Arquivos brasileiros de oftalmologia最新文献

{"title":"Structural analysis of amniotic membrane for use in ophthalmology with different preservation techniques.","authors":"Caio Costa Santos, Roberta Tovo Borghetto Abud, Alvio Isao Shiguematsu, Daniela Carvalho Dos Santos","doi":"10.5935/0004-2749.2025-0105","DOIUrl":"10.5935/0004-2749.2025-0105","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate structural differences in amniotic membrane fragments subjected to different preservation techniques for potential ophthalmologic applications.</p><p><strong>Methods: </strong>Three placentas were collected from healthy donors, and four amniotic membrane fragments were prepared from each placenta. The fragments were divided into four groups with three samples each: cryopreserved, lyophilized, vacuum--dried using a vacuum concentrator, and fresh (control). After processing, the fragments were fixed, sectioned, and analyzed using scanning transmission electron microscopy to assess tissue morphology.</p><p><strong>Results: </strong>All samples met the established evaluation criteria. No morphological differences were observed among the groups. The structural characteristics of lyophilized and vacuum-dried membranes were comparable with those of cryopreserved and fresh membranes. However, vacuum drying demonstrated the greatest practicality for ophthalmologic use, as it allows membrane availability at any time and storage at room temperature.</p><p><strong>Conclusion: </strong>Vacuum drying using a vacuum concentrator, lyophilization, and cryopreservation preserve the morphological characteristics of the human amniotic membrane similar to those of fresh tissue. A standardized protocol using a vacuum concentrator may be established owing to its advantages in storage convenience and accessibility.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 2","pages":"0105"},"PeriodicalIF":1.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430484","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":"Effect of a propylene-glycol-hydroxypropyl guar nanoemulsion on symptoms and ocular surface parameters in patients with evaporative dry eye.","authors":"Cristian Cartes, Claudia Zapata, Camila Lopez, Camila Gaete, Nicolás Aguilera, Christian Segovia","doi":"10.5935/0004-2749.2025-0148","DOIUrl":"10.5935/0004-2749.2025-0148","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effects of a propylene glycol-hydroxypropyl guar nanoemulsion on symptoms and ocular surface parameters in patients with evaporative dry eye.</p><p><strong>Methods: </strong>This prospective, single-center, interventional study included patients aged 18-50 years with evaporative dry eye who received a propylene glycol-hydroxypropyl guar nanoemulsion. Participants were instructed to instill the nanoemulsion three times daily for 90 days. Evaluations included the Ocular Surface Disease Index, tear osmolarity, tear meniscus height, lipid layer thickness, noninvasive tear break-up time, fluorescein tear break-up time, corneal fluorescein staining (National Eye Institute Scale), Schirmer's test I, and meibum quality.</p><p><strong>Results: </strong>Thirty-three participants were enrolled, and 30 completed the study. The mean age was 36 ± 10 yr, and 73.3% were women. The mean Ocular Surface Disease Index score significantly decreased from 43.1 ± 20 at baseline to 25.2 ± 17 at 3 months (p=0.009). Median corneal fluorescein staining decreased from 2 (IQ range=1-3) to 1 (IQ range 25-75 = 0-1) at the final follow-up (p=0.002). The mean fluorescein tear break-up time increased significantly increased from 3.8 ± 2.1 at baseline to 5.8 ± 2.2 at 3 months (p=0.002). Tear osmolarity decreased significantly (p=0.01) and lipid layer thickness improved markedly (p<0.001). No significant changes were observed in tear meniscus height or noninvasive tear break-up time (p>0.05).</p><p><strong>Conclusions: </strong>Treatment with a propylene glycol-hydroxypropyl guar nanoemulsion significantly improved dry-eye symptoms, corneal staining, tear film stability, and lipid layer quality in patients with evaporative dry eye. No adverse events were reported, supporting the safety and efficacy of this formulation.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 1","pages":"0148"},"PeriodicalIF":1.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430411","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":"Brazil among the world's most cited researchers: Significance, methods, and the place of Ophthalmology.","authors":"Marcony R Santhiago","doi":"10.5935/0004-2749.2026-1021","DOIUrl":"https://doi.org/10.5935/0004-2749.2026-1021","url":null,"abstract":"","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 1","pages":"1021"},"PeriodicalIF":1.2,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430389","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":"Evaluation of intrastromal micropuncture in Eye Bank corneas using a tattoo machine.","authors":"Michelle de Lima Farah, Samir Arbache, Rubens Belfort","doi":"10.5935/0004-2749.2025-0208","DOIUrl":"10.5935/0004-2749.2025-0208","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the reliability and penetration depth of an automated micropuncture system using a tattoo machine.</p><p><strong>Methods: </strong>Twenty human corneas were obtained and subjected to intrastromal micropuncture using a tattoo machine. Each cornea was divided into two halves: one received pigment, while the other received saline solution as a control. The Cheyenne tattoo machine was operated at 60 Hz, with standardized needle exposure (six passes per application). The machine used cartridges containing five microneedles. The study was registered with Agência Nacional de Vigilância Sanitária ANVISA (numbers 80281110015, 80281110016, and 80281110019). The pigment used was Electric Ink black ink, with a density of 1,271,460 μg/mL. Puncture depth was measured before and after the procedure using both anterior segment optical coherence tomography and histopathological analysis. Puncture depth measurements were analyzed using ImageJ software. Each cornea was measured thrice, and the results were subsequently compared.</p><p><strong>Results: </strong>No corneal perforations were observed with the use of the tattoo machine, and puncture depth measurements ranged from 107 to 486 μm.</p><p><strong>Conclusions: </strong>The use of a tattoo machine represents a viable and accessible approach for keratopigmentation, with potential for both cosmetic and therapeutic applications. Its adaptation for controlled intrastromal drug delivery may enable the targeted treatment of deep infectious keratitis, corneal neovascularization, and stromal inflammatory disorders, representing a promising approach for corneal stromal diseases. Further research is needed to optimize techniques and evaluate long-term safety and efficacy, particularly for the delivery of antimicrobial, anti-inflammatory, and anti-vascular endothelial growth factor agents.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 2","pages":"0208"},"PeriodicalIF":1.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430522","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":"Alumni in Focus: Profile, scientific production, and career of graduates from the postgraduate program in ophthalmology at UNIFESP.","authors":"Rosângela Demetrio, Adriano Cypriano Faneli, Denise de Freitas, Caio Vinicius Saito Regatieri","doi":"10.5935/0004-2749.2025-0224","DOIUrl":"10.5935/0004-2749.2025-0224","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the academic and professional trajectories of graduates from the Graduate Program in Ophthalmology and Visual Sciences at the Escola Paulista de Medicina, Universidade Federal de São Paulo, including geographic distribution, occupational characteristics, and scientific productivity.</p><p><strong>Methods: </strong>This descriptive, retrospective, quantitative study included 498 alumni who completed the program between 1979 and 2021. Data were obtained from institutional records and supplemented by public databases (Google Scholar, Lattes Platform, and LinkedIn). The analyzed variables included demographic characteristics, academic background, current professional role, and bibliometric indicators (citation count and h-index). Statistical analyses comprised nonparametric tests and linear regression, with a significance level set at 5%.</p><p><strong>Results: </strong>Most alumni were Brazilian (96.6%) and physicians (90.7%), predominantly located in the Southeast region (66.9%). Doctoral training was completed by 80.5% of participants. Alumni with current institutional ties to Universidade Federal de São Paulo or Hospital São Paulo demonstrated significantly higher citation counts and h-index values. No significant correlation was observed between time since graduation and citation count (p=0.185). Alumni engaged in academic roles or with postdoctoral training showed greater scientific productivity.</p><p><strong>Conclusions: </strong>The findings highlight the strong academic performance and professional integration of alumni from Universidade Federal de São Paulo, particularly within public institutions and the Southeast region of Brazil. Doctoral training and institutional affiliation were associated with higher scientific productivity. Alumni tracking provides valuable insights into the impact of postgraduate programs and informs strategic planning and development.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 2","pages":"0224"},"PeriodicalIF":1.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430457","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":"Evaluation of the pachychoroid spectrum in patients with mild autonomous cortisol secretion.","authors":"Elif Kiliç Kan, Emrah Kan, Bilge Eraydin, Betül Gündüz, Ozlem Eski Yucel","doi":"10.5935/0004-2749.2025-0184","DOIUrl":"10.5935/0004-2749.2025-0184","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate choroidal structural and vascular changes in patients with mild autonomous cortisol secretion using enhanced depth imaging optical coherence tomography and optical coherence tomography angiography.</p><p><strong>Methods: </strong>This cross-sectional study included 60 eyes of 30 patients with mild autonomous cortisol secretion and 60 eyes of 30 subjects with nonfunctional adenoma (controls) between February 2023 and January 2024. Subfoveal choroidal thickness, pachychoroid spectrum disease and choroidal vascularity index were evaluated using spectral-domain optical coherence tomography. Group comparisons were performed, and correlations between subfoveal choroidal thickness and clinical features were analyzed.</p><p><strong>Results: </strong>Pachyvessels were more common in patients with mild autonomous cortisol secretion than in controls (71.4% vs. 42.9%, p=0.002). The frequency of pachychoroidal spectrum disease was significantly higher in the mild autonomous cortisol secretion Group (68.3% vs. 31.7%; p<0.001). Median subfoveal choroidal thickness was 355 μm (range, 150-535) in the mild autonomous cortisol secretion Group and 297 μm (range, 162-597) in controls (p=0.014). Choroidal vascularity index was comparable between groups (p=0.072). Subfoveal choroidal thickness correlated significantly with axial length, spherical equivalent, post-1-mg dexamethasone suppression test cortisol level, and disease duration.</p><p><strong>Conclusion: </strong>Patients with mild autonomous cortisol secretion exhibited greater subfoveal choroidal thickness and a higher frequency of pachychoroidal spectrum disease compared with controls, whereas stromal and vascular structural alterations were proportionally similar between groups.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 1","pages":"0184"},"PeriodicalIF":1.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430363","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":"A trilogy of the oculomotor system Part II - active, passive, and dissipative forces Part III - diagnostic tests.","authors":"Harley E A Bicas","doi":"10.5935/0004-2749.2025-0242","DOIUrl":"10.5935/0004-2749.2025-0242","url":null,"abstract":"&lt;p&gt;&lt;p&gt;In Part II, this paper addresses ocular motions, their causes (forces), and the governing laws, beginning with the fundamental question: Why do the eyes move? Ocular rotations and different types of translations (ocular, orbital, and corporeal) are reviewed. The discussion then turns to how the eyes move, where concepts such as the plane of muscular action, torque, and arc of contact provide possible explanations for the anatomical arrangement of the ocular muscles within the orbit. Sherrington's law of reciprocal innervation is used to explain the distribution of muscular active forces in a conservative mechanical system, but in combination with Hering's law, it may prevent eye rotation (e.g., isometric contractions of antagonist muscles of an asymmetrical convergence). Normally, however, the limitation of an eye rotation is determined by passive forces, evoked by muscular activity itself, particularly natural muscular elasticity. Thus, elongation of an antagonist muscle may passively restrict the active contraction of an agonist. In addition to mechanisms for initiating rotation (active forces) and stopping it (passive forces), the oculomotor system also requires a means of dissipating energy (dissipative forces) to initiate subsequent movements. Hence, it cannot function as a perfectly conservative system of forces. The paper concludes with a review of \"selective\" effects of muscle function (due to the sparse distribution of fibers), the role of intermuscular membranes (and pulleys), and mechanical considerations of surgical procedures, such as muscular transpositions to alter or abolish actions (e.g., bifid reinsertions). Part III will address the diagnostic complexities of the oculomotor system, general treatment principles, and ocular fixation (eye and head positions). Although the basic concept of the primary position is relativized, the absolute need for referential conditions in defining, qualifying, and measuring strabismus is emphasized. The prim-diopter is challenged due to its lack of \"linearity\" relative to angular units, and an alternative is proposed. Methods of examining oculomotor disturbances are outlined, including monocular rotations (ductions), and tests to differentiate between muscular deficiencies and opposing forces. Techniques for identifying the site of a rotational restriction are described, followed by approaches to measuring ocular deviations in diagnostic positions. The concepts of muscular overactions and underactions are analyzed before introducing the concept of diagnostic muscle pairs. Classical knowledge about deviations caused by deficient or restricted muscle actions reinforces the theory of distribution of rotational ocular muscles by diagnostic pairs. For vertical deviations, \"underactive\" muscle pairs must be separately matched (e.g., RSR with LIR, RIO with LSO). Since vertical recti exert stronger vertical actions than oblique muscles, head tilts are recommended to enhance stress on both pairs, mai","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 2","pages":"e20250242"},"PeriodicalIF":1.0,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147353764","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":"Myopia control strategies: a survey of Brazilian ophthalmologists.","authors":"Raíra Fortuna Cavaliere Mendes Moraes, Carolina Pelegrini Barbosa Gracitelli, Célia Regina Nakanami, Julia Dutra Rossetto","doi":"10.5935/0004-2749.2025-0192","DOIUrl":"10.5935/0004-2749.2025-0192","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to identify the strategies adopted by Brazilian ophthalmologists to control myopia in clinical practice.</p><p><strong>Methods: </strong>This was a prospective cross-sectional study. Data were collected using an online questionnaire.</p><p><strong>Results: </strong>Responses from 148 participants were collected between March and May 2024. The majority of respondents were general ophthalmologists (51%) and pediatric ophthalmologists (43%). They came from all regions of Brazil, but more than half (52%) were from the Southeast region. Most participants (30%) had over 20 years of clinical practice experience. A significant proportion (89.2%) treated progressive myopia. The most requested complementary exams were optical biometry (83.78%) and corneal topography or tomography (69.59%). Behavioral measures were considered the most effective myopia treatment strategies by 41.2% of the respondents, followed by optical (33.8%) and pharmacological interventions (25%). Most recommended spending more time outdoors (94.59%) and reducing screen time (93.92%). Spectacle lenses for myopia (83.11%) and 0.025% atropine eye drops (54.73%) were the most prescribed treatments after the recommendation of environmental and behavioral changes.</p><p><strong>Conclusion: </strong>This study presents a novel analysis of the clinical strategies for myopia control among Brazilian ophthalmologists. Understanding current clinical practices and identifying possible improvements are essential steps toward developing evidence-based guidelines and professional education aimed at improving patient care.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 2","pages":"e20250192"},"PeriodicalIF":1.0,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147353730","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":"Beyond pressure control: Periorbital impact of prostaglandins vs. laser trabeculoplasty.","authors":"Leonardo Leivas, Fernando Procianoy, Rafaela C Almeida, Marina M Pakter, Marcelo V Fabris, Rodrigo L Lindenmayer, Fábio Lavinsky, Daniel Lavinsky, Helena M Pakter","doi":"10.5935/0004-2749.2025-0181","DOIUrl":"10.5935/0004-2749.2025-0181","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the one-year impact of prostaglandin analog (travoprost) on periorbital appearance and lower eyelid horizontal tension, compared with the contralateral eye treated with Pascal selective laser trabeculoplasty.</p><p><strong>Methods: </strong>This nested case-control study was derived from a non-inferiority randomized clinical trial comparing Pascal selective laser trabeculoplasty efficacy with travoprost in fellow eyes over 12 months. One eye received daily travoprost, while the contralateral eye underwent Pascal selective laser trabeculoplasty. Lower eyelid horizontal tension was measured using a validated digital imaging method, and prostaglandin-associated periorbitopathy signs were graded by masked observers. Statistical analyses included generalized estimating equations and the Mann-Whitney U test for nonparametric data, with p<0.05 considered significant.</p><p><strong>Results: </strong>Ten patients met the inclusion criteria for this subanalysis. Travoprost-treated eyes had significantly lower mean lower eyelid distension compared with Pascal selective laser trabeculoplasty-treated eyes (4.32 mm vs. 5.02 mm; mean difference: 0.70 mm; p<0.001). Prostaglandin--associated periorbitopathy scores were significantly higher in the travoprost group, reflecting more pronounced changes in ptosis, periorbital hyperpigmentation, and eyelid retraction.</p><p><strong>Conclusions: </strong>Chronic use of prostaglandin analogs is associated with notable periorbital changes and increased lower eyelid tension, potentially affecting aesthetics and ocular function. Pascal selective laser trabeculoplasty may offer a safer profile for preserving periorbital anatomy while maintaining effective intraocular pressure control. Laser trabeculoplasty should be considered as an initial treatment when appropriate to minimize cosmetic and functional changes from chronic topical therapy.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 2","pages":"e20250181"},"PeriodicalIF":1.0,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147353775","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":"Performance of generative large language models in answering questions from the Brazilian Retina and Vitreous Society certification exam.","authors":"Adriano Cypriano Faneli, Ricardo Danilo Chagas Oliveira, Luis Filipe Nakayama, Rodrigo Amaral Torres, Cristina Muccioli, Caio Vinicius Saito Regatieri","doi":"10.5935/0004-2749.2025-0113","DOIUrl":"10.5935/0004-2749.2025-0113","url":null,"abstract":"<p><strong>Purpose: </strong>Natural language models and chatbots, particularly OpenAI's Generative Pre-Trained Transformer architecture, have transformed human interaction with digital interfaces. The latest versions, including ChatGPT-4o, offer enhanced functionalities compared to their predecessors. This study evaluates the accuracy of ChatGPT-4, ChatGPT-4o, and Claude 3.5 Sonnet in answering questions from the Brazilian Retina and Vitreous Society certification exam.</p><p><strong>Methods: </strong>We compiled 200 multiple-choice questions from the Brazilian Retina and Vitreous Society 2018 and 2019 exams. Questions were categorized into three domains: Anatomy and Physiology of the Retina, Retinal Pathology, and Diagnosis and Treatment. Using a standardized prompt developed according to prompt design guidelines, we tested ChatGPT-4, ChatGPT-4o, and Claude 3.5 Sonnet, recording their first responses as final. Three retina specialists performed a qualitative analysis of the answers. Accuracy was determined by comparing responses to the official correct answers. Statistical analysis was conducted using chi-square tests and Cohen's Kappa.</p><p><strong>Results: </strong>Claude 3.5 Sonnet achieved the highest overall accuracy (72.5%), followed by ChatGPT-4o (66.0%) and ChatGPT-4 (55.5%). Claude 3.5 Sonnet and ChatGPT-4o significantly outperformed ChatGPT-4 (p<0.01 and p=0.03, respectively), while no significant difference was observed between Claude 3.5 Sonnet and ChatGPT-4o (p=0.16). Model responses agreed 74.5% of the time, with a Cohen's κ of 0.47. Retinal Pathology was the best-performing domain for all models, whereas Anatomy and Physiology of the Retina and Diagnosis and Treatment were the weakest domains for Claude 3.5 Sonnet and ChatGPT-4, respectively.</p><p><strong>Conclusions: </strong>This study is the first to assess Claude 3.5 Sonnet, ChatGPT-4, and ChatGPT-4o in retina specialist certification exams. Claude 3.5 Sonnet and ChatGPT-4o significantly outperformed ChatGPT-4, highlighting their potential as effective tools for studying retina specialist board exams. These findings suggest that the enhanced functionalities of Claude 3.5 Sonnet and ChatGPT-4o offer substantial improvements in medical education contexts.</p>","PeriodicalId":8397,"journal":{"name":"Arquivos brasileiros de oftalmologia","volume":"89 2","pages":"e20250113"},"PeriodicalIF":1.0,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147353794","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}