AJO International最新文献

{"title":"Three-year outcomes of a multidisciplinary ocular genetics clinic: Diagnostic yield and workflow insights from an Australian tertiary center","authors":"Sujan A. Surendran ,&nbsp;Sena A. Gocuk ,&nbsp;Aamira J. Huq ,&nbsp;Alex W. Hewitt ,&nbsp;Thomas G. Campbell ,&nbsp;Doron G. Hickey ,&nbsp;Lisa Kearns ,&nbsp;Joshua Schulz ,&nbsp;Thomas L. Edwards ,&nbsp;Jonathan B. Ruddle ,&nbsp;Lauren N. Ayton","doi":"10.1016/j.ajoint.2025.100163","DOIUrl":"10.1016/j.ajoint.2025.100163","url":null,"abstract":"<div><h3>Background</h3><div>Genetic diagnosis of inherited retinal diseases (IRDs) is challenging due to significant disease heterogeneity and the many potential gene loci. The Royal Victorian Eye and Ear Hospital Ocular Genetics Clinic (OGC) was established in 2018 to streamline IRD diagnosis in Victoria, Australia. This study audited the activities of the OGC during its first three years of operation, focusing on clinical and genetic diagnoses, and identifying areas for improvement in clinic workflow. The aim was to highlight how an integrated multidisciplinary care model – combining ophthalmology, clinical genetics, and genetic counselling – can address gaps in diagnostic access, care coordination and variant interpretation.</div></div><div><h3>Methods</h3><div>Retrospective chart review of suspected or confirmed IRD patients assessed in the OGC between December 2018 to December 2021. Genetic testing approach was determined by the OGC and tailored to each patient’s clinical presentation, in conjunction with sequencing and panel options available through funded laboratories. Demographic data, clinical information and timing between key steps within the clinical workflow were systematically recorded.</div></div><div><h3>Results</h3><div>Five hundred and thirty-nine patients were seen in the first three years of operation. Of the total, 249 patients (46.2 %) underwent diagnostic genetic testing, the mean age of the IRD group being 36.2 years and 51.8 % male, 219 patients (40.6 %) had an IRD phenotype. Panretinal pigmentary retinopathies were the most common phenotype (63.9 %), followed by macular retinopathies (26.9 %), stationary retinopathies (5.5 %), and hereditary vitreoretinopathies (5.5 %). Diagnostic yield of the tested cohort was 71.2 %. Comparison between 2019 and 2020-2021 revealed an overall improvement in mean time from referral to disclosure of results of 647 to 467 days (p=0.001).</div></div><div><h3>Conclusion</h3><div>The OGC provides patients with an accessible, holistic care model for diagnosing inherited retinal diseases. The distribution of phenotypes and diagnostic yield of genetic tests were consistent with published literature. It provides a good framework for global healthcare systems implementing an ocular genomic service, especially where subspeciality ophthalmologists and genetics services are a limited resource. Although in its early stages, there are opportunities to improve clinic workflow, and a compelling case for increased resources to support timely diagnosis, especially as emerging therapies for IRDs become available.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 3","pages":"Article 100163"},"PeriodicalIF":0.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144879107","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":"Gender-based differences in career paths, parenthood and perspectives on professional barriers among Asian ophthalmologists","authors":"Claire L Peterson ,&nbsp;Brian S.Y. Yeo ,&nbsp;Shelley Yin-Hsi Chang ,&nbsp;Rachel S Chong ,&nbsp;Marcus Ang ,&nbsp;Anna CS Tan ,&nbsp;Tina Wong ,&nbsp;Andrew S.H. Tsai","doi":"10.1016/j.ajoint.2025.100161","DOIUrl":"10.1016/j.ajoint.2025.100161","url":null,"abstract":"<div><h3>Background</h3><div>Gender equality in Asia remains under-researched, especially within medical fields. This study explored gender-related differences among ophthalmologists in Asia.</div></div><div><h3>Design</h3><div>Observational, cross-sectional survey study.</div></div><div><h3>Methods</h3><div>An anonymous online survey was distributed across 21 Asian regions via the Young Ophthalmologist network (June–July 2024), examining career paths, leadership, research, parenthood and gender-related workplace experiences.</div></div><div><h3>Results</h3><div>A total of 242 cisgendered ophthalmologists from 20 regions responded; 163(67%) identified as women. Although most institutions had gender-balanced workforces, gender disparities persisted. Men were more likely than women to pursue surgically-oriented subspecialties such as surgical retina and cornea (M83% VS W52%, p=0.02). Women reported a greater impact on parenthood on subspecialty choice (W54% vs M28%, p&lt;0.001) and career progression (W64% vs M39%, p&lt;0.001). Women were also more likely to work part-time due to family commitments.</div><div>While overall leadership, academic positions and research output were similar, head of department roles in particular were predominantly held by men (62%), with women perceiving they had less opportunities in leadership (W61% vs M90%, p&lt;0.001) and research (W80%, M93%, p=0.01) compared to their male counterparts, and reporting a need to champion women in these areas. Women also experienced more gender discrimination and sexual harassment from their patients, colleagues, and bosses of the opposite sex compared to men(p&lt;0.05).</div></div><div><h3>Conclusion</h3><div>Women contribute significantly to ophthalmology in Asia but gender-related disparities remain for subspecialty choice, perceived leadership and research opportunities, parenthood, discrimination and harassment. Addressing these through mentorship, education, flexible career support, advocacy and institutional reform is essential to achieving gender equity in all areas of ophthalmology.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 3","pages":"Article 100161"},"PeriodicalIF":0.0,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144861343","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":"Prevalence, coverage and effective coverage of refractive error in all age groups in Theni District, India","authors":"Ganesh-Babu Balu Subburaman ,&nbsp;Sachin Gupta ,&nbsp;Ashok Vardhan S ,&nbsp;Dipankar Datta ,&nbsp;Balagiri Sundar ,&nbsp;Thulasiraj Ravilla","doi":"10.1016/j.ajoint.2025.100162","DOIUrl":"10.1016/j.ajoint.2025.100162","url":null,"abstract":"<div><h3>Purpose</h3><div>To estimate prevalence of distance and near vision refractive errors (RE) across all age groups in Theni district, Tamil Nadu, India, using the World Health Organization’s (WHO) visual acuity threshold. To report refractive error coverage for distance and near vision (REC_D and REC_N) and effective REC (eREC_D and eREC_N), and to examine association with socio-demographic variables.</div></div><div><h3>Design</h3><div>Population-based cross-sectional study</div></div><div><h3>Methods</h3><div>In 2017–2018 we recruited 24,327 participants through random cluster sampling. Basic eye examinations were performed for those below 40 years, while those ≥40 years, along with referrals from those &lt;40 underwent full eye examinations, resulting in 16,963 participants.</div></div><div><h3>Results</h3><div>The prevalence of distance RE was 12%, increasing with age and tripling among those &gt;60 years. Females had a higher prevalence (<em>p</em> &lt; 0.001). Overall, REC_D was 35.5% but declined with age, dropping to 26% in the 61–70 age group. Coverage was higher among urban populations, better educated individuals, pre-school-age children, and students. eREC_D was 33.4%, with a small relative quality gap of 5.9%.</div><div>The prevalence of near vision RE was 30%, increasing with age but declining beyond 50 years. Females and rural populations had higher prevalence (<em>p</em> &lt; 0.001). Overall, REC_N was alarmingly low at 15.9%, improving to 24% in those &gt;70 years, with higher coverage in males and urban populations (<em>p</em> &lt; 0.001). eREC_N was 9.6%, with a quality gap of 39.8%.</div></div><div><h3>Conclusion</h3><div>Prevalence rates, REC and eREC, can serve as the basis for planning and tracking progress toward WHO’s global target of a 40 percentage-point increase in eREC in Theni District.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 3","pages":"Article 100162"},"PeriodicalIF":0.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144809745","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":"Understanding barriers to spectacle wear compliance among schoolchildren in Calabar Nigeria: A qualitative study","authors":"Anne Effiom Ebri ,&nbsp;Pirindha Govender ,&nbsp;Kovin Naidoo ,&nbsp;Frank Albert ,&nbsp;Kajal Shah ,&nbsp;Ving Fai Chan","doi":"10.1016/j.ajoint.2025.100160","DOIUrl":"10.1016/j.ajoint.2025.100160","url":null,"abstract":"<div><h3>Purpose</h3><div>Despite the availability of free spectacles, many schoolchildren in Africa do not wear them regularly. This study explores the factors affecting compliance with spectacle wear among schoolchildren in Nigeria, aiming to inform targeted eye health education strategies and future interventions.</div></div><div><h3>Design</h3><div>A qualitative study using Focus group discussion with 42 participants including 34 schoolchildren.</div></div><div><h3>Methods</h3><div>Participants for the focus group discussions (FGD) were selected from a cluster-randomized controlled trial that assessed spectacle compliance between September 2017 and June 2018. Out of 4241 schoolchildren aged 10 to 18 recruited for the study, 308 received spectacles. In early February 2018, during the third month of the trial, 40 students were purposively identified and invited to participate in the FGD. A total of 34 students were interviewed in four groups across four schools. Additionally, a fifth group of selected adults was interviewed in a hall. The interviews took place in mid-February 2018 and each session lasted between 45 and 85 min<strong>.</strong></div></div><div><h3>Results</h3><div>The findings reveal a mix of sociocultural misconceptions, stigma, environmental factors and self-perception issues influence children's decision to wear spectacles. According to the Health Belief Model, low perceived risk, high barriers to use, and limited cues to action hinder consistent wear. While improved vision and academic performance motivate some children, these benefits are outweighed by peer pressure and a lack of support.</div></div><div><h3>Conclusion</h3><div>Enhancing self-efficacy through child-centred approaches, such as frame choice and improving frame aesthetics, promoting peer acceptance through targeted. School and community-based eye health initiatives should improve compliance.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 3","pages":"Article 100160"},"PeriodicalIF":0.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144779567","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":"The Brazilian experience on screening, visual assessment, and prescription of glasses in childhood: A perspective of global interest","authors":"ACSB Carneiro ,&nbsp;JM Furtado ,&nbsp;AL Silva ,&nbsp;ALF Darcie ,&nbsp;AC Ribeiro ,&nbsp;LM Hopker ,&nbsp;C Nakanami ,&nbsp;SP Donahue ,&nbsp;JD Rossetto","doi":"10.1016/j.ajoint.2025.100158","DOIUrl":"10.1016/j.ajoint.2025.100158","url":null,"abstract":"<div><h3>Purpose</h3><div>This perspective presents evidence-based guidelines developed by a representative expert group from Brazil. The guidelines aim to enhance pediatric eye care through structured screening protocols, comprehensive eye examinations, and effective eyeglass prescriptions tailored to local contexts.</div></div><div><h3>Methods</h3><div>The guidelines were developed through a narrative literature review and expert consensus among Brazilian Society of Pediatric Ophthalmology members, utilizing a comprehensive search strategy on PubMed from September 2022 to July 2024.</div></div><div><h3>Results</h3><div>Key recommendations include performing the red reflex test (RRT) before neonatal discharge and repeating it at least three times per year during the first three years of life. Additional recommendations include initiating photoscreening at one year of age and conducting visual acuity screening between ages 3 and 5—prioritizing age 5 for amblyopia detection—and again at ages 10–11. Follow-up screenings are advised at critical developmental stages. To expand access, trained non-ophthalmology professionals should participate in screening efforts within existing healthcare frameworks. Scaling secondary and tertiary care and aligning the program with other governmental initiatives are essential for sustainability and impact. Additionally, structuring the health program to align with other government initiatives will help ensure its sustainability and long-term impact.</div></div><div><h3>Conclusion</h3><div>These guidelines provide a solid foundation for effective pediatric eye health programs, contributing to broader public health and sustainable development goals.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 3","pages":"Article 100158"},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757146","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":"Pilot study of ASSORT (AI-based Symptom Stratification in Ophthalmology for Rapid Triage): a triage tool for ophthalmic emergencies","authors":"Claudio Xompero,&nbsp;Lorenzo Rossi,&nbsp;Francesca Amoroso,&nbsp;Antonio Bechara Ghobril,&nbsp;Diana Elena Ionita,&nbsp;Eric H. Souied,&nbsp;Carl-Joe Mehanna","doi":"10.1016/j.ajoint.2025.100159","DOIUrl":"10.1016/j.ajoint.2025.100159","url":null,"abstract":"<div><h3>Introduction</h3><div>ASSORT (AI-based Symptom Stratification in Ophthalmology for Rapid Triage) is a GPT-4-based triage tool designed to assess ophthalmic emergencies using a three-tier color-coded system. This study compares ASSORT to the Rescue triage method, using the ophthalmologist’s final assessment as the reference standard.</div></div><div><h3>Materials and methods</h3><div>A prospective study was conducted at the Créteil University Hospital from April to June 2024. Each patient underwent triage using ASSORT, followed by the Rescue triage method. Both tools used the same color-coding system to stratify severity: yellow for emergency cases, green for urgent cases, and white for non-urgent cases. An examining ophthalmologist in their final year of residency performed the final assessment. Concordance between the ophthalmologist and each of the tools was analyzed using Cohen’s kappa coefficient, alongside precision and recall metrics.</div></div><div><h3>Results</h3><div>Fifty-one patients were included. Case severities were distributed as follows: 22/51 white, 27/51 green, and 2/51 yellow, with conjunctivitis (17.5 %) and corneal abrasions (12.5 %) being the two most common presentations. ASSORT demonstrated moderate agreement with the ophthalmologist (κ = 0.54), whereas Rescue showed stronger concordance (κ = 0.85). ASSORT tended to overestimate urgency, assigning more yellow codes than the ophthalmologist. McNemar’s test confirmed significant misclassification by ASSORT (<em>p</em> = 0.0156), while Rescue showed no significant deviation (<em>p</em> = 0.5).</div></div><div><h3>Conclusion</h3><div>While the small sample size limits generalizability, ASSORT shows potential for AI-driven ophthalmic triage but currently overestimates severity compared to the ophthalmologist. Further refinements such as reinforcement learning and multimodal input, as well as large-scale validation are needed to improve accuracy and reduce unnecessary emergency classifications before clinical implementation.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 3","pages":"Article 100159"},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724726","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":"Barriers to access diabetic retinopathy treatment in Sri Lanka: A qualitative study","authors":"D. M. Mangala Dharmapriya Bandara Dhanapala ,&nbsp;Mapa Prabath Piyasena ,&nbsp;M. G. L. Mahesh Premarathna ,&nbsp;P. F. Supun Chameera Fonseka ,&nbsp;Sairuban K ,&nbsp;Niruththan K ,&nbsp;Jagjit Gilhotra ,&nbsp;Robert Casson ,&nbsp;Upul Senarath","doi":"10.1016/j.ajoint.2025.100157","DOIUrl":"10.1016/j.ajoint.2025.100157","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore patient and service provider perceptions on diabetic retinopathy (DR), its treatment and barriers faced by patients when accessing care, in order to develop strategies to improve uptake and outcomes of DR treatment care pathway.</div></div><div><h3>Study Design</h3><div>A qualitative study based on 12 focus group discussions (FGDs) and 8 semi-structured interviews (SSIs) was conducted.</div></div><div><h3>Methods</h3><div>Patients were selected from three treatment care pathways: intra-vitreal injections, laser photocoagulation and vitrectomy in a tertiary care public eye hospital. Separate FGDs were conducted for males and females, as well as Sinhalese and Tamil patients, within each treatment method to examine how gender and ethnicity influenced treatment experiences and health seeking behavior. FGDs were conducted in the two main native languages separately by two experienced sociologists. The SSIs were conducted with doctors and nurses in a language preferred by each healthcare worker. A pre-defined topic guide was used in the conduction of FGDs and SSIs. The recordings of these FGDs and SSIs were transcribed and subsequently used to conduct a thematic analysis using the Socio-Ecological Model and the health systems approach as a guide. Recurring concepts were identified by review of the transcripts which informed the development of a thematic code book.</div></div><div><h3>Results</h3><div>A total of 73 patients participated in the FGDs with a majority being male (54.7 %, <em>n</em> = 40) while Sinhala was the language spoken by most (60.2 %, <em>n</em> = 44). A total of four doctors and four nurses were interviewed in the SSIs. The lack of knowledge on diabetes, DR and DR treatment modalities was identified as a key barrier to seeking early care and a significant contributor to patient dissatisfaction. In addition, inadequacy of infrastructure, lack of wayfinding signage systems in the hospital, behavior of healthcare assistants, discrimination, long waiting times, postponement of surgeries and inadequacy of information given by doctors were among many other sub-themes that were identified as barriers. Interviews with healthcare workers revealed lack of public awareness, overcrowding, lack of proper referral systems and inadequacy of opportunities for continuous professional development as major barriers.</div></div><div><h3>Conclusion</h3><div>Multi-dimensional factors at all levels of the Socio-Ecological Model were found to act as barriers to patient care, principal among which was the lack of knowledge among patients on the impact of diabetes on the eye. Tailormade strategies to address these barriers should be implemented in order to improve quality of care. Patient education, staff training and infrastructure development should be the cornerstones among such measures.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 3","pages":"Article 100157"},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144702967","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":"Prevalence and phase-related changes in dry eye symptoms among Vietnamese medical students","authors":"Huong T. Vu ,&nbsp;Thanh D.L. Bui ,&nbsp;Hai T. Le","doi":"10.1016/j.ajoint.2025.100156","DOIUrl":"10.1016/j.ajoint.2025.100156","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the prevalence of dry eye (DE) symptoms among Vietnamese medical students, with a focus on differences across academic years and changes associated with an inter-semester break.</div></div><div><h3>Design</h3><div>Cross-sectional, observational study.</div></div><div><h3>Methods</h3><div>A total of 405 medical students (Years 1–6) at Pham Ngoc Thach University of Medicine, Vietnam, completed the Ocular Surface Disease Index (OSDI) questionnaire at two time points: during a four-week inter-semester break (Phase 1) and one week after returning to academic activities (Phase 2). Participants also reported their average daily study duration using digital and printed materials. Dry eye prevalence (OSDI &gt;13) and severity were analysed using multivariable models, including modified Poisson regression and cumulative logit models, adjusting for demographic, clinical, and behavioural covariates.</div></div><div><h3>Results</h3><div>DE symptom prevalence was high at both time points, increasing from 77.8 % in Phase 1 to 88.6 % in Phase 2 (<em>p</em> &lt; 0.001). A significant rise in OSDI scores was observed in Phase 2, particularly among pre-clinical students (Years 1–3), who showed higher odds of more severe symptoms compared to clinical-year students. The most affected symptom domains included visual function and environmental triggers, with “windy conditions” and screen-related tasks frequently reported as aggravating factors. Study duration did not differ significantly between phases.</div></div><div><h3>Conclusion</h3><div>Dry eye symptoms are highly prevalent among medical students and worsen following academic resumption, especially in junior cohorts. Persistent visual strain and environmental exposures may contribute. Interventions targeting modifiable risk factors are warranted to support ocular health and academic performance.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 3","pages":"Article 100156"},"PeriodicalIF":0.0,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144596628","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":"Fundus photograph interpretation of common retinal disorders by artificial intelligence chatbots","authors":"Andrew Mihalache ,&nbsp;Ryan S. Huang ,&nbsp;Marko M. Popovic ,&nbsp;Peng Yan ,&nbsp;Rajeev H. Muni ,&nbsp;Suber S. Huang ,&nbsp;David T. Wong","doi":"10.1016/j.ajoint.2025.100154","DOIUrl":"10.1016/j.ajoint.2025.100154","url":null,"abstract":"<div><h3>Purpose</h3><div>While previous studies have examined the ability of artificial intelligence (AI) chatbots to interpret optical coherence tomography scans, their performance in interpreting fundus photographs of retinal disorders without text-based context remains unexplored. This study aims to evaluate the ability of three widely used AI chatbots to accurately diagnose common retinal disorders from fundus photographs in the absence of text-based context.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Methods</h3><div>We prompted ChatGPT-4, Gemini, and Copilot, with a set of 50 fundus photographs from the American Society of Retina Specialists Retina Image Bank® in March 2024, comprising age-related macular degeneration, diabetic retinopathy, epiretinal membrane, retinal vein occlusion, and retinal detachment. Chatbots were re-prompted four times using the same images throughout June 2024. The primary endpoint was the proportion of each chatbot’s correct diagnoses. No text-based guidance was provided.</div></div><div><h3>Results</h3><div>In March 2024, Gemini provided a correct diagnosis for 17 (34 %, 95 % CI: 21–49 %) fundus images, ChatGPT-4 for 16 (32 %, 95 % CI: 20–47 %), and Copilot for 9 (18 %, 95 % CI: 9–31 %) (<em>p</em> &gt; 0.05). In June 2024, Gemini provided a correct diagnosis for 122 (61 %, 95 % CI: 53–67 %) images, ChatGPT-4 for 101 (51 %, 95 % CI: 43–58 %), and Copilot for 57 (29 %, 95 % CI: 22–35 %).</div></div><div><h3>Conclusion</h3><div>No AI chatbot use in this study was sufficiently accurate for the diagnosis of common retinal disorders from fundus photographs. AI chatbots should not currently be utilized in any clinical setting involving fundus images, given concerns for accuracy and bioethical considerations.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 3","pages":"Article 100154"},"PeriodicalIF":0.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604650","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":"Association of neutrophil-to-lymphocyte ratio and neutrophil activation with treatment response in neovascular AMD","authors":"Alexander Kai Thomsen ,&nbsp;Maria Abildgaard Steffensen ,&nbsp;Kathrine Gotfredsen ,&nbsp;Henrik Vorum ,&nbsp;Bent Honoré ,&nbsp;Mogens Holst Nissen ,&nbsp;Torben Lykke Sørensen","doi":"10.1016/j.ajoint.2025.100155","DOIUrl":"10.1016/j.ajoint.2025.100155","url":null,"abstract":"<div><h3>Purpose</h3><div>The neutrophil-to-lymphocyte ratio (NLR) and alterations of activation surface markers on circulating neutrophils have been suggested to be involved in the pathogenesis of age-related macular degeneration (AMD). The aim of this study was to investigate the relationship between NLR, activation surface markers on neutrophils, AMD stage, and treatment response in neovascular AMD (nAMD).</div></div><div><h3>Design</h3><div>Prospective cohort study.</div></div><div><h3>Methods</h3><div>Treatment-naïve nAMD patients, intermediate AMD (iAMD) patients, and healthy controls were consecutively enrolled. Treatment response in nAMD patients was categorized as good, partial and poor based on change of retinal fluid and central retinal thickness. Treatment response was evaluated after the loading phase and after one year of treatment with aflibercept 2 mg. NLR and activation surface markers on circulating neutrophils (CD11a, CD11b, CD31, CD66b, CD162, and CD182) were examined with flow cytometry. NLR and activation surface markers were compared between healthy controls, iAMD, and nAMD patients, as well as between nAMD treatment response groups. Polymorphisms in the CFH and ARMS2 genes were compared to NLR and the surface markers in nAMD patients.</div></div><div><h3>Results</h3><div>NLR was significantly elevated in nAMD patients compared to healthy controls (<em>P</em> &lt; 0.001). nAMD patients with poor 1-year treatment response had a significantly higher NLR compared to good 1-year treatment responders. Expression levels of CD11a, CD11b, CD31, CD66b, CD162, and CD182 on circulating neutrophils were elevated in nAMD patients compared to healthy controls (all <em>P</em> &lt; 0.05), however no significant differences were found between nAMD treatment response groups. No significant associations were found between CFH or ARMS2 genotypes with NLR or neutrophil surface markers in nAMD patients.</div></div><div><h3>Conclusion</h3><div>Elevated NLR was associated with a poor 1-year treatment response. The NLR and expression levels of activation surface markers on circulating neutrophils were significantly elevated in treatment-naïve nAMD patients compared to healthy controls.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"2 3","pages":"Article 100155"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144596627","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}