melissa Yuan, Keerti Pally, Brian Do, Jared J Ebert, Ehsan Rahimy, Murtaza K Adam

{"title":"Adjunct 0.025% Povidone-Iodine Irrigation at Time of Vitrectomy for Management of Infectious Endophthalmitis: A Multicenter Single-Intervention Study.","authors":"Melissa Yuan, Keerti Pally, Brian Do, Jared J Ebert, Ehsan Rahimy, Murtaza K Adam","doi":"10.1097/IAE.0000000000005006","DOIUrl":"https://doi.org/10.1097/IAE.0000000000005006","url":null,"abstract":"Purpose: To determine whether adjunctive 0.025% povidone-iodine irrigation during pars plana vitrectomy might improve ocular morbidity in infectious endophthalmitis compared to standard irrigation.Methods: Multicenter, retrospective, comparative cohort study (2019-2024) at four tertiary referral centers. 63 eyes from 63 patients with presumed infectious endophthalmitis requiring vitrectomy were included. Povidone-iodine group (n=32) received 0.025% povidone-iodine in balanced salt solution; control group (n=31) received standard irrigation. Primary outcome was visual acuity at 3 and 6 months. Secondary outcomes included reoperation rates and adverse events.Results: Groups were similar in age, presenting visual acuity (20/2890 vs 20/4000), and culture positivity (13/32 [40.6%] vs 13/31 [41.9%]). Povidone-iodine group was associated with better median visual acuity at 3 months (20/138 [0.84 logMAR] vs 20/3000 [2.21 logMAR], P=.017) and 6 months (20/60 [0.48 logMAR] vs 20/400 [1.34 logMAR], p=.010). Vision improved in 96.7% (29/30) vs 48.3% (14/29) at 6 months (p<0.001). Clinically meaningful improvement of at least 0.3 logMAR occurred in 80.0% of PI-treated eyes (24/30) and 41.4% of control eyes (12/29; p=.003). Reoperation rates were statistically similar, but slightly increased in the povidone-iodine group (28.1% vs 16.1%, p=.365). No ocular toxicity was attributed to povidone-iodine.Conclusion: Adjunctive 0.025% povidone-iodine irrigation during vitrectomy was associated with significantly improved visual outcomes without observed ocular toxicity. This simple, cost-effective intervention may benefit endophthalmitis management, though etiologic imbalances between groups limit attribution of this benefit to PI irrigation alone.","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparative Incidence of Cystoid Macular Edema after Secondary Intraocular Lens Placement Versus Routine and Complex Cataract Surgery. 继发性人工晶状体置入术与常规和复杂白内障手术后黄斑水肿发生率的比较。

IF 2.1 2区医学

Retina-The Journal of Retinal and Vitreous Diseases Pub Date : 2026-08-31 DOI: 10.1097/IAE.0000000000005003

Charles Zhang, Sinan Ersan, Alexander S Bae, Bryant A Menke, Basil K Williams, Justin H Townsend, Nicolas A Yannuzzi

{"title":"Comparative Incidence of Cystoid Macular Edema after Secondary Intraocular Lens Placement Versus Routine and Complex Cataract Surgery.","authors":"Charles Zhang, Sinan Ersan, Alexander S Bae, Bryant A Menke, Basil K Williams, Justin H Townsend, Nicolas A Yannuzzi","doi":"10.1097/IAE.0000000000005003","DOIUrl":"https://doi.org/10.1097/IAE.0000000000005003","url":null,"abstract":"Purpose: To compare the cumulative incidence of postoperative cystoid macular edema (CME) after secondary intraocular lens (IOL) placement versus routine and complex cataract surgery.Methods: This retrospective cohort study utilized the TriNetX US Collaborative Network to identify all adult patients who underwent routine cataract surgery, complex cataract surgery, or secondary IOL placement. Propensity score matching was performed, and 90-day CME incidence was compared between groups using relative risks (RRs) with 95% confidence intervals (CIs). Multivariable Cox proportional hazards models were performed to assess the relative hazard of CME, including an analysis of the effect of concurrent pars plana vitrectomy (PPV) in the secondary IOL group.Results: A total of 506,095 routine cataract, 99,337 complex cataract, and 12,644 secondary IOL surgeries met inclusion criteria. The incidence of postoperative CME after secondary IOL placement was 5.1%, significantly higher than routine cataract surgery (1.4%; risk ratio [RR] 3.6; p<0.0001) and complex cataract surgery (2.0%; RR 2.5; p<0.0001). Multivariable Cox proportional hazards models demonstrated an increased risk of CME in patients that had undergone secondary IOL implantation compared to routine cataract surgery (hazard ratio 3.6; p<0.0001). Of the patients that had undergone secondary IOL placement, concurrent PPV was associated with an increased risk of postoperative CME (7.1% vs 5.3%; p<0.0001). Patients who had undergone secondary IOL placement had a lower utilization of prophylactic NSAID eyedrops compared to primary cataract cases (23% vs 32-34%, p<0.0001).Conclusions: Secondary IOL placement is associated with a higher risk of postoperative CME compared to primary and complex cataract surgery.","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predictive factors for visual acuity and metamorphopsia after epiretinal membrane surgery. 视网膜前膜手术后视力及变形的预测因素。

IF 2.1 2区医学

Retina-The Journal of Retinal and Vitreous Diseases Pub Date : 2026-08-27 DOI: 10.1097/IAE.0000000000005002

Navid Johannigmann-Malek, Karolin Deichl, Leonard Coulibaly, Mathias Maier, Peter Charbel Issa, Febo, Niklas Wiederholt, Katharina Gabka, Katharina Kirchmair, Stephen B Kaye, Carmen Baumann

{"title":"Predictive factors for visual acuity and metamorphopsia after epiretinal membrane surgery.","authors":"Navid Johannigmann-Malek, Karolin Deichl, Leonard Coulibaly, Mathias Maier, Peter Charbel Issa, Febo, Niklas Wiederholt, Katharina Gabka, Katharina Kirchmair, Stephen B Kaye, Carmen Baumann","doi":"10.1097/IAE.0000000000005002","DOIUrl":"https://doi.org/10.1097/IAE.0000000000005002","url":null,"abstract":"Purpose: To identify predictive parameters of best-corrected visual acuity (BCVA) and metamorphopsia following epiretinal membrane (ERM) surgery.Methods: In this prospective consecutive case series, BCVA, vertical (VM-score) and horizontal M-Charts scores (HM-score) were measured preoperatively and at 2, 6 and 12 months postoperatively. Optical coherence tomography (OCT) features analyzed included central subfoveal thickness (CSFT), ectopic inner foveal layer thickness (EIFLT), inner macular cysts (IMC), ellipsoid zone (EZ) disruptions, the presence of a cotton ball sign (CBS), and the absence of the foveal pit (AoFP).Results: Seventy-two eyes with primary idiopathic ERM were included. With reference to 12 months, improvements in BCVA, VM-score and HM-score were greatest between baseline and 2 months (all p<0.001), smaller between 2 and 6 months (all p<0.05), and not significant thereafter (all p≥0.12). Across all timepoints, higher EIFLT, and the presence of IMC and EZ disruptions (all p<0.001) were associated with worse BCVA, while none of the OCT parameters assessed demonstrated a significant association with VM-score or HM-score.BCVA at 12 months was significantly associated with preoperative BCVA (p=0.02), EZ disruption (p=0.04) and CBS (p=0.02) at baseline. Both VM-score and HM-score at 12 months were significantly associated with preoperative VM-score and HM-score (p<0.01 and p<0.001) but not with any of the baseline OCT parameters analyzed.Conclusions: Worse preoperative BCVA and metamorphopsia were associated with worse respective postoperative outcomes. Baseline photoreceptor-related abnormalities, i.e. EZ disruption and cotton ball sign, were associated with worse postoperative BCVA, whereas none of the OCT parameters assessed predicted postoperative metamorphopsia.","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148834411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Match Gap: Towards Reducing Disparities in Retina Fellowship Match Outcomes. 匹配差距：减少视网膜奖学金匹配结果的差异。

IF 2.1 2区医学

Retina-The Journal of Retinal and Vitreous Diseases Pub Date : 2026-08-26 DOI: 10.1097/IAE.0000000000004998

Judy E Kim

引用次数: 0

Factors Associated with Matching into Retina Fellowship: A San Francisco Match Analysis. 与视网膜配对相关的因素：旧金山配对分析。

IF 2.1 2区医学

Retina-The Journal of Retinal and Vitreous Diseases Pub Date : 2026-08-26 DOI: 10.1097/IAE.0000000000004997

Anupam K Garg, Muhammad Jehanzeb Khan, Zainab Rustam, Malik Muhammad Hamza Khan, Ambar Faridi, Adrienne Scott, Fasika A Woreta

{"title":"Factors Associated with Matching into Retina Fellowship: A San Francisco Match Analysis.","authors":"Anupam K Garg, Muhammad Jehanzeb Khan, Zainab Rustam, Malik Muhammad Hamza Khan, Ambar Faridi, Adrienne Scott, Fasika A Woreta","doi":"10.1097/IAE.0000000000004997","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004997","url":null,"abstract":"Purpose: The retina subspecialty has previously shown the lowest rate of matched female and underrepresented in medicine (URiM) applicants. This study was conducted to examine trends in gender and racial/ethnic diversity in retina fellowship applicants and match outcomes from 2021 to 2023.Methods: Anonymized data of fellowship applicants from 2021-2023 San Francisco match was obtained and stratified by gender, racial/ethnic background, and URiM status. Continuous variables were summarized as median (IQR); categorical variables as counts and percentages. We compared groups with chi square or Fisher exact tests and Wilcoxon rank sum tests. A multivariable logistic regression model was used to assess the association of applicant characteristics with match outcomes.Results: Among 583 applicants, 172 (29.5%) were female, and 74 (12.7%) were from URiM backgrounds. 398 applicants matched; 106 (26.6%) were female, and 47 (11.8%) had URiM status, with match rates of 61.6% for women and 71.3% for men. Matched applicants submitted more applications (median 34 vs 11, p<0.001) and completed more interviews (median 14 vs 2, p<0.001) than those who did not match. The proportion of matched female applicants declined from 38 (30.6%) in 2021 to 33 (23.6%) in 2023, with match rates declining from 62.3% to 56.9%. Female gender (OR 0.52, p = 0.002) was associated with decreased likelihood of matching.Conclusion: Disparities in the retina fellowship match exist, with under-representation of women and URiM applicants. Monitoring trends can inform efforts to improve representation.","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

RE: Comment on: "Impact of GLP-1 Receptor Agonists for Type 2 Diabetes Mellitus on the Development and Progression of Age-Related Macular Degeneration. 评论：“GLP-1受体激动剂治疗2型糖尿病对年龄相关性黄斑变性发生和进展的影响。”

IF 2.1 2区医学

Retina-The Journal of Retinal and Vitreous Diseases Pub Date : 2026-08-25 DOI: 10.1097/IAE.0000000000004995

Samantha A McLaughlin, Niloufar Bineshfar, Basil K Williams

引用次数: 0

Anatomical and Functional Outcomes of Inferior Versus Non-Inferior Giant Retinal Tear-Related Retinal Detachment: The Manchester GRT Study. 下与非下巨大视网膜泪相关性视网膜脱离的解剖和功能结果：曼彻斯特GRT研究。

IF 2.1 2区医学

Retina-The Journal of Retinal and Vitreous Diseases Pub Date : 2026-08-25 DOI: 10.1097/IAE.0000000000004996

Peter Kiraly, George Moussa, Tsveta Ivanova, Evita E Christou, Fernando J Huelin, Mariam Hussain, Felipe Dhawahir-Scala, Niall Patton, Kirti M Jasani, Assad Jalil

{"title":"Anatomical and Functional Outcomes of Inferior Versus Non-Inferior Giant Retinal Tear-Related Retinal Detachment: The Manchester GRT Study.","authors":"Peter Kiraly, George Moussa, Tsveta Ivanova, Evita E Christou, Fernando J Huelin, Mariam Hussain, Felipe Dhawahir-Scala, Niall Patton, Kirti M Jasani, Assad Jalil","doi":"10.1097/IAE.0000000000004996","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004996","url":null,"abstract":"Purpose: To compare anatomical and visual outcomes of inferior versus non-inferior giant retinal tear related rhegmatogenous retinal detachment (GRT-RRD) after primary pars plana vitrectomy (PPV).Methods: This retrospective single-centre study included 110 eyes undergoing primary PPV for GRT-RRD between 2012 and 2024. Inferior GRTs were defined as GRTs crossing the 5-7 o'clock meridians. Outcomes included single-surgery anatomical success (SSAS), final anatomical success (FAS), postoperative PVR grade C, and best-corrected visual acuity (BCVA). Propensity score matching with double-robust regression and G-computation was used to adjust for baseline confounders.Results: Of 110 eyes, 63 (57.3%) had inferior GRT-RRDs. Inferior GRT-RRDs occurred in younger patients (47 vs 54 years, p=0.01) and were more extensive (6.0 vs 4.5 clock-hours, p=0.027). SSAS (93.5% vs 83.0%), FAS (95.7% vs 93.5%), postoperative PVR-C rates, and BCVA at 2 months and final follow-up were comparable between inferior and non-inferior groups on univariable analysis. After propensity score matching (PSM), inferior GRT crossing was associated with a lower risk of SSAS failure (risk difference -9.9%, p=0.027) in all eyes and with better final follow-up BCVA in macula-on eyes (mean difference -0.493 logMAR, p=0.001). Within inferior GRT-RRDs, gas and silicone oil tamponade achieved similar SSAS (97.4% vs 87.0%), but gas was associated with better final follow-up BCVA (median 0.21 logMAR (20/32) vs 0.55 logMAR (20/70); p<0.001).Conclusion: After PSM, inferior GRT-RRDs were associated with a lower risk of SSAS failure and better final follow-up BCVA in macula-on eyes. Gas tamponade achieved comparable anatomical outcomes and was associated with better final follow-up BCVA than silicone oil.","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Incidence and associations of Retinal pigment epithelial (RPE) tear post-loading phase of aflibercept 2mg in Treatment Naïve Neovascular Age-Related Macular Degeneration (nAMD): PRECISE study report 10. 阿波西普2mg治疗Naïve新生血管性年龄相关性黄斑变性（nAMD）后视网膜色素上皮（RPE）撕裂的发生率和相关性：PRECISE研究报告

IF 2.1 2区医学

Retina-The Journal of Retinal and Vitreous Diseases Pub Date : 2026-08-25 DOI: 10.1097/IAE.0000000000004985

Dimitrios Kazantzis, Sridevi Thottarath, Abhishek Sheemar, Ayse Merve Keskin, Heena Syed Kubravi, Sobha Sivaprasad

{"title":"Incidence and associations of Retinal pigment epithelial (RPE) tear post-loading phase of aflibercept 2mg in Treatment Naïve Neovascular Age-Related Macular Degeneration (nAMD): PRECISE study report 10.","authors":"Dimitrios Kazantzis, Sridevi Thottarath, Abhishek Sheemar, Ayse Merve Keskin, Heena Syed Kubravi, Sobha Sivaprasad","doi":"10.1097/IAE.0000000000004985","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004985","url":null,"abstract":"Purpose: To report the incidence of retinal pigment epithelial (RPE) tears following three monthly 2-mg aflibercept injections in treatment-naïve neovascular age-related macular degeneration (nAMD) and to identify associated risk factors.Methods: Treatment-naïve patients aged ≥50 years with nAMD and baseline visual acuity (VA) between 24 and 78 Early Treatment of Diabetic Retinopathy Study (ETDRS) letters were included. RPE tears were diagnosed on optical coherence tomography (OCT) as a definite discontinuity of the RPE. Logistic regression using Generalized Estimating Equations (GEE) was performed to account for correlated eye data and identify factors associated with RPE tear development. Cluster bootstrap receiver operating characteristic (ROC) curve analysis assessed the predictive value of baseline pigment epithelial detachment (PED) height.Results: A total of 1,929 eyes were analyzed; 67 eyes (3.5%) developed an RPE tear after the aflibercept loading phase. Multivariable analysis adjusted for age, ethnicity, and sex showed that male sex, poorer baseline VA, increased central subfield thickness, hemorrhagic PED, increased PED height, presence of subretinal hyperreflective material (SHRM), and polypoidal choroidal vasculopathy (PCV) were associated with higher odds of RPE tear and that presence of drusen with decreased odds of RPE tear. ROC analysis demonstrated that a baseline PED height of 244 µm optimally predicted RPE tear development with a sensitivity of 73.8% and a specificity of 73.6%.Conclusion: RPE tears occurred in 3.5% of treatment-naïve nAMD eyes after aflibercept loading phase. Several baseline clinical and imaging risk factors were identified to be significantly associated with RPE tear development.","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Is vitreoretinal traction the cause of 'Combined Hamartoma of the Retina and Retinal Pigment Epithelium' (CHRRPE)? A case series and proposal for 'Traction-Induced Retinal and Retinal Pigment Epithelium Lesion' (TRIPEL). 玻璃体视网膜牵拉是“视网膜和视网膜色素上皮合并错构瘤”（CHRRPE）的原因吗？“牵引诱导的视网膜和视网膜色素上皮病变”（TRIPEL）的病例系列和建议。

IF 2.1 2区医学

Retina-The Journal of Retinal and Vitreous Diseases Pub Date : 2026-08-25 DOI: 10.1097/IAE.0000000000004965

Shivesh Varma, Verity Moynihan, Siegfried K Wagner, Sarah E Coupland, Mandeep S Sagoo, Sui Chien Wong, Robert H Henderson

{"title":"Is vitreoretinal traction the cause of 'Combined Hamartoma of the Retina and Retinal Pigment Epithelium' (CHRRPE)? A case series and proposal for 'Traction-Induced Retinal and Retinal Pigment Epithelium Lesion' (TRIPEL).","authors":"Shivesh Varma, Verity Moynihan, Siegfried K Wagner, Sarah E Coupland, Mandeep S Sagoo, Sui Chien Wong, Robert H Henderson","doi":"10.1097/IAE.0000000000004965","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004965","url":null,"abstract":"Purpose: Combined hamartoma of the retina and retinal pigment epithelium (CHRRPE) is traditionally described as arising from hamartomatous proliferation. We hypothesize that posterior hyaloid membrane (PHM) traction is the primary driver with secondary retinal/RPE changes, supported by imaging and surgical outcomes.Methods: Dual-center retrospective series of 64 eyes with 'CHRRPE' and OCT imaging.Results: Mean age was 16.2±16.9 years. The PHM was adherent and thickened on OCT in 97%, with broad (>1500µm) attachment in 76%. Traction was present in all eyes (mini-peaks 69%, maxi-peaks in 73%).Thirty-six eyes had follow-up (mean 6.3±5.7 years). Those undergoing surgery (n=15) were younger (6.6 vs 15.0 years, p=0.010), more likely to have macular phenotype (80% vs 50%, p=0.008), and had worse baseline visual acuity (1.01±0.62logMAR [20/200] vs 0.52±0.38logMAR [20/66], p=0.024) versus observation.Surgery resulted in greater reduction in CST (-183±168µm vs -47.4±179µm, p=0.007), reduction in clinically apparent pigmentary change (100% vs 15%, p<0.001), and visual acuity improvement (-0.26±0.46logMAR [13 letter gain] vs +0.29±0.67logMAR [15 letter loss], p=0.045) versus observation, including after adjustment for follow-up. Traction features resolved postoperatively in all cases.Conclusion: Traction appears to be a defining feature of CHRRPE. We propose the term 'Traction-Induced Retinal and Retinal Pigment Epithelium Lesion' (TRIPEL) to reflect the pathophysiology.","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diagnostic Accuracy of Multimodal Large Language Models in Retinal Fundus Photography. 视网膜眼底摄影中多模态大语言模型的诊断准确性。

IF 2.1 2区医学

Retina-The Journal of Retinal and Vitreous Diseases Pub Date : 2026-08-25 DOI: 10.1097/IAE.0000000000004986

Lia Huo, Astha Chandra, Michael Balas, Marko Popovic, Peng Yan, Peter J Kertes, Radha Kohly, Rajeev Muni

{"title":"Diagnostic Accuracy of Multimodal Large Language Models in Retinal Fundus Photography.","authors":"Lia Huo, Astha Chandra, Michael Balas, Marko Popovic, Peng Yan, Peter J Kertes, Radha Kohly, Rajeev Muni","doi":"10.1097/IAE.0000000000004986","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004986","url":null,"abstract":"Purpose: Artificial intelligence in ophthalmology has mostly used task-specific convolutional neural networks. The performance of general-purpose multimodal large language models (LLMs) for fundus image diagnosis remains largely unexplored. This study evaluated and compared the performance of four multimodal LLMs in diagnosing retinal diseases from color fundus photographs.Methods: A total of 800 images (100 per category across 8 conditions) were randomly sampled and evaluated by ChatGPT-4o, Claude 3.5 Sonnet, Gemini 1.5, and Grok-2. Each model received a standardized prompt with a single fundus photograph and was asked to provide a free-text diagnosis, confidence rating (1-10), and justification type, defined as the reasoning category behind its diagnosis. Primary outcome was overall diagnostic accuracy. Secondary outcomes included sensitivity, specificity, F1-scores, misclassification patterns, justification-accuracy association, confidence-accuracy correlation, Cohen's κ agreement across models, and mean response time per image.Results: ChatGPT achieved the highest diagnostic accuracy (75%; 603/800), far exceeding Claude (18%), Grok (18%), and Gemini (14%). Unlike other models, ChatGPT demonstrated a meaningful association between justification type and diagnostic correctness and showed a positive correlation between confidence and accuracy (r = 0.19; P < 0.001). Claude and Gemini exhibited weaker confidence-accuracy correlations, while Grok showed none. Agreement across models was consistently low (κ = 0.11-0.16 with ChatGPT; κ ≈ 0.05 among Claude, Gemini, and Grok).Conclusions: ChatGPT demonstrated the strongest accuracy, justification-accuracy association, and confidence-accuracy correlation compared with Claude, Gemini, and Grok. While promising, refinement, validation, and workflow integration are essential before clinical deployment.","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0