Canadian journal of ophthalmology. Journal canadien d'ophtalmologie最新文献

Objective: Our goal was to evaluate the efficacy of OpenAI's ChatGPT-4.0 large language model (LLM) in translating technical ophthalmology terminology into more comprehensible language for allied health care professionals and compare it with other LLMs.

Design: Observational cross-sectional study.

Participants: Five ophthalmologists each contributed three clinical encounter notes, totaling 15 reports for analysis.

Methods: Notes were translated into more comprehensible language using ChatGPT-4.0, ChatGPT-4o, Claude 3 Sonnet, and Google Gemini. Ten family physicians, masked to whether the note was original or translated by an LLM, independently evaluated both sets using Likert scales to assess comprehension and utility for clinical decision-making. Readability was evaluated using Flesch Reading Ease and Flesch-Kincaid Grade Level scores. Five ophthalmologist raters compared performance between LLMs and identified translation errors.

Results: LLM translations significantly outperformed the original notes in terms of comprehension (mean score of 4.7/5.0 vs 3.7/5.0; p < 0.001) and perceived usefulness (mean score of 4.6/5.0 vs 3.8/5.0; p < 0.005). Readability analysis demonstrated mildly increased linguistic complexity in the translated notes. ChatGPT-4.0 was preferred in 8 of 15 cases, ChatGPT-4o in 4, Gemini in 3, and Claude 3 Sonnet in 0 cases. All models exhibited some translation errors, but ChatGPT-4o and ChatGPT-4.0 had fewer inaccuracies.

Conclusions: ChatGPT-4.0 can significantly enhance the comprehensibility of ophthalmic notes, facilitating better interprofessional communication and suggesting a promising role for LLMs in medical translation. However, the results also underscore the need for ongoing refinement and careful implementation of such technologies. Further research is needed to validate these findings across a broader range of specialties and languages.

Objective: To analyze longitudinal changes of retinal neovessels (NV) in eyes with proliferative diabetic retinopathy (PDR) after 3 monthly intravitreal injections (IVI) of ranibizumab by means of different imaging modalities, particularly focusing on optical coherence tomography (OCT) and OCT-angiography (OCT-A) features.

Methods: Prospective, monocentric study, Luigi Sacco Hospital, Milan. Consecutive patients with PDR were enrolled. All patients underwent color fundus photography (CFP), fluorescein angiography (FA), SD-OCT, and OCT-A at baseline (t0) and after 3 monthly IVI of ranibizumab (t1). Neovessels (NVs) were classified as flat, elevated, flat-elevated, or table-top using OCT scans and further analyzed on FIJI. Qualitative and quantitative NV characteristics were evaluated. Vessel density (VD) was calculated as the mean of all the white pixels of the NV and expressed as a percentage of the area of the NV (VD = NV area × 100).

Results: Thirty-six NVs in 10 patients were studied. The regression of NVs at t1 was partial in 66.7% of cases and complete in 33.3%. Table-top NV demonstrated more frequently a complete regression (P = .03). A significant reduction of the NV area, perimeter, and VD was observed at t1 (P < .001). NVs that showed a complete regression had higher mean VD values at t0 compared with NVs, which showed a partial regression (P = .02). Flat NVs had more frequently a complete vitreous attachment, while table-top showed more often a partial vitreous detachment with focal NV adhesion (P < .05). A complete regression was more often observed for NVs with a partial vitreous detachment and focal NV adhesion at t0 (10/12), while most of the NVs with a complete vitreous attachment showed a partial regression (18/24) (P < .001).

Conclusions: The table-top configuration of the neovessel, higher VD values at baseline, and the presence of a focal adhesion of the vitreous over the NV were factors associated with a higher risk of complete regression of the NV in response to 3 monthly IVI of ranibizumab.

Background: Idiopathic apical orbital inflammation (AOI) is used to describe inflammation involving the posterior third of the orbit where no specific cause can be identified. It is a rare entity in which the presentation can vary widely. We aim to describe a case series of patients with idiopathic AOI and their clinicoradiological features and visual outcomes.

Method: Retrospective multi-centre case series involving patients with idiopathic AOI.

Results: Seven patients were included. The mean age was 50.3 ± 18.4 years (range: 31-84 years). The left eye was involved in the majority of patients (4, 57.1%), with the most common presenting clinical symptoms and signs being limitation of extraocular movements (6, 85.7%), periorbital pain (4, 57.1%), and blurred vision (4, 57.1%). Optic neuropathy was present in 3 (42.9%) patients. Three patients (42.9%) underwent an orbital biopsy, which were all consistent with nonspecific inflammation. Medical treatment was used for all patients in the form of oral steroids (5, 71.4%) or nonsteroidal anti-inflammatories (1, 14.3%). Two (28.6%) patients had additional immunosuppression. At last follow-up, 2 (28.6%) patients had achieved complete resolution of all of their symptoms, 2 (28.6%) patients had significant clinical improvement with mild residual disease, 2 (28.6%) had stable disease, and 1 (28.6%) was lost to follow-up.

Conclusion: Idiopathic AOI is a rare condition that can present with a wide variety of symptoms and be potentially blinding. Patients responded well to oral corticosteroids, but biopsy and additional immunosuppressive agents should be considered in those with recurrent, poorly responsive, or atypical disease.