Asia-Pacific Journal of Ophthalmology最新文献

{"title":"Cybersecurity in the generative artificial intelligence era","authors":"Zhen Ling Teo ,&nbsp;Chrystie Wan Ning Quek ,&nbsp;Joy Le Yi Wong ,&nbsp;Daniel Shu Wei Ting","doi":"10.1016/j.apjo.2024.100091","DOIUrl":"10.1016/j.apjo.2024.100091","url":null,"abstract":"<div><p>Generative Artificial Intelligence (GenAI) are algorithms capable of generating original content. The ability of GenAI to learn and generate novel outputs alike human cognition has taken the world by storm and ushered in a new era. In this review, we explore the role of GenAI in healthcare, including clinical, operational, and research applications, and delve into the cybersecurity risks of this technology. We discuss risks such as data privacy risks, data poisoning attacks, the propagation of bias, and hallucinations. In this review, we recommend risk mitigation strategies to enhance cybersecurity in GenAI technologies and further explore the use of GenAI as a tool in itself to enhance cybersecurity across the various AI algorithms. GenAI is emerging as a pivotal catalyst across various industries including the healthcare domain. Comprehending the intricacies of this technology and its potential risks will be imperative for us to fully capitalise on the benefits that GenAI can bring.</p></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"13 4","pages":"Article 100091"},"PeriodicalIF":3.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2162098924000926/pdfft?md5=e6d130e1d7f34e0f4b1d729d7677d647&pid=1-s2.0-S2162098924000926-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An unusual iris in Waardenburg syndrome","authors":"Arnav Panigrahi,&nbsp;Siddhartha Rao,&nbsp;Shikha Gupta,&nbsp;Viney Gupta","doi":"10.1016/j.apjo.2024.100081","DOIUrl":"10.1016/j.apjo.2024.100081","url":null,"abstract":"","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"13 4","pages":"Article 100081"},"PeriodicalIF":3.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2162098924000823/pdfft?md5=f628c44a5d11276e57e15feafcb3620f&pid=1-s2.0-S2162098924000823-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141615863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of oculomics artificial intelligence for cardiovascular risk factors: A case study in fundus oculomics for HbA1c assessment and clinically relevant considerations for clinicians","authors":"Joshua Ong ,&nbsp;Kuk Jin Jang ,&nbsp;Seung Ju Baek ,&nbsp;Dongyin Hu ,&nbsp;Vivian Lin ,&nbsp;Sooyong Jang ,&nbsp;Alexandra Thaler ,&nbsp;Nouran Sabbagh ,&nbsp;Almiqdad Saeed ,&nbsp;Minwook Kwon ,&nbsp;Jin Hyun Kim ,&nbsp;Seongjin Lee ,&nbsp;Yong Seop Han ,&nbsp;Mingmin Zhao ,&nbsp;Oleg Sokolsky ,&nbsp;Insup Lee ,&nbsp;Lama A. Al-Aswad","doi":"10.1016/j.apjo.2024.100095","DOIUrl":"10.1016/j.apjo.2024.100095","url":null,"abstract":"<div><p>Artificial Intelligence (AI) is transforming healthcare, notably in ophthalmology, where its ability to interpret images and data can significantly enhance disease diagnosis and patient care. Recent developments in oculomics, the integration of ophthalmic features to develop biomarkers for systemic diseases, have demonstrated the potential for providing rapid, non-invasive methods of screening leading to enhance in early detection and improve healthcare quality, particularly in underserved areas. However, the widespread adoption of such AI-based technologies faces challenges primarily related to the trustworthiness of the system. We demonstrate the potential and considerations needed to develop trustworthy AI in oculomics through a pilot study for HbA1c assessment using an AI-based approach. We then discuss various challenges, considerations, and solutions that have been developed for powerful AI technologies in the past in healthcare and subsequently apply these considerations to the oculomics pilot study. Building upon the observations in the study we highlight the challenges and opportunities for advancing trustworthy AI in oculomics. Ultimately, oculomics presents as a powerful and emerging technology in ophthalmology and understanding how to optimize transparency prior to clinical adoption is of utmost importance.</p></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"13 4","pages":"Article 100095"},"PeriodicalIF":3.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2162098924000963/pdfft?md5=acb8dd43f5863a99daef807eebad2890&pid=1-s2.0-S2162098924000963-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing a patient with uveitis in the era of artificial intelligence: Current approaches, emerging trends, and future perspectives","authors":"William Rojas-Carabali ,&nbsp;Carlos Cifuentes-González ,&nbsp;Laura Gutierrez-Sinisterra ,&nbsp;Lim Yuan Heng ,&nbsp;Edmund Tsui ,&nbsp;Sapna Gangaputra ,&nbsp;Srinivas Sadda ,&nbsp;Quan Dong Nguyen ,&nbsp;John H. Kempen ,&nbsp;Carlos E. Pavesio ,&nbsp;Vishali Gupta ,&nbsp;Rajiv Raman ,&nbsp;Chunyan Miao ,&nbsp;Bernett Lee ,&nbsp;Alejandra de-la-Torre ,&nbsp;Rupesh Agrawal","doi":"10.1016/j.apjo.2024.100082","DOIUrl":"10.1016/j.apjo.2024.100082","url":null,"abstract":"<div><p>The integration of artificial intelligence (AI) with healthcare has opened new avenues for diagnosing, treating, and managing medical conditions with remarkable precision. Uveitis, a diverse group of rare eye conditions characterized by inflammation of the uveal tract, exemplifies the complexities in ophthalmology due to its varied causes, clinical presentations, and responses to treatments. Uveitis, if not managed promptly and effectively, can lead to significant visual impairment. However, its management requires specialized knowledge, which is often lacking, particularly in regions with limited access to health services. AI's capabilities in pattern recognition, data analysis, and predictive modelling offer significant potential to revolutionize uveitis management. AI can classify disease etiologies, analyze multimodal imaging data, predict outcomes, and identify new therapeutic targets. However, transforming these AI models into clinical applications and meeting patient expectations involves overcoming challenges like acquiring extensive, annotated datasets, ensuring algorithmic transparency, and validating these models in real-world settings. This review delves into the complexities of uveitis and the current AI landscape, discussing the development, opportunities, and challenges of AI from theoretical models to bedside application. It also examines the epidemiology of uveitis, the global shortage of uveitis specialists, and the disease's socioeconomic impacts, underlining the critical need for AI-driven approaches. Furthermore, it explores the integration of AI in diagnostic imaging and future directions in ophthalmology, aiming to highlight emerging trends that could transform management of a patient with uveitis and suggesting collaborative efforts to enhance AI applications in clinical practice.</p></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"13 4","pages":"Article 100082"},"PeriodicalIF":3.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2162098924000835/pdfft?md5=6458b1f573cc4656f4f4f828f864a316&pid=1-s2.0-S2162098924000835-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141632508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response: Comment on \"Update on coronavirus disease 2019: Ophthalmic manifestations and adverse reactions to vaccination\"","authors":"Timothy P.H. Lin","doi":"10.1016/j.apjo.2024.100083","DOIUrl":"10.1016/j.apjo.2024.100083","url":null,"abstract":"","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"13 4","pages":"Article 100083"},"PeriodicalIF":3.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2162098924000847/pdfft?md5=6bdc129df9908045303c1dd36cf331d4&pid=1-s2.0-S2162098924000847-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141747347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep Learning‐Enabled Vasculometry Depicts Phased Lesion Patterns in High Myopia Progression","authors":"Hai-Long He ,&nbsp;Yi-Xin Liu ,&nbsp;Hanruo Liu ,&nbsp;Xiaomei Zhang ,&nbsp;Hao Song ,&nbsp;Tian-Ze Xu ,&nbsp;Yuxin Fang ,&nbsp;Ya Ma ,&nbsp;Hao-Ying Ren ,&nbsp;Sai-Guang Ling ,&nbsp;Zhou Dong ,&nbsp;Jie Xu ,&nbsp;Lei Qin ,&nbsp;Tien Yin Wong ,&nbsp;Marcus Ang ,&nbsp;Zi-Bing Jin","doi":"10.1016/j.apjo.2024.100086","DOIUrl":"10.1016/j.apjo.2024.100086","url":null,"abstract":"<div><h3>Purpose</h3><p>To investigate the potential phases in myopic retinal vascular alterations for further elucidating the mechanisms underlying the progression of high myopia (HM).</p></div><div><h3>Methods</h3><p>For this retrospective study, participants diagnosed with high myopia at Beijing Tongren Hospital were recruited. Based on bionic mechanisms of human vision, an intelligent image processing model was developed and utilized to extract and quantify the morphological characteristics of retinal vasculatures in different regions measured by papilla-diameter (PD), including vascular caliber, arteriole-to-venule ratio (AVR), tortuosity, the angle of the vascular arch (AVA), the distance of the vascular arch (DVA), density, fractal dimension, and venular length. In addition, the optic disc and the area of peripapillary atrophy (PPA) were also quantified. The characteristics of the overall population, as well as patients aged less than 25 years old, were compared by different genders. Univariate and multiple linear regression analyses were conducted to investigate the correlation of retinal vasculature parameters with PPA width, and detailed trends of the vascular indicators were analyzed to explore the potential existence of staged morphological changes.</p></div><div><h3>Findings</h3><p>The study included 14,066 fundus photographs of 5775 patients (aged 41.2 ± 18.6 years), of whom 7379 (61.2 %) were female. The study included 12,067 fundus photographs of 5320 patients (aged 41.2 ± 18.6 years). Significant variations in the morphological parameters of retinal vessels were observed between males and females. After adjusting for age and sex, multiple linear regression analysis showed that an increased PPA width ratio was associated with lower AVA (1PD), DVA (1PD), vascular caliber (0.5–1.0 PD), tortuosity (0.5–1.0 PD), density and fractal dimension (all P &lt; 0.001, Spearman’s ρ &lt; 0). Overall, the changes in retinal vascular morphology showed two phases: tortuosity (0.5–1.0PD) and AVA (1PD) decreased rapidly in the first stage but significantly more slowly in the second stage, while vascular density and fractal dimension showed a completely opposite trend with an initial slow decline followed by a rapid decrease.</p></div><div><h3>Conclusions</h3><p>This study identified two distinct phases of retinal vascular morphological changes during the progression of HM. Traction lesions were predominant in the initial stage, while atrophic lesions were predominant in the later stage. These findings provide further insight into the development mechanism of HM from the perspective of retinal vasculature.</p></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"13 4","pages":"Article 100086"},"PeriodicalIF":3.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2162098924000872/pdfft?md5=cbe2792816086903d279eb12d98f67f8&pid=1-s2.0-S2162098924000872-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Letter to the Editor: “Discrepancies in reported prevalence rates of keratoconus in Russia”","authors":"Mukharram M. Bikbov ,&nbsp;Gyulli M. Kazakbaeva ,&nbsp;Timur R. Gilmanshin ,&nbsp;Ellina M. Iakupova ,&nbsp;Albina A. Fakhretdinova ,&nbsp;Azaliia M. Tuliakova ,&nbsp;Songhomitra Panda-Jonas ,&nbsp;Iuliia A. Rusakova ,&nbsp;Leisan I. Gilemzianova ,&nbsp;Dinar A. Khakimov ,&nbsp;Liana A. Miniazeva ,&nbsp;Emin L. Usubov ,&nbsp;Jost B. Jonas","doi":"10.1016/j.apjo.2024.100078","DOIUrl":"10.1016/j.apjo.2024.100078","url":null,"abstract":"","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"13 3","pages":"Article 100078"},"PeriodicalIF":4.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2162098924000793/pdfft?md5=0595cb12b080eadc9198559173b3fe8d&pid=1-s2.0-S2162098924000793-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141154881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate versus delayed sequential bilateral ICL implantation: A retrospective comparison of vault height and visual outcomes","authors":"Yinjie Jiang ,&nbsp;Xun Chen ,&nbsp;Mingrui Cheng ,&nbsp;Boliang Li ,&nbsp;Yadi Lei ,&nbsp;I-Chun Lin ,&nbsp;Guanghan Xu ,&nbsp;Li Mingwei ,&nbsp;Xingtao Zhou ,&nbsp;Xiaoying Wang","doi":"10.1016/j.apjo.2024.100075","DOIUrl":"10.1016/j.apjo.2024.100075","url":null,"abstract":"<div><h3>Purpose</h3><p>To compare the visual outcomes and risks of suboptimal vault-related complications between immediate sequential bilateral ICL surgery (ISBICLS) and delayed sequential bilateral ICL surgery (DSBICLS).</p></div><div><h3>Design</h3><p>A retrospective cohort study.</p></div><div><h3>Methods</h3><p>Patients who underwent bilateral ICL implantation between November 2014 and December 2021 at the Eye and ENT Hospital of Fudan University (Shanghai, China) were included and divided into two groups: (1) ISBICLS: both eye surgeries performed on the same day, and (2) DSBICLS: second eye surgery performed &lt; 7 days following the first one. Propensity score matching (PSM) was performed to compare the visual outcomes. Multivariable logistic regression models were used to estimate the odds ratios (ORs) of the suboptimal vaults.</p></div><div><h3>Results</h3><p>Finally, 10,985 eyes were included. After PSM, 204 first surgery eyes and 162 s surgery eyes with complete postoperative data were matched. The safety and efficacy indices did not statistically differ between groups (all &gt; 1.00), except that ISBICLS first surgery eyes achieved better efficacy index than DSBICLS group (1.03 ± 0.26 vs. 1.08 ± 0.23, <em>P</em> = 0.034). Excessive vault was observed in eight (4.06 %) ISBICLS first eyes, one (0.50 %) DSBICLS first eye, and none in the second surgery eye in either group. An insufficient vault was observed in one second eye and one DSBICLS second eye. We found no evidence of differences in the rate of excessive vault (OR = 0.831, 95 % CI: 0.426–1.622, <em>P</em> = 0.588) or insufficient vault (OR = 0.609, 95 % CI:0.062–5.850, <em>P</em> = 0.668).</p></div><div><h3>Conclusion</h3><p>ISBICLS provided safety, efficacy, and refraction predictability comparable to DSBICLS without increasing the risk of suboptimal vault-related complications.</p></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"13 3","pages":"Article 100075"},"PeriodicalIF":4.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2162098924000768/pdfft?md5=94e38baf1a68bfcb3c409a84c7684fc4&pid=1-s2.0-S2162098924000768-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141137391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exaggerated immune response to fungal keratitis post-COVID-19 vaccination","authors":"Isana Nakajima,&nbsp;Ken Fukuda,&nbsp;Tamaki Sumi,&nbsp;Kenji Yamashiro","doi":"10.1016/j.apjo.2024.100063","DOIUrl":"10.1016/j.apjo.2024.100063","url":null,"abstract":"","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"13 3","pages":"Article 100063"},"PeriodicalIF":4.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2162098924000586/pdfft?md5=0787111ba15b04d8bde508f7995cc33e&pid=1-s2.0-S2162098924000586-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140852801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concealed retro-iridic multi-cavitary melanoma revealed by ultrasound biomicroscopy","authors":"Miguel E. Hernandez-Emanuelli,&nbsp;Rolika Bansal,&nbsp;Thomas M. Catapano,&nbsp;Carol L. Shields","doi":"10.1016/j.apjo.2024.100049","DOIUrl":"10.1016/j.apjo.2024.100049","url":null,"abstract":"","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"13 3","pages":"Article 100049"},"PeriodicalIF":4.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2162098924000446/pdfft?md5=77e7d2e15a66e9202e418edc3df804fd&pid=1-s2.0-S2162098924000446-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140179283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}