Ophthalmology science最新文献

{"title":"Role of Systemic Factors in Improving the Prognosis of Diabetic Retinal Disease and Predicting Response to Diabetic Retinopathy Treatment","authors":"Joe Mellor PhD ,&nbsp;Anita Jeyam PhD ,&nbsp;Joline W.J. Beulens PhD ,&nbsp;Sanjeeb Bhandari MD ,&nbsp;Geoffrey Broadhead MD ,&nbsp;Emily Chew MD ,&nbsp;Ward Fickweiler MD ,&nbsp;Amber van der Heijden PhD ,&nbsp;Daniel Gordin MD, DMsc ,&nbsp;Rafael Simó MD, PhD ,&nbsp;Janet Snell-Bergeon PhD ,&nbsp;Anniina Tynjälä PhD ,&nbsp;Helen Colhoun MD ,&nbsp;Systemic Health Working Group of the Mary Tyler Moore Vision Initiative","doi":"10.1016/j.xops.2024.100494","DOIUrl":"https://doi.org/10.1016/j.xops.2024.100494","url":null,"abstract":"<div><h3>Topic</h3><p>To review clinical evidence on systemic factors that might be relevant to update diabetic retinal disease (DRD) staging systems, including prediction of DRD onset, progression, and response to treatment.</p></div><div><h3>Clinical relevance</h3><p>Systemic factors may improve new staging systems for DRD to better assess risk of disease worsening and predict response to therapy.</p></div><div><h3>Methods</h3><p>The Systemic Health Working Group of the Mary Tyler Moore Vision Initiative reviewed systemic factors individually and in multivariate models for prediction of DRD onset or progression (i.e., prognosis) or response to treatments (prediction).</p></div><div><h3>Results</h3><p>There was consistent evidence for associations of longer diabetes duration, higher glycosylated hemoglobin (HbA1c), and male sex with DRD onset and progression. There is strong trial evidence for the effect of reducing HbA1c and reducing DRD progression. There is strong evidence that higher blood pressure (BP) is a risk factor for DRD incidence and for progression. Pregnancy has been consistently reported to be associated with worsening of DRD but recent studies reflecting modern care standards are lacking. In studies examining multivariate prognostic models of DRD onset, HbA1c and diabetes duration were consistently retained as significant predictors of DRD onset. There was evidence of associations of BP and sex with DRD onset. In multivariate prognostic models examining DRD progression, retinal measures were consistently found to be a significant predictor of DRD with little evidence of any useful marginal increment in prognostic information with the inclusion of systemic risk factor data apart from retinal image data in multivariate models. For predicting the impact of treatment, although there are small studies that quantify prognostic information based on imaging data alone or systemic factors alone, there are currently no large studies that quantify marginal prognostic information within a multivariate model, including both imaging and systemic factors.</p></div><div><h3>Conclusion</h3><p>With standard imaging techniques and ways of processing images rapidly evolving, an international network of centers is needed to routinely capture systemic health factors simultaneously to retinal images so that gains in prediction increment may be precisely quantified to determine the usefulness of various health factors in the prognosis of DRD and prediction of response to treatment.</p></div><div><h3>Financial Disclosure(s)</h3><p>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666914524000307/pdfft?md5=e4de95c6602adc53b10110e55d30d1fe&pid=1-s2.0-S2666914524000307-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140638047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FA4SANS-GAN: A Novel Machine Learning Generative Adversarial Network to Further Understand Ophthalmic Changes in Spaceflight Associated Neuro-Ocular Syndrome (SANS)","authors":"Sharif Amit Kamran PhD ,&nbsp;Khondker Fariha Hossain MS ,&nbsp;Joshua Ong MD ,&nbsp;Ethan Waisberg Mb BCh, BAO ,&nbsp;Nasif Zaman MS ,&nbsp;Salah A. Baker PhD ,&nbsp;Andrew G. Lee MD ,&nbsp;Alireza Tavakkoli PhD","doi":"10.1016/j.xops.2024.100493","DOIUrl":"10.1016/j.xops.2024.100493","url":null,"abstract":"<div><h3>Purpose</h3><p>To provide an automated system for synthesizing fluorescein angiography (FA) images from color fundus photographs for averting risks associated with fluorescein dye and extend its future application to spaceflight associated neuro-ocular syndrome (SANS) detection in spaceflight where resources are limited.</p></div><div><h3>Design</h3><p>Development and validation of a novel conditional generative adversarial network (GAN) trained on limited amount of FA and color fundus images with diabetic retinopathy and control cases.</p></div><div><h3>Participants</h3><p>Color fundus and FA paired images for unique patients were collected from a publicly available study.</p></div><div><h3>Methods</h3><p>FA4SANS-GAN was trained to generate FA images from color fundus photographs using 2 multiscale generators coupled with 2 patch-GAN discriminators. Eight hundred fifty color fundus and FA images were utilized for training by augmenting images from 17 unique patients. The model was evaluated on 56 fluorescein images collected from 14 unique patients. In addition, it was compared with 3 other GAN architectures trained on the same data set. Furthermore, we test the robustness of the models against acquisition noise and retaining structural information when introduced to artificially created biological markers.</p></div><div><h3>Main Outcome Measures</h3><p>For GAN synthesis, metric Fréchet Inception Distance (FID) and Kernel Inception Distance (KID). Also, two 1-sided tests (TOST) based on Welch’s <em>t</em> test for measuring statistical significance.</p></div><div><h3>Results</h3><p>On test FA images, mean FID for FA4SANS-GAN was 39.8 (standard deviation, 9.9), which is better than GANgio model’s mean of 43.2 (standard deviation, 13.7), Pix2PixHD’s mean of 57.3 (standard deviation, 11.5) and Pix2Pix’s mean of 67.5 (standard deviation, 11.7). Similarly for KID, FA4SANS-GAN achieved mean of 0.00278 (standard deviation, 0.00167) which is better than other 3 model’s mean KID of 0.00303 (standard deviation, 0.00216), 0.00609 (standard deviation, 0.00238), 0.00784 (standard deviation, 0.00218). For TOST measurement, FA4SANS-GAN was proven to be statistically significant versus GANgio (<em>P</em> = 0.006); versus Pix2PixHD (<em>P</em> &lt; 0.00001); and versus Pix2Pix (<em>P</em> &lt; 0.00001).</p></div><div><h3>Conclusions</h3><p>Our study has shown FA4SANS-GAN to be statistically significant for 2 GAN synthesis metrics. Moreover, it is robust against acquisition noise, and can retain clear biological markers compared with the other 3 GAN architectures. This deployment of this model can be crucial in the International Space Station for detecting SANS.</p></div><div><h3>Financial Disclosure(s)</h3><p>The authors have no proprietary or commercial interest in any materials discussed in this article.</p></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666914524000290/pdfft?md5=41737a518d5b2ff8293eb883bd6938e7&pid=1-s2.0-S2666914524000290-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139885036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association of Sickle-Cell Disorders With Diabetic Retinopathy: A Large Database Study","authors":"Muhammad Z. Chauhan MD, MS,&nbsp;Abdelrahman M. Elhusseiny MD, MSc,&nbsp;Ahmed B. Sallam MD, PhD","doi":"10.1016/j.xops.2024.100490","DOIUrl":"10.1016/j.xops.2024.100490","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate the association of sickle-cell disease (SCD) and sickle-cell trait (SCT) disease with diabetic retinopathy (DR) in patients with diabetes mellitus (DM).</p></div><div><h3>Design</h3><p>Population-based, retrospective cohort study utilizing data from the TriNetX Research Network, including 119 million patients across 80 health care organizations worldwide.</p></div><div><h3>Participants</h3><p>Diabetes mellitus patients (type 1 [T1DM] or 2 [T2DM]), with or without SCD and SCT, were included. Three cohorts were analyzed, including (1) DM patients without SCD, SCT, or sickle-cell/hemoglobin-C; (2) DM with SCD; and (3) DM with SCT.</p></div><div><h3>Methods</h3><p>All patients with DM were categorized into 3 cohorts based on the presence of SCD and SCT. Each cohort underwent 1:1 propensity score matching for demographics, blood glucose levels, hemoglobin A1C, and other relevant comorbidities.</p></div><div><h3>Main Outcome Measures</h3><p>Risk of DR in DM patients with and without SCD or SCT.</p></div><div><h3>Results</h3><p>There was no significant difference in the risk of any T1DR between those with and without SCD. However, for those with SCT, there was a notable twofold increased risk for T1-proliferative DR (PDR) (relative risk [RR]: 2.03; 95% confidence interval [CI]: 1.33–3.01). In contrast, there was an elevated risk for any T2DR in patients with SCD (RR: 1.50; 95% CI: 1.19–1.88), particularly due to higher PDR risks in T2DM patients (RR: 1.83; 95% CI: 1.29–2.60). The risk of mild to moderate T2DM non-PDR was also found to be higher in patients with SCT.</p></div><div><h3>Conclusions</h3><p>The risk of any DR was increased in T2DM patients with SCD or SCT, with increased risks for PDR in patients with SCT and T1DM. This indicates there may be a potential role of sickle-cell disorders in diabetic eye disease progression.</p></div><div><h3>Financial Disclosure(s)</h3><p>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666914524000265/pdfft?md5=b316c5fbc8b109bea49ece0660adc6b0&pid=1-s2.0-S2666914524000265-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139814330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suppression of Neovascularization by Topical and Subconjunctival Bevacizumab After High-Risk Corneal Transplantation","authors":"Thomas H. Dohlman MD ,&nbsp;Rohan Bir Singh MD ,&nbsp;Francisco Amparo MD ,&nbsp;Tatiana Carreno-Galeano MD ,&nbsp;Mohammad Dastjerdi MD ,&nbsp;Giulia Coco MD ,&nbsp;Antonio Di Zazzo MD ,&nbsp;Hasanain Shikari MD ,&nbsp;Ujwala Saboo MD ,&nbsp;Kimberly Sippel MD ,&nbsp;Jessica Ciralsky MD ,&nbsp;Sonia H. Yoo MD ,&nbsp;Matheus Sticca MD ,&nbsp;Tais H. Wakamatsu MD ,&nbsp;Somasheila Murthy MD ,&nbsp;Pedram Hamrah MD ,&nbsp;Ula Jurkunas MD ,&nbsp;Joseph B. Ciolino MD ,&nbsp;Hajirah Saeed MD, MPH ,&nbsp;Jose A.P. Gomes MD ,&nbsp;Reza Dana MD, MPH","doi":"10.1016/j.xops.2024.100492","DOIUrl":"10.1016/j.xops.2024.100492","url":null,"abstract":"<div><h3>Purpose</h3><p>To assess the effectiveness of topical and subconjunctival bevacizumab in suppressing vascularization in graft and host bed after high-risk corneal transplantation.</p></div><div><h3>Design</h3><p>Secondary analysis of prospective, randomized, double-blind, placebo-controlled multicentric clinical trial.</p></div><div><h3>Participants</h3><p>The study includes patients aged &gt; 18 years who underwent high-risk penetrating keratoplasty, which was defined as corneal vascularization in ≥ 1 quadrants of the corneal graft and host bed, excluding the limbus.</p></div><div><h3>Methods</h3><p>Patients were randomized to treatment and control groups. The patients in the treatment group received subconjunctival injection of bevacizumab (2.5 mg/0.1 ml) on the day of the procedure, followed by topical bevacizumab (10 mg/ml) 4 times per day for 4 weeks. The patients in control group received injection of vehicle (0.9% sodium chloride) on the day of procedure, followed by topical vehicle (carboxymethylcellulose sodium 1%) 4 times a day for 4 weeks.</p></div><div><h3>Main Outcome Measures</h3><p>Vessel and invasion area of vessels in the corneal graft and host beds.</p></div><div><h3>Results</h3><p>This study included 56 eyes of 56 patients who underwent high-risk corneal transplantation, with equal numbers in the bevacizumab and vehicle (control) treatment groups. The mean age of patients who received bevacizumab was 61.2 ± 15.9 years, and the mean age of those treated with vehicle was 60.0 ± 16.1 years. The vessel area at baseline was comparable in the bevacizumab (16.72% ± 3.19%) and control groups (15.48% ± 3.12%; <em>P</em> = 0.72). Similarly, the invasion areas were also similar in the treatment (35.60% ± 2.47%) and control (34.23% ± 2.64%; <em>P</em> = 0.9) groups at baseline. The reduction in vessel area was significantly higher in the bevacizumab-treated group (83.7%) over a period of 52 weeks compared with the control group (61.5%; <em>P</em> &lt; 0.0001). In the bevacizumab-treated group, invasion area was reduced by 75.8% as compared with 46.5% in the control group. The vessel area was similar at 52 weeks postprocedure in cases of first (3.54% ± 1.21%) and repeat (3.80% ± 0.40%) corneal transplantation in patients who received bevacizumab treatment. In the vehicle-treated patients, the vessel area was significantly higher in repeat (9.76% ± 0.32%) compared with first (8.06% ± 1.02%; <em>P</em> &lt; 0.0001) penetrating keratoplasty. In the bevacizumab treatment group, invasion areas at week 52 were comparable in first (11.70% ± 3.38%) and repeat (11.64% ± 1.74%) procedures, whereas invasion area was significantly higher in repeat (27.87% ± 2.57%) as compared with first (24.11% ± 2.17%) penetrating keratoplasty in vehicle-treated patients.</p></div><div><h3>Conclusions</h3><p>In patients undergoing vascularized high-risk corneal transplantation, bevacizumab is efficacious in reducing vascularization of corneal graft and host b","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666914524000289/pdfft?md5=97957bc214417f0840e12fe909c8eef3&pid=1-s2.0-S2666914524000289-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139815686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Slowing of Greater Axial Length Elongation Stemming from the Coronavirus Disease 2019 Pandemic with Increasing Time Outdoors: The Tokyo Myopia Study","authors":"Erisa Yotsukura MD, PhD ,&nbsp;Hidemasa Torii MD, PhD ,&nbsp;Kiwako Mori MD, PhD ,&nbsp;Mamoru Ogawa MD, PhD ,&nbsp;Akiko Hanyuda MD, PhD ,&nbsp;Kazuno Negishi MD, PhD ,&nbsp;Toshihide Kurihara MD, PhD ,&nbsp;Kazuo Tsubota MD, PhD","doi":"10.1016/j.xops.2024.100491","DOIUrl":"10.1016/j.xops.2024.100491","url":null,"abstract":"<div><h3>Purpose</h3><p>To investigate the changes in axial length (AL) elongation and other ocular parameters before and during the coronavirus disease 2019 pandemic.</p></div><div><h3>Design</h3><p>A longitudinal school-based study.</p></div><div><h3>Participants</h3><p>Public elementary schoolchildren in Tokyo (grades 1–6; age, 6–12 years) participated in this study from 2018 to 2021.</p></div><div><h3>Methods</h3><p>All participants underwent eye examinations and provided written consent to measurements of the noncycloplegic refraction and ocular biometry including AL, among others. The students’ parents also completed a questionnaire about the students’ lifestyles. We included the right eye in our analysis and compared the changes in the ocular parameters among the periods using a linear mixed-effects model for repeated measures and examined the univariate and step-wise multiple regression analyses to evaluate the associations between myopia and other covariates.</p></div><div><h3>Main Outcome Measures</h3><p>Changes in AL elongation and other ocular parameters from 2018 to 2019 (prepandemic), that of 2019 to 2020 (immediately after the pandemic onset), and that of 2020 to 2021 (during the pandemic).</p></div><div><h3>Results</h3><p>A total of 578 students before the pandemic period, 432 immediately after the pandemic onset, and 457 during the pandemic period were evaluated. The changes in the ALs and spherical equivalents (SEs) a year before, immediately after onset, and during the pandemic were 0.31 mm/−0.20 diopter, 0.38 mm/−0.27 diopter, and 0.28 mm/−0.47 diopter, respectively (ALs, <em>P</em> &lt; 0.001; SEs, <em>P</em> = 0.014). The results of the questionnaire showed that time spent outdoors daily had changed during the 3 years to 79, 63, and 77 minutes/day, respectively (<em>P</em> &lt; 0.001). Time spent using smartphones or tablets increased year by year to 41, 52, and 62 minutes/day (<em>P</em> &lt; 0.001). The greatest AL elongation occurred during the period when the shortest amount of time was spent outdoors during the 3 years.</p></div><div><h3>Conclusions</h3><p>These results suggested that the school closures and decreasing time spent outdoors might have caused greater AL elongation among schoolchildren in Tokyo; however, it is possible that, although the time spent in near work still increased, the return to the time spent outdoors to the prepandemic levels may have affected the slowing of AL elongation after lockdown.</p></div><div><h3>Financial Disclosure(s)</h3><p>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666914524000277/pdfft?md5=03b45d1bd30beb6bdb016ad3a8943397&pid=1-s2.0-S2666914524000277-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139885225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twelve-month Natural History Study of Centrosomal Protein 290 (CEP290)-associated Inherited Retinal Degeneration","authors":"Eric A. Pierce MD, PhD ,&nbsp;Bright S. Ashimatey OD, PhD ,&nbsp;Thiran Jayasundera MD ,&nbsp;Carel Hoyng MD ,&nbsp;Byron L. Lam MD ,&nbsp;Birgit Lorenz MD, PhD ,&nbsp;Keunpyo Kim PhD ,&nbsp;Alia Rashid MD ,&nbsp;Rene Myers PhD ,&nbsp;Mark E. Pennesi MD, PhD","doi":"10.1016/j.xops.2024.100483","DOIUrl":"https://doi.org/10.1016/j.xops.2024.100483","url":null,"abstract":"<div><h3>Purpose</h3><p>To define the clinical characteristics of centrosomal protein 290 (<em>CEP290</em>)-associated inherited retinal degeneration (IRD) and determine which assessments may provide reliable endpoints in future interventional trials.</p></div><div><h3>Design</h3><p>Participants in this natural history study were enrolled into 2 best-corrected visual acuity (BCVA) cohorts: light perception to &gt; 1.0 logarithm of the minimum angle of resolution (logMAR) and 1.0 logMAR to 0.4 logMAR. Each comprised 4 age cohorts (3–5, 6–11, 12–17, and ≥ 18 years).</p></div><div><h3>Participants</h3><p>Patients with <em>CEP290</em>-associated IRD caused by the intron 26 c.2991+1655A&gt;G mutation and BCVA ranging from light perception to 0.4 logMAR.</p></div><div><h3>Methods</h3><p>Best-corrected visual acuity, full-field stimulus threshold (FST) sensitivity, Ora–Visual Navigation Challenge (Ora–VNC) composite score, and OCT–outer nuclear layer (OCT–ONL) average thickness were assessed at screening, baseline, 3 months, 6 months, and 12 months.</p></div><div><h3>Main Outcome Measures</h3><p>Best-corrected visual acuity, FST sensitivity, Ora–VNC composite score, and OCT–ONL average thickness.</p></div><div><h3>Results</h3><p>Twenty-six participants were included in this analysis. Nineteen were female. All participants were White and 4 reported Hispanic ethnicity. At screening, 13 of 16 adult and 9 of 10 pediatric participants had BCVA &gt; 1.0 logMAR. Baseline BCVA was variable (median [range] = 2.0 [0.5, 3.9] logMAR) and was uncorrelated with age, as were VNC composite score, FST sensitivity, and OCT–ONL average thickness. Mean (95% confidence interval [CI]) test-retest variability was −0.04 (−0.09, 0.01) logMAR for BCVA (n = 25); 0.6 (−0.1, 1.3) for VNC composite score (n = 18); and 0.10 (−0.07, 0.27) log cd.s/m² for red FST (n = 14). A greater than expected test-retest variability (5 [0, 10] μm, n = 14) was observed for OCT–ONL average thickness as nystagmus impacted ability to repeat measures at the same retinal location. Functional assessments were stable over 12 months. Mean (95% CI) change from baseline was 0.06 (−0.17, 0.29) logMAR for BCVA (n = 23); −0.1 (−1.2, 1.0) for VNC composite score (n = 21); and −0.15 (−0.43, 0.14) log cd.s/m² for red FST (n = 16).</p></div><div><h3>Conclusions</h3><p>Vision was stable over 12 months. Best-corrected visual acuity, FST, and VNC composite score are potentially viable endpoints for future studies in CEP290-associated IRD. Repeatability of OCT measures poses challenges for quantifying anatomical changes in this population.</p></div><div><h3>Financial Disclosure(s)</h3><p>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666914524000198/pdfft?md5=b79641bae2c993d7c363453a589fb4b2&pid=1-s2.0-S2666914524000198-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141242437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated Identification of Different Severity Levels of Diabetic Retinopathy Using a Handheld Fundus Camera and Single-Image Protocol","authors":"Fernando K. Malerbi MD, PhD ,&nbsp;Luis Filipe Nakayama MD ,&nbsp;Gustavo Barreto Melo MD, PhD ,&nbsp;José A. Stuchi MSC, PhD ,&nbsp;Diego Lencione MSC ,&nbsp;Paulo V. Prado MSC ,&nbsp;Lucas Z. Ribeiro MD ,&nbsp;Sergio A. Dib MD, PhD ,&nbsp;Caio V. Regatieri MD, PhD","doi":"10.1016/j.xops.2024.100481","DOIUrl":"https://doi.org/10.1016/j.xops.2024.100481","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate the performance of artificial intelligence (AI) systems embedded in a mobile, handheld retinal camera, with a single retinal image protocol, in detecting both diabetic retinopathy (DR) and more-than-mild diabetic retinopathy (mtmDR).</p></div><div><h3>Design</h3><p>Multicenter cross-sectional diagnostic study, conducted at 3 diabetes care and eye care facilities.</p></div><div><h3>Participants</h3><p>A total of 327 individuals with diabetes mellitus (type 1 or type 2) underwent a retinal imaging protocol enabling expert reading and automated analysis.</p></div><div><h3>Methods</h3><p>Participants underwent fundus photographs using a portable retinal camera (Phelcom Eyer). The captured images were automatically analyzed by deep learning algorithms retinal alteration score (RAS) and diabetic retinopathy alteration score (DRAS), consisting of convolutional neural networks trained on EyePACS data sets and fine-tuned using data sets of portable device fundus images. The ground truth was the classification of DR corresponding to adjudicated expert reading, performed by 3 certified ophthalmologists.</p></div><div><h3>Main Outcome Measures</h3><p>Primary outcome measures included the sensitivity and specificity of the AI system in detecting DR and/or mtmDR using a single-field, macula-centered fundus photograph for each eye, compared with a rigorous clinical reference standard comprising the reading center grading of 2-field imaging protocol using the International Classification of Diabetic Retinopathy severity scale.</p></div><div><h3>Results</h3><p>Of 327 analyzed patients (mean age, 57.0 ± 16.8 years; mean diabetes duration, 16.3 ± 9.7 years), 307 completed the study protocol. Sensitivity and specificity of the AI system were high in detecting any DR with DRAS (sensitivity, 90.48% [95% confidence interval (CI), 84.99%–94.46%]; specificity, 90.65% [95% CI, 84.54%–94.93%]) and mtmDR with the combination of RAS and DRAS (sensitivity, 90.23% [95% CI, 83.87%–94.69%]; specificity, 85.06% [95% CI, 78.88%–90.00%]). The area under the receiver operating characteristic curve was 0.95 for any DR and 0.89 for mtmDR.</p></div><div><h3>Conclusions</h3><p>This study showed a high accuracy for the detection of DR in different levels of severity with a single retinal photo per eye in an all-in-one solution, composed of a portable retinal camera powered by AI. Such a strategy holds great potential for increasing coverage rates of screening programs, contributing to prevention of avoidable blindness.</p></div><div><h3>Financial Disclosure(s)</h3><p>F.K.M. is a medical consultant for Phelcom Technologies. J.A.S. is Chief Executive Officer and proprietary of Phelcom Technologies. D.L. is Chief Technology Officer and proprietary of Phelcom Technologies. P.V.P. is an employee at Phelcom Technologies.</p></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666914524000174/pdfft?md5=fbb1170100a68fa3c3edffca532778fd&pid=1-s2.0-S2666914524000174-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140649843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparative Study of Responses to Retina Questions from Either Experts, Expert-Edited Large Language Models, or Expert-Edited Large Language Models Alone","authors":"Prashant D. Tailor MD ,&nbsp;Lauren A. Dalvin MD ,&nbsp;John J. Chen MD, PhD ,&nbsp;Raymond Iezzi MD ,&nbsp;Timothy W. Olsen MD ,&nbsp;Brittni A. Scruggs MD, PhD ,&nbsp;Andrew J. Barkmeier MD ,&nbsp;Sophie J. Bakri MD ,&nbsp;Edwin H. Ryan MD ,&nbsp;Peter H. Tang MD, PhD ,&nbsp;D. Wilkin. Parke III MD ,&nbsp;Peter J. Belin MD ,&nbsp;Jayanth Sridhar MD ,&nbsp;David Xu MD ,&nbsp;Ajay E. Kuriyan MD ,&nbsp;Yoshihiro Yonekawa MD ,&nbsp;Matthew R. Starr MD","doi":"10.1016/j.xops.2024.100485","DOIUrl":"10.1016/j.xops.2024.100485","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the quality, empathy, and safety of expert edited large language model (LLM), human expert created, and LLM responses to common retina patient questions.</p></div><div><h3>Design</h3><p>Randomized, masked multicenter study.</p></div><div><h3>Participants</h3><p>Twenty-one common retina patient questions were randomly assigned among 13 retina specialists.</p></div><div><h3>Methods</h3><p>Each expert created a response (Expert) and then edited a LLM (ChatGPT-4)-generated response to that question (Expert + artificial intelligence [AI]), timing themselves for both tasks. Five LLMs (ChatGPT-3.5, ChatGPT-4, Claude 2, Bing, and Bard) also generated responses to each question. The original question along with anonymized and randomized Expert + AI, Expert, and LLM responses were evaluated by the other experts who did not write an expert response to the question. Evaluators judged quality and empathy (very poor, poor, acceptable, good, or very good) along with safety metrics (incorrect information, likelihood to cause harm, extent of harm, and missing content).</p></div><div><h3>Main Outcome</h3><p>Mean quality and empathy score, proportion of responses with incorrect information, likelihood to cause harm, extent of harm, and missing content for each response type.</p></div><div><h3>Results</h3><p>There were 4008 total grades collected (2608 for quality and empathy; 1400 for safety metrics), with significant differences in both quality and empathy (<em>P</em> &lt; 0.001, <em>P</em> &lt; 0.001) between LLM, Expert and Expert + AI groups. For quality, Expert + AI (3.86 ± 0.85) performed the best overall while GPT-3.5 (3.75 ± 0.79) was the top performing LLM. For empathy, GPT-3.5 (3.75 ± 0.69) had the highest mean score followed by Expert + AI (3.73 ± 0.63). By mean score, Expert placed 4 out of 7 for quality and 6 out of 7 for empathy. For both quality (<em>P</em> &lt; 0.001) and empathy (<em>P</em> &lt; 0.001), expert-edited LLM responses performed better than expert-created responses. There were time savings for an expert-edited LLM response versus expert-created response (<em>P</em> = 0.02). ChatGPT-4 performed similar to Expert for inappropriate content (<em>P</em> = 0.35), missing content (<em>P</em> = 0.001), extent of possible harm (<em>P</em> = 0.356), and likelihood of possible harm (<em>P</em> = 0.129).</p></div><div><h3>Conclusions</h3><p>In this randomized, masked, multicenter study, LLM responses were comparable with experts in terms of quality, empathy, and safety metrics, warranting further exploration of their potential benefits in clinical settings.</p></div><div><h3>Financial Disclosure(s)</h3><p>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of the article.</p></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666914524000216/pdfft?md5=5e2ad31ae6fa487a208c371f1e37de20&pid=1-s2.0-S2666914524000216-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139876184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Slowing of Greater Axial Length Elongation Stemming from the COVID-19 Pandemic with Increasing Time Outdoors: The Tokyo Myopia Study","authors":"Erisa Yotsukura, H. Torii, Kiwako Mori, Mamoru Ogawa, Akiko Hanyuda, K. Negishi, T. Kurihara, Kazuo Tsubota","doi":"10.1016/j.xops.2024.100491","DOIUrl":"https://doi.org/10.1016/j.xops.2024.100491","url":null,"abstract":"","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139825190","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":"Analysis of the retinal and choroidal vasculature using ultra-widefield fundus imaging in mild cognitive impairment and normal cognition","authors":"Suzanna Joseph, Alice Haystead, Cason B. Robbins, Adam Threlfall, Tom J. MacGillivray, Sandra Stinnett, D. Grewal, Sharon Fekrat","doi":"10.1016/j.xops.2024.100480","DOIUrl":"https://doi.org/10.1016/j.xops.2024.100480","url":null,"abstract":"","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139825722","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}