Die Ophthalmologie最新文献

Retinal optical coherence tomography (OCT) biomarkers have the potential to serve as early, noninvasive, and cost-effective markers for identifying individuals at risk for cognitive impairments and neurodegenerative diseases. They may also aid in monitoring disease progression and evaluating the effectiveness of interventions targeting cognitive decline. The association between retinal OCT biomarkers and cognitive performance has been demonstrated in several studies, and their importance in cognitive assessment is increasingly being recognized. Machine learning (ML) is a branch of artificial intelligence (AI) with an exponential number of applications in the medical field, particularly its deep learning (DL) subset, which is widely used for the analysis of medical images. These techniques efficiently deal with novel biomarkers when their outcome for the applications of interest is unclear, e.g., for diagnosis, prognosis prediction, disease staging, or any other relevance to clinical practice. However, using AI-based tools for medical purposes must be approached with caution, despite the many efforts to address the black-box nature of such approaches, especially due to the general underperformance in datasets other than those used for their development. Retinal OCT biomarkers are promising as potential indicators for decline in cognitive function. The underlying mechanisms are currently being explored to gain deeper insights into this relationship linking retinal health and cognitive function. Insights from neurovascular coupling and retinal microvascular changes play an important role. Further research is needed to establish the validity and utility of retinal OCT biomarkers as early indicators of cognitive decline and neurodegenerative diseases in routine clinical practice. Retinal OCT biomarkers could then provide a new avenue for early detection, monitoring and intervention in cognitive impairment with the potential to improve patient care and outcomes.

Background: The new patient cataract and lens ophthalmic questionnaire (CLOQ) determines subjective patient satisfaction before and after cataract surgery according to item response theory (IRT).

Methods: A total of 317 patients with bilateral cataract surgery and implantation of different intraocular lens (IOL) types were included. The questionnaire (37 questions) is divided into questions on visual acuity-relevant quality of life (VRQoL), quality of vision (QoV), spectacle dependence, and general satisfaction. For all questions, five response categories are available. Analysis is performed by determining the model parameters/item characteristic curves. Testing of the model is performed by expected score curves, infit/outfit statistics, and determination of reliability and Cronbach's α.

Results: The IRT analyses for the QoL and QoV questions showed 1. a clear order of threshold parameters in the multilevel response scale; 2. a good fit of the response model of the empirical and the expected score curves; 3. unidimensionality, with values of < 1 for the mean square in- and outfit statistics; and 4. reliability of F_WLE = 0.87 and 0.71, respectively. The post-surgical improvement is clearly evident in the higher person parameters, spectacle dependency, and better visual acuity.

Conclusion: Standard calculations were performed for model parameters, model tests, and reliability based on a partial credit model. The results confirm the suitability for evaluation of subjective patient satisfaction.

Background: The proportion of female ophthalmologists in Germany has risen to approximately 50% in recent years, and approximately 66% of medical students are women. This represents a reversal of the past situation with a male predominance. Despite this change, many international studies show that women are still underrepresented at scientific conferences, particularly among invited speakers, chairpersons, and program committees. This study aims to investigate whether these differences in gender representation are also reflected at German ophthalmological congresses and whether the situation has changed in recent years.

Methods: Data collection covered the years 2013, 2022, and 2023 and included the congresses of the five large German ophthalmological associations: the German Ophthalmological Society (DOG), German Ophthalmic Surgical Society (DOC), German Ophthalmological Academy (AAD), German Society of Cataract and Refractive Surgery (DGII) and the German Retinological Society (RG). Data were collected based on online programs and information provided by the offices and the managing committees. The numbers of female and male speakers and chairpersons were identified, as were the gender distributions of the specific program committees.

Results: Overall, the percentage of female speakers across all years and conferences surveyed averaged 25%, while female chairs averaged 17%. The percentage of females in the program committees ranged from 0% to 17%. There was an increase in the percentage of female speakers over 10 years (2013-2023). For the DOG (p_trend < 0.01) and the DOC (p_trend = 0.01) there was a significant rise, while it was highest at the DOG (37%) and lowest at the DGII (11%). The percentage of female chairs was in general lower than the percentage of female speakers for all conferences (between 11% and 26% in 2023). Only for the DOG was there a statistically significant increase over the 10 years (p_trend < 0.01).

Conclusion: The representation of women as speakers and chairpersons at German ophthalmology conferences is low; these continue to be predominantly male dominated. Although there has been an increase in female representation over time, it remains lower than the overall proportion of women in the profession in 2023. Significant differences are observed between the various ophthalmological conferences. Further investigation into the underrepresentation of women at these conferences is necessary, and measures to encourage greater female participation at congresses should be implemented.

Background: The number of female ophthalmologists has risen steadily in recent years. The aim of this study is to investigate the gender ratios, subspecialties, and academic degrees of ophthalmologists at German university hospitals. Additionally, the study analyzes the proportion of women in science programs such as the Clinician Scientist Program.

Methods: Data collection was performed in August 2023 based on the official websites of university eye clinics and the German Ophthalmological Society (DOG). The numbers of male and female residents, specialists, senior physicians, and chief physicians as well as subspecialties and academic degrees were determined. Information on the Clinician Scientist Program was collected in a 2022 survey by the Medical Faculty Council.

Results: In August 2023 there were two female chief physicians at the university eye clinics (5%), both specialized in retinal surgery. There were more male senior physicians than female senior physicians (59.9% vs. 40.1%). There was no significant difference between the genders in terms of the number of habilitations (p = 0.554). There were more female specialists than male specialists at the university clinics (58.6% vs. 41.4%) as well as more female residents (56.9% vs. 43.1%). Female specialists were significantly more likely to hold a doctorate than their male colleagues (p = 0.037). The percentage of female applicants for the Clinician Scientist Program nationwide in 2022 was 46.6%, with 41.8% female program starters in 2021 and 39.7% female program graduates in 2021.

Conclusion: Senior and chief physician roles at university eye clinics remain predominantly occupied by men. Additionally, support programs for young researchers are still predominantly awarded to men.

Background: Evidence-based treatment recommendations are helpful in the corresponding discipline-specific treatment but can hardly take data from real-world care into account. In order to make better use of this in everyday clinical practice, including with respect to predictive statements about disease development or treatment success, models with data from treatment must be developed in order to use them for the development of assistive artificial intelligence.

Goal: The aim of the Use Case 1 of the medical informatics hub in Saxony (MiHUBx) is the development of a model based on treatment and research data for a treatment algorithm supported by biomarkers and also the development of the necessary digital infrastructure.

Material and methods: Step by step, the necessary partners in hospitals and practices will be brought together technically or through research questions within Use Case 1 "Ophthalmology meets Diabetology", a regional digital progress hub in health, the medical informatics hub in Saxony (MiHUBx ) of the nationwide medical informatics initiative (MII).

Results: Based on joint studies with diabetologists, robust serological and imaging biomarkers were selected that provide evidence of the development of diabetic macular edema (DME). In the future, these and other scientifically proven prognostic markers will be incorporated into a treatment algorithm that is supported by artificial intelligence (AI). For this purpose, model procedures are being developed together with medical informatics specialists. At the same time, a data integration center (DIZ) was established.

Conclusion: In addition to the structured and technical combination of the previously disseminated and partially heterogeneous treatment data, the Use Case 1 defines the chances and hurdles for using such real-world data to develop artificial intelligence.