AIM:To investigate the capabilities of large language models(LLM)for providing information and diagnoses in the field of neuro-ophthalmology by comparing the performances of ChatGPT-3.5 and-4.0,Bard,and Bing.METHODS:E...AIM:To investigate the capabilities of large language models(LLM)for providing information and diagnoses in the field of neuro-ophthalmology by comparing the performances of ChatGPT-3.5 and-4.0,Bard,and Bing.METHODS:Each chatbot was evaluated for four criteria,namely diagnostic success rate for the described case,answer quality,response speed,and critical keywords for diagnosis.The selected topics included optic neuritis,nonarteritic anterior ischemic optic neuropathy,and Leber hereditary optic neuropathy.RESULTS:In terms of diagnostic success rate for the described cases,Bard was unable to provide a diagnosis.The success rates for the described cases increased in the order of Bing,ChatGPT-3.5,and ChatGPT-4.0.Further,ChatGPT-4.0 and-3.5 provided the most satisfactory answer quality for judgment by neuro-ophthalmologists,with their sets of answers resembling the sample set most.Bard was only able to provide ten differential diagnoses in three trials.Bing scored the lowest for the satisfactory standard.A Mann-Whitney test indicated that Bard was significantly faster than ChatGPT-4.0(Z=-3.576,P=0.000),ChatGPT-3.5(Z=-3.576,P=0.000)and Bing(Z=-2.517,P=0.011).ChatGPT-3.5 and-4.0 far exceeded the other two interfaces at providing diagnoses and were thus used to find the critical keywords for diagnosis.CONCLUSION:ChatGPT-3.5 and-4.0 are better than Bard and Bing in terms of answer success rate,answer quality,and critical keywords for diagnosis in ophthalmology.This study has broad implications for the field of ophthalmology,providing further evidence that artificial intelligence LLM can aid clinical decision-making through free-text explanations.展开更多
Background:With the rapid development of artificial intelligence(AI),large language models(LLMs)have emerged as a potent tool for invigorating ophthalmology across clinical,educational,and research fields.Their accura...Background:With the rapid development of artificial intelligence(AI),large language models(LLMs)have emerged as a potent tool for invigorating ophthalmology across clinical,educational,and research fields.Their accuracy and reliability have undergone tested.This bibliometric analysis aims to provide an overview of research on LLMs in ophthalmology from both thematic and geographical perspectives.Methods:All existing and highly cited LLM-related ophthalmology research papers published in English up to 24th April 2025 were sourced from Scopus,PubMed,and Web of Science.The characteristics of these publications,including publication output,authors,journals,countries,institutions,citations,and research domains,were analyzed using Biblioshiny and VOSviewer software.Results:A total of 277 articles from 1,459 authors and 89 journals were included in this study.Although relevant publications began to appear in 2019,there was a significant increase starting from 2023.He M and Shi D are the most prolific authors,while Investigative Ophthalmology&Visual Science stands out as the most prominent journal.Most of the top-publishing countries are high-income economies,with the USA taking the lead,and the University of California is the leading institution.VOSviewer identified 5 clusters in the keyword co-occurrence analysis,indicating that current research focuses on the clinical applications of LLMs,particularly in diagnosis and patient education.Conclusions:While LLMs have demonstrated effectiveness in retaining knowledge,their accuracy in image-based diagnosis remains limited.Therefore,future research should investigate fine-tuning strategies and domain-specific adaptations to close this gap.Although research on the applications of LLMs in ophthalmology is still in its early stages,it holds significant potential for advancing the field.展开更多
ChatGPT technology based on large language models(LLM)shows great potential in improving the quality of medical care,assisting clinical decision making and optimizing patient communication.The role of ChatGPT in ophth...ChatGPT technology based on large language models(LLM)shows great potential in improving the quality of medical care,assisting clinical decision making and optimizing patient communication.The role of ChatGPT in ophthalmology is still in its infancy.This review aims to explore the application prospect of ChatGPT in ophthalmology.Relevant literature was reviewed and analyzed,and the application prospects of LLM represented by ChatGPT in ophthalmology were summarized,including clinical assisted diagnosis,patient education and communication,history collection and text writing,clinical research,and medical education,etc.At the same time,the challenges and solutions faced by ChatGPT in ophthalmology were pointed out.Its safety,efficacy and ethics remain controversial in practical applications.Therefore,it is necessary to strengthen the supervision and research on its application to ensure safety and effectiveness.In the future,with the development of technology,ChatGPT is expected to play a greater role in ophthalmology and enhance the medical experience.展开更多
Cytomegalovirus (CMV) retinitis is a significant yet infrequent complication inpediatric hematopoietic stem cell transplant recipients, occurring in approximately4% of cases. Its presentation typically coincides with ...Cytomegalovirus (CMV) retinitis is a significant yet infrequent complication inpediatric hematopoietic stem cell transplant recipients, occurring in approximately4% of cases. Its presentation typically coincides with immune reconstitution,between 6 weeks to 6 months post-transplant, emphasizing the need fortimely detection. Symptoms often develop insidiously, underscoring the role offundus examinations during episodes of CMV viremia. However, the low incidencechallenges the necessity of routine screenings, as they may strain clinicalresources without clear benefits to patient outcomes. Management includes systemicand intravitreal antivirals, such as ganciclovir and foscarnet, and adoptiveT-cell therapy for refractory cases. Tailored follow-up strategies are crucial, withconsiderations for lesion activity and CMV viremia status to determine theduration of therapy. Baseline and post-transplant screenings remain a topic ofdebate, with evolving guidelines needed to balance patient safety and clinicalfeasibility. Future research is needed to address optimal screening intervals andinvestigate the role of pre-existing CMV serostatus in transplant eligibility andoutcomes.展开更多
Virtual Reality(VR)technology is widely recognized as a prominent technological paradigm.Its potential and promise in the domain of ophthalmology are substantial,and the evolution of VR technology has significantly in...Virtual Reality(VR)technology is widely recognized as a prominent technological paradigm.Its potential and promise in the domain of ophthalmology are substantial,and the evolution of VR technology has significantly influenced the contemporary landscape of ophthalmology.Numerous empirical studies have validated the practical utility of VR technology in domains such as ophthalmic disease treatment and surgery training.This paper offers a comprehensive overview of VR technology's utilization in ophthalmic disease treatment,student education,and surgery training,expands the application of VR technology in ophthalmic evaluation and disease diagnosis,discusses the challenges and limitations of VR technology in ophthalmology,and expounds on emerging trends and future developments of VR technology in ophthalmology.This endeavor aims to provide readers with an in-depth comprehension of the current status and future prospects of VR technology application in ophthalmology,with the ultimate objective of fostering more effective advancements and applications of VR technology in the realm of ophthalmology.展开更多
AIM:To evaluate the flipped classroom model for teaching horizontal strabismus didactics in an ophthalmology residency program in China as part of a visiting professorship from the United States.METHODS:Residents from...AIM:To evaluate the flipped classroom model for teaching horizontal strabismus didactics in an ophthalmology residency program in China as part of a visiting professorship from the United States.METHODS:Residents from an ophthalmology residency program in China were invited to participate in flipped classroom sessions taught by an experienced American ophthalmology faculty in 2018.Residents were instructed to watch a pre-class video lecture prior to the in-class-casebased activity.Content tests(5 Ophthalmic Knowledge Assessment Program style questions)and surveys were administered before and after the classroom sessions(100%response rate).These results were compared to that of an American cohort who were taught the same content.RESULTS:The Chinese cohort of 12 residents preferred the flipped classroom to the traditional classroom at higher rates than the American cohort of 40 residents(92%vs 55%,P=0.04)and felt that all ophthalmology topics would be appropriate for the flipped classroom teaching style(P-values between 0.008 and<0.001).In both Chinese and American cohorts,we found that the exotropia curriculum saw a small but significant improvement in performance following the flipped classroom session(P=0.025 for Chinese residents;P=0.001 for US residents),whereas scores in both groups for the esotropia course did not significantly improve.CONCLUSION:This is the first study to evaluate the flipped classroom model implemented by a visiting ophthalmology professor in a global outreach setting.The flipped classroom sessions are viewed favorably by the Chinese residents relative to the US cohort with a modest impact on knowledge.Decreased in-person interpreter requirement and increased student engagement make this model valuable in cross-cultural visiting professorship settings.Finally,the flipped classroom may lend itself well to a virtual format to prevent the transmission of COVID-19,although such a format requires further study.展开更多
Telemedicine is an emerging field in recent medical achievements with rapid development. The ＂smartphone＂ availability has increased in both developed and developing counffies even among people in rural and remotes ...Telemedicine is an emerging field in recent medical achievements with rapid development. The ＂smartphone＂ availability has increased in both developed and developing counffies even among people in rural and remotes areas. Telebased services can be used for screening ophthalmic diseases and also monitoring patients with known diseases. Electronic ophthalmologic records of the patients including captured images by smartphones from anterior and posterior segments of the eye will be evaluated by ophthalmologists, and if patients require further evaluations, they will be referred to experts in the relevant field. Eye diseases such as cataract, glaucoma, age-related macular degeneration, diabetic retinopathy, and retinopathy of prematurity are the most common causes of blindness in many countries and beneficial use of teleophthalmology with smartphones will be a good way to achieve the aim of VISION 2020 all over the world. Numerous studies have shown that teleophthalmology is similar to the conventional eye care system in clinical outcomes and even provides more patient satisfaction as it saves time and cost, This review explains how teleophthalmology helps to improve patient outcomes through smartphones.展开更多
Some recent advances in neuro-ophthalmology including clinical trials,diagnostic testing and newly elucidated disease entitites were summarized in present paper,such as neuromyelitis optica spectrum disorder.The revie...Some recent advances in neuro-ophthalmology including clinical trials,diagnostic testing and newly elucidated disease entitites were summarized in present paper,such as neuromyelitis optica spectrum disorder.The review goes into great detail regarding recent clinical trials in neuro-ophthalmology.These trials have investigated the management of idiopathic intracranial hypertension as well as treatment of Leber hereditary optic neuropathy and optic nerve glioma.The potential gene therapy for Leber hereditary optic neuropathy seems very promising and may have a significant clinical impact within the next few years.This review also includes an extensive discussion about the application of optical coherence tomography(OCT)and OCT-angiography(OCTA)in neuro-ophthalmology.OCT has important clinical relevance not only for the diagnosis and management of optic neuropathies,such as optic neuritis,ischemic optic neuropathy and chiasmal compression,but also for retro-chiasmal injury.In terms of OCTA,recent studies have demonstrated increased vessel density in acute stage of ischemic optic neuropathy(NAION)and optic neuritis,but decreased vessel density in severe papilloedema and late stage of optic atrophy of any cause.These serve as the potential foundation for future clinical applications.Ophthalmologists should pay more attentions to these recent progress in neuro-ophthalmology.展开更多
Background: Ophthalmology is an important medical science subject, but it is given with insufficient attention in undergraduate medical education. Flipped classroom(FC) and problem-based learning(PBL) are well-known e...Background: Ophthalmology is an important medical science subject, but it is given with insufficient attention in undergraduate medical education. Flipped classroom(FC) and problem-based learning(PBL) are well-known education methods that can be integrated into ophthalmology education to improve students' competence level and promote active learning. Methods: We used a mixed teaching methodology that integrated a FC and PBL into a 1-week ophthalmology clerkship for 72 fourth-year medical students. The course includes two major sessions: FC session and PBL session, relying on clinical and real-patient cases. Written examinations were set up to assess students' academic performance and questionnaires were designed to evaluate their perceptions. Results: The post-course examination results were higher than the pre-course results, and many students gained ophthalmic knowledge and learning skills to varying levels. Comparison of pre-and post-course questionnaires indicated that interests in ophthalmology increased and more students expressed desires to be eye doctors. Most students were satisfied with the new method, while some suggested the process should be slower and the communication with their teacher needed to strengthen.Conclusions: FC and PBL are complementary methodologies. Utilizing the mixed teaching meth of FC and PBL was successful in enhancing academic performance, student satisfactions and promoting active learning.展开更多
AIM： To explore the trends in the ophthalmic literature over a 5-year period in relation to country, research expenditure and demographics. METHODS： Articles published between 2009 and 2013 by the 20 highest-con...AIM： To explore the trends in the ophthalmic literature over a 5-year period in relation to country, research expenditure and demographics. METHODS： Articles published between 2009 and 2013 by the 20 highest-contributing countries in the 20 top- ranked ophthalmology journals were identified by their country of affiliation. The number of articles published and mean impact factor were measured per country for each year and trends explored using regression analysis with 5-year and 10-year forecasts calculated. Data on research expenditure was collected and tested for correlation with the number of articles and mean impact factor. RESULTS： The analysis included 19 338 articles. The USA, UK and Europe accounted for 60.2% of articles published, with the USA contributing 7388 articles （34.0%）. The USA also demonstrated the highest mean impact factor （3.5）. Research expenditure was significantly correlated with both research output （r=0,86, P〈0.001） and scholarly impact （r=0.42, P〈0.001）. China （P〈0.01）, Korea （P〈0.01） and India （P〈0.02） demonstrated a significant growth in research output over the study period. The research contribution of these three countries combined is forecasted to overtake that of Europe within ten years, with China expected to be the second-largest contributor within five years. These countries were also among those demonstrating the greatest growth in research expenditure. CONCLUSION： While the USA and European countries are major contributors of ophthalmic research, the productivity of some Asian countries is growing impressively. The contribution of China, Korea and Indiais forecasted to outweigh that of Europe by 2023. Research expenditure is highly correlated with research productivity and these trends reflect the differing economic priorities across the world.展开更多
Background:The“flipped classroom”is a learner-centered approach that centers on delivering videos,podcasts or slide-based material to learners prior to a lecture or class session.The class session is then dedicated ...Background:The“flipped classroom”is a learner-centered approach that centers on delivering videos,podcasts or slide-based material to learners prior to a lecture or class session.The class session is then dedicated to discussion,analysis,and problem-solving activities.The aim of this study was to investigate whether the flipped classroom could be adapted to medical(ophthalmology)students learning about ocular trauma and to assess the impact of the flipped classroom on those students’performance and attitudes.Methods:Questionnaires(using a 4-point scale)were distributed to 93 fifth-year medical students at Sun Yat-sen University,and the data showed that the majority of students preferred the flipped classroom approach to the traditional lecture method.Results:The results of pre-and post-test scores were 14.35±3.404 and 20.37±4.356,which showed a significant improvement in students’performance after the flipped classroom was introduced(P<0.05).Conclusions:Student response to the flipped classroom strategy was largely positive,indicating that the strategy received a high level of approval in an ophthalmology clerkship course taken by medical students in China.展开更多
This paper analyzes the current status,technological developments,academic exchange platforms,and future challenges and solutions in the field of intelligent ophthalmology(IO)in China.In terms of technology,significan...This paper analyzes the current status,technological developments,academic exchange platforms,and future challenges and solutions in the field of intelligent ophthalmology(IO)in China.In terms of technology,significant progress has been made in various areas,including diabetic retinopathy,fundus image analysis,quality assessment of medical artificial intelligence products,clinical research methods,technical evaluation,and industry standards.Researchers continually enhance the safety and standardization of IO technology by formulating a series of clinical application guidelines and standards.The establishment of domestic and international academic exchange platforms provides extensive collaboration opportunities for professionals in various fields,and various academic journals serve as publication platforms for IO research.However,challenges such as technological innovation,data privacy and security,lagging regulations,and talent shortages still pose obstacles to future development.To address these issues,future efforts should focus on strengthening technological research and development,regulatory framework construction,talent cultivation,and increasing patient awareness and acceptance of new technologies.By comprehensively addressing these challenges,IO in China is poised to further lead the industry’s development on a global scale,bringing more innovation and convenience to the field of ophthalmic healthcare.展开更多
Objective:To explore the application effect of the Eyesi surgical simulator in the teaching of cataract surgery for professional ophthalmology postgraduate students.Methods:The professional postgraduate students who w...Objective:To explore the application effect of the Eyesi surgical simulator in the teaching of cataract surgery for professional ophthalmology postgraduate students.Methods:The professional postgraduate students who were trained in the third year of ophthalmology at the First Affiliated Hospital of Xi’an Medical University were selected as the research objects.After passing the theoretical examination,they were randomly divided into the pig eyeball group,Eyesi group,and pig eye+Eyesi group,with 5 students in each group.The pig eyeball,Eyesi surgery simulator,and pig eye+Eyesi surgery simulator were used for microscopic technique operation and cataract surgery steps training,respectively.After the training,the overall training effects of the three groups of postgraduates were scored,and questionnaires were used to objectively evaluate the three training methods.Results:The scores of the students in the pig eye+Eyesi group were better than those in the Eyesi group,and the students in the Eyesi group were better than those in the pig eyeball group.Conclusion:The Eyesi surgical simulation training system can evaluate the microsurgical skills of professional masters and improve their surgical skills.This system is of great significance for the training of the cataract surgery skills of professional masters.展开更多
AIM: To examine the publication trend of oculoplastic articles throughout the last decade in general ophthalmology journals.METHODS: A review of all abstracts published between Januar y 2010 to December 2019 in genera...AIM: To examine the publication trend of oculoplastic articles throughout the last decade in general ophthalmology journals.METHODS: A review of all abstracts published between Januar y 2010 to December 2019 in general, clinical ophthalmic journals was conducted. Articles that were categorized as original articles in general and clinical journals were included in the study.RESULTS: Totally 10 281 abstracts were included. Of them 465(4.5%) were oculoplastic publications. The mean number of annual-publications was 46.5 and the mean annual-rate of oculoplastic publications was 4.51%. A significant decreasing trend in the number of oculoplastic publication in the last decade was found(P<0.01, R^(2)=0.770). However, there was no significant change in the annual-rate of oculoplastic publications during the last decade(P=0.191, R2=0.203). From the 465 oculoplastic articles: 179(38.5%) were articles about eyelid diseases, 160(34.40%) were about orbit diseases, 92(19.80%) were about lacrimal diseases and 34(7.30%) were about thyroid eye disease(TED). A significant decreasing trends in the number of orbital and eyelids publications were found(P<0.01, P<0.01). However, there were no significant changes in the annual-rate of orbital, eyelids, TED and lacrimal-diseases publications throughout the last decade.CONCLUSION: Oculoplastic subspecialty deals with a wide range of pathologies in different ages. However, less than 5% of the articles in general, clinical, high impact factor ophthalmology journals are about oculoplastic diseases. One of the best way for ophthalmologists from different subspecilties, nowadays, to be updated, is to read highimpact-factor, general ophthalmology journals. Therefore, it is important that those journals will include articles about breakthroughs in oculoplastic.展开更多
AIM:To review international guidelines and to share our infection control experience during the coronavirus disease 2019(COVID-19)pandemic at a tertiary eye centre in Hong Kong.METHODS:Infection control guidelines and...AIM:To review international guidelines and to share our infection control experience during the coronavirus disease 2019(COVID-19)pandemic at a tertiary eye centre in Hong Kong.METHODS:Infection control guidelines and recommendations from international ophthalmological bodies are reviewed and discussed.The measures at our hospital were drawn up as per international and local health authorities’guidelines and implemented with the collaboration of doctors,nurses and administrative staff.RESULTS:The aims of our infection control measures are to 1)minimize cross-infection within the hospital;2)protect and support hospital staff;3)ensure environmental control.To minimize the risk of cross-infection,outpatient attendance and elective surgery have been reduced by 40%,and general anesthesia procedures were reduced by 90%.Patients entering the hospital are screened for fever,travel history,contact and cluster history,and COVID-19 related symptoms.To protect and support hospital staff,we ensure provision of adequate personal protective equipment(PPE)and provide clear guidelines on the level of PPE needed,depending on the clinical situation.Other protective measures include provision of work uniforms,easy access to alcohol-based hand rub,opening new lunch areas,implementation of self-monitoring and self-reporting systems,and communication via online education and updates.Finally,environmental control is achieved by ensuring regular disinfection of the hospital premise,enhancing ventilation,and usage of disposable ophthalmic instruments.CONCLUSION:Our multi-pronged approach to infection control is,so far,successful in minimizing infection risks,while allowing the maintenance of essential ophthalmic services.展开更多
AIM：To investigate the published papers of ophthalmology in past ten years and explore the development of ophthalmology.METHORDS：The data of this study retrieved from Science Citation Index Expanded and downloaded o...AIM：To investigate the published papers of ophthalmology in past ten years and explore the development of ophthalmology.METHORDS：The data of this study retrieved from Science Citation Index Expanded and downloaded online in November 2017,including all the papers with publication year from 2007-2016 were analyzed.The papers were based on the Web of Science category and the journals were based on the Journal Citation Report category.RESULTS：The number of ophthalmology papers increased from 7450 to 9089 during 2007 to 2017.The average rate increased 2.2% annually.USA accounts for one thirds of the total and two thirds of the highly cited papers.In Asia,China,Japan and South Korea were in Top 10 by the number of ophthalmology papers.UK,Germany,Japan and Australia also had great impact in global ophthalmology.The hot spots included endothelial growth factor,optical coherence tomography and open-angle glaucoma.CONCLUSION：USA is in the leading position in global ophthalmology.Part of Asian countries play an important role in the development of ophthalmology,but the impact needs to be improved.展开更多
AIM:To evaluate residents’perceptions and attitudes toward the various aspects of a comprehensive ophthalmic examination,and to determine if these factors correlate with their choices for fellowship and future career...AIM:To evaluate residents’perceptions and attitudes toward the various aspects of a comprehensive ophthalmic examination,and to determine if these factors correlate with their choices for fellowship and future career plans.METHODS:This is a cross-sectional study.A questionnaire on the perception of the ophthalmic exam was sent via SurveyMonkey to ophthalmology residents throughout Israel.Eighty of them(one-half of all ophthalmology residents in 2019)completed it.The first part related to how they perceived each component of the ophthalmic evaluation.The second part related to their future fellowship plans.The Chi-squared test was used to compare categorical variables and Student’s t-test and One-way ANOVA were used to compare continuous variables.Multivariate logistic regression analysis was applied as needed to detect interactions between variables and to exclude confounder effects.RESULTS:Slit-lamp examination of the anterior and posterior segments ranked as the most likeable aspects,whereas gonioscopy,ocular motility examination and visual acuity assessment were least likeable.Anterior segment and retina subspecialties were the ones most sought after.Forty-nine respondents(61.3%)noted a direct correlation between their preferred parts of comprehensive ophthalmic evaluations and their choice of subspecialty.Perceptions of selected components of those evaluations were significantly associated with responders’intentions to pursue anterior segment,retina,or oculoplastic fellowships(P<0.05).CONCLUSION:Perspectives of residents toward the ophthalmic examination,and most specifically its individual components,play an important role in their choice of subspecialty training.展开更多
Optical coherence tomography(OCT)is a widely used non-invasive medical imaging technology that has revolutionized clinical care in ophthalmology.New developments,such as OCT angiography(OCTA)are expected to contribute...Optical coherence tomography(OCT)is a widely used non-invasive medical imaging technology that has revolutionized clinical care in ophthalmology.New developments,such as OCT angiography(OCTA)are expected to contribute even further to the widespread use of OCT-based imaging devices in the diagnosis and monitoring of patients with ophthalmic diseases.In recent years,many of the disadvantages such as limited field of view and imaging artefacts have been substantially reduced.Similar to the progress achieved in the assessment of retinal disorders,OCT is expected to change the approach to patients seen in the neuro-ophthalmology clinic.In this article,we review the technical features of OCT and OCT-based imaging techniques,highlighting the specific factors that should be taken into account when interpreting OCT in the field of neuro-ophthalmology.展开更多
Welcome to the World Journal of Ophthalmology （WJO）, a new general ophthalmology journal from Baishideng Publishing Group. The aim of the journal is to promote high quality research for and from eye-care practitio-...Welcome to the World Journal of Ophthalmology （WJO）, a new general ophthalmology journal from Baishideng Publishing Group. The aim of the journal is to promote high quality research for and from eye-care practitio-ners all over the world. The WJO is a new member of the World Journal series of peer-reviewed, international English-language, open-access journals that are de-signed to provide a fast peer review process for all sub-mitted manuscripts. We intended to provide the most up-to-date electronic means of articles in all fields of ophthalmology. New journal that is available on internet for everyone will provide a forum for publication and free access of high quality scientifc papers document-ing clinical and experimental advances in the areas of ophthalmology. All subspecialties within ophthalmol-ogy, visual sciences, pharmacology and drug therapy in eye diseases, primary and secondary eye care, patient safety reports, surgical techniques, and improvements in quality of care will be accepted for publication. We look forward in the future to your fascinating contribu-tions to the WJO.展开更多
Pediatric neuro-ophthalmology is a subspecialty within neuro-ophthalmology.Pediatric neuro-ophthalmic diseases must be considered separate from their adult counterparts,due to the distinctive nature of the examination...Pediatric neuro-ophthalmology is a subspecialty within neuro-ophthalmology.Pediatric neuro-ophthalmic diseases must be considered separate from their adult counterparts,due to the distinctive nature of the examination,clinical presentations,and management choices.This manuscript will highlight four common pediatric neuro-ophthalmic disorders by describing common clinical presentations,recommended management,and highlighting recent developments.Diseases discussed include pediatric idiopathic intracranial hypertension(IIH),pseudopapilledema,optic neuritis(ON)and optic pathway gliomas(OPG).The demographics,diagnosis and management of common pediatric neuro-ophthalmic disease require a working knowledge of the current research presented herein.Special attention should be placed on the differences between pediatric and adult entities such that children can be appropriately diagnosed and treated.展开更多
文摘AIM:To investigate the capabilities of large language models(LLM)for providing information and diagnoses in the field of neuro-ophthalmology by comparing the performances of ChatGPT-3.5 and-4.0,Bard,and Bing.METHODS:Each chatbot was evaluated for four criteria,namely diagnostic success rate for the described case,answer quality,response speed,and critical keywords for diagnosis.The selected topics included optic neuritis,nonarteritic anterior ischemic optic neuropathy,and Leber hereditary optic neuropathy.RESULTS:In terms of diagnostic success rate for the described cases,Bard was unable to provide a diagnosis.The success rates for the described cases increased in the order of Bing,ChatGPT-3.5,and ChatGPT-4.0.Further,ChatGPT-4.0 and-3.5 provided the most satisfactory answer quality for judgment by neuro-ophthalmologists,with their sets of answers resembling the sample set most.Bard was only able to provide ten differential diagnoses in three trials.Bing scored the lowest for the satisfactory standard.A Mann-Whitney test indicated that Bard was significantly faster than ChatGPT-4.0(Z=-3.576,P=0.000),ChatGPT-3.5(Z=-3.576,P=0.000)and Bing(Z=-2.517,P=0.011).ChatGPT-3.5 and-4.0 far exceeded the other two interfaces at providing diagnoses and were thus used to find the critical keywords for diagnosis.CONCLUSION:ChatGPT-3.5 and-4.0 are better than Bard and Bing in terms of answer success rate,answer quality,and critical keywords for diagnosis in ophthalmology.This study has broad implications for the field of ophthalmology,providing further evidence that artificial intelligence LLM can aid clinical decision-making through free-text explanations.
基金supported by Health and Medical Research Fund,Hong Kong(11220386,12230246).
文摘Background:With the rapid development of artificial intelligence(AI),large language models(LLMs)have emerged as a potent tool for invigorating ophthalmology across clinical,educational,and research fields.Their accuracy and reliability have undergone tested.This bibliometric analysis aims to provide an overview of research on LLMs in ophthalmology from both thematic and geographical perspectives.Methods:All existing and highly cited LLM-related ophthalmology research papers published in English up to 24th April 2025 were sourced from Scopus,PubMed,and Web of Science.The characteristics of these publications,including publication output,authors,journals,countries,institutions,citations,and research domains,were analyzed using Biblioshiny and VOSviewer software.Results:A total of 277 articles from 1,459 authors and 89 journals were included in this study.Although relevant publications began to appear in 2019,there was a significant increase starting from 2023.He M and Shi D are the most prolific authors,while Investigative Ophthalmology&Visual Science stands out as the most prominent journal.Most of the top-publishing countries are high-income economies,with the USA taking the lead,and the University of California is the leading institution.VOSviewer identified 5 clusters in the keyword co-occurrence analysis,indicating that current research focuses on the clinical applications of LLMs,particularly in diagnosis and patient education.Conclusions:While LLMs have demonstrated effectiveness in retaining knowledge,their accuracy in image-based diagnosis remains limited.Therefore,future research should investigate fine-tuning strategies and domain-specific adaptations to close this gap.Although research on the applications of LLMs in ophthalmology is still in its early stages,it holds significant potential for advancing the field.
基金Supported by the Hainan Provincial Natural Science Foundation of China(No.825RC898)and Hainan Province Clinical Medical Center.
文摘ChatGPT technology based on large language models(LLM)shows great potential in improving the quality of medical care,assisting clinical decision making and optimizing patient communication.The role of ChatGPT in ophthalmology is still in its infancy.This review aims to explore the application prospect of ChatGPT in ophthalmology.Relevant literature was reviewed and analyzed,and the application prospects of LLM represented by ChatGPT in ophthalmology were summarized,including clinical assisted diagnosis,patient education and communication,history collection and text writing,clinical research,and medical education,etc.At the same time,the challenges and solutions faced by ChatGPT in ophthalmology were pointed out.Its safety,efficacy and ethics remain controversial in practical applications.Therefore,it is necessary to strengthen the supervision and research on its application to ensure safety and effectiveness.In the future,with the development of technology,ChatGPT is expected to play a greater role in ophthalmology and enhance the medical experience.
文摘Cytomegalovirus (CMV) retinitis is a significant yet infrequent complication inpediatric hematopoietic stem cell transplant recipients, occurring in approximately4% of cases. Its presentation typically coincides with immune reconstitution,between 6 weeks to 6 months post-transplant, emphasizing the need fortimely detection. Symptoms often develop insidiously, underscoring the role offundus examinations during episodes of CMV viremia. However, the low incidencechallenges the necessity of routine screenings, as they may strain clinicalresources without clear benefits to patient outcomes. Management includes systemicand intravitreal antivirals, such as ganciclovir and foscarnet, and adoptiveT-cell therapy for refractory cases. Tailored follow-up strategies are crucial, withconsiderations for lesion activity and CMV viremia status to determine theduration of therapy. Baseline and post-transplant screenings remain a topic ofdebate, with evolving guidelines needed to balance patient safety and clinicalfeasibility. Future research is needed to address optimal screening intervals andinvestigate the role of pre-existing CMV serostatus in transplant eligibility andoutcomes.
基金supported by the Fujian Provincial Undergraduate Teaching Reform Project(J21008)Teaching Research Program for Undergraduate Education at Fujian Medical University(J24030).
文摘Virtual Reality(VR)technology is widely recognized as a prominent technological paradigm.Its potential and promise in the domain of ophthalmology are substantial,and the evolution of VR technology has significantly influenced the contemporary landscape of ophthalmology.Numerous empirical studies have validated the practical utility of VR technology in domains such as ophthalmic disease treatment and surgery training.This paper offers a comprehensive overview of VR technology's utilization in ophthalmic disease treatment,student education,and surgery training,expands the application of VR technology in ophthalmic evaluation and disease diagnosis,discusses the challenges and limitations of VR technology in ophthalmology,and expounds on emerging trends and future developments of VR technology in ophthalmology.This endeavor aims to provide readers with an in-depth comprehension of the current status and future prospects of VR technology application in ophthalmology,with the ultimate objective of fostering more effective advancements and applications of VR technology in the realm of ophthalmology.
基金Supported by unrestricted grants from the National Institutes of Health CORE grant(No.EY001730)Research to Prevent Blindness to the University of Washington Department of Ophthalmology。
文摘AIM:To evaluate the flipped classroom model for teaching horizontal strabismus didactics in an ophthalmology residency program in China as part of a visiting professorship from the United States.METHODS:Residents from an ophthalmology residency program in China were invited to participate in flipped classroom sessions taught by an experienced American ophthalmology faculty in 2018.Residents were instructed to watch a pre-class video lecture prior to the in-class-casebased activity.Content tests(5 Ophthalmic Knowledge Assessment Program style questions)and surveys were administered before and after the classroom sessions(100%response rate).These results were compared to that of an American cohort who were taught the same content.RESULTS:The Chinese cohort of 12 residents preferred the flipped classroom to the traditional classroom at higher rates than the American cohort of 40 residents(92%vs 55%,P=0.04)and felt that all ophthalmology topics would be appropriate for the flipped classroom teaching style(P-values between 0.008 and<0.001).In both Chinese and American cohorts,we found that the exotropia curriculum saw a small but significant improvement in performance following the flipped classroom session(P=0.025 for Chinese residents;P=0.001 for US residents),whereas scores in both groups for the esotropia course did not significantly improve.CONCLUSION:This is the first study to evaluate the flipped classroom model implemented by a visiting ophthalmology professor in a global outreach setting.The flipped classroom sessions are viewed favorably by the Chinese residents relative to the US cohort with a modest impact on knowledge.Decreased in-person interpreter requirement and increased student engagement make this model valuable in cross-cultural visiting professorship settings.Finally,the flipped classroom may lend itself well to a virtual format to prevent the transmission of COVID-19,although such a format requires further study.
文摘Telemedicine is an emerging field in recent medical achievements with rapid development. The ＂smartphone＂ availability has increased in both developed and developing counffies even among people in rural and remotes areas. Telebased services can be used for screening ophthalmic diseases and also monitoring patients with known diseases. Electronic ophthalmologic records of the patients including captured images by smartphones from anterior and posterior segments of the eye will be evaluated by ophthalmologists, and if patients require further evaluations, they will be referred to experts in the relevant field. Eye diseases such as cataract, glaucoma, age-related macular degeneration, diabetic retinopathy, and retinopathy of prematurity are the most common causes of blindness in many countries and beneficial use of teleophthalmology with smartphones will be a good way to achieve the aim of VISION 2020 all over the world. Numerous studies have shown that teleophthalmology is similar to the conventional eye care system in clinical outcomes and even provides more patient satisfaction as it saves time and cost, This review explains how teleophthalmology helps to improve patient outcomes through smartphones.
文摘Some recent advances in neuro-ophthalmology including clinical trials,diagnostic testing and newly elucidated disease entitites were summarized in present paper,such as neuromyelitis optica spectrum disorder.The review goes into great detail regarding recent clinical trials in neuro-ophthalmology.These trials have investigated the management of idiopathic intracranial hypertension as well as treatment of Leber hereditary optic neuropathy and optic nerve glioma.The potential gene therapy for Leber hereditary optic neuropathy seems very promising and may have a significant clinical impact within the next few years.This review also includes an extensive discussion about the application of optical coherence tomography(OCT)and OCT-angiography(OCTA)in neuro-ophthalmology.OCT has important clinical relevance not only for the diagnosis and management of optic neuropathies,such as optic neuritis,ischemic optic neuropathy and chiasmal compression,but also for retro-chiasmal injury.In terms of OCTA,recent studies have demonstrated increased vessel density in acute stage of ischemic optic neuropathy(NAION)and optic neuritis,but decreased vessel density in severe papilloedema and late stage of optic atrophy of any cause.These serve as the potential foundation for future clinical applications.Ophthalmologists should pay more attentions to these recent progress in neuro-ophthalmology.
基金supported by National Natural Science Foundation of China for Young Scientist (81200686, 81400426)Research Fund for the Doctoral Program of Higher Education of China (20120171120108)+1 种基金Natural Science Foundation of Guangdong Province, China(S2011040005378)Fundamental Research Funds for the Central Universities (11ykpy65, 15ykpy31)
文摘Background: Ophthalmology is an important medical science subject, but it is given with insufficient attention in undergraduate medical education. Flipped classroom(FC) and problem-based learning(PBL) are well-known education methods that can be integrated into ophthalmology education to improve students' competence level and promote active learning. Methods: We used a mixed teaching methodology that integrated a FC and PBL into a 1-week ophthalmology clerkship for 72 fourth-year medical students. The course includes two major sessions: FC session and PBL session, relying on clinical and real-patient cases. Written examinations were set up to assess students' academic performance and questionnaires were designed to evaluate their perceptions. Results: The post-course examination results were higher than the pre-course results, and many students gained ophthalmic knowledge and learning skills to varying levels. Comparison of pre-and post-course questionnaires indicated that interests in ophthalmology increased and more students expressed desires to be eye doctors. Most students were satisfied with the new method, while some suggested the process should be slower and the communication with their teacher needed to strengthen.Conclusions: FC and PBL are complementary methodologies. Utilizing the mixed teaching meth of FC and PBL was successful in enhancing academic performance, student satisfactions and promoting active learning.
文摘AIM： To explore the trends in the ophthalmic literature over a 5-year period in relation to country, research expenditure and demographics. METHODS： Articles published between 2009 and 2013 by the 20 highest-contributing countries in the 20 top- ranked ophthalmology journals were identified by their country of affiliation. The number of articles published and mean impact factor were measured per country for each year and trends explored using regression analysis with 5-year and 10-year forecasts calculated. Data on research expenditure was collected and tested for correlation with the number of articles and mean impact factor. RESULTS： The analysis included 19 338 articles. The USA, UK and Europe accounted for 60.2% of articles published, with the USA contributing 7388 articles （34.0%）. The USA also demonstrated the highest mean impact factor （3.5）. Research expenditure was significantly correlated with both research output （r=0,86, P〈0.001） and scholarly impact （r=0.42, P〈0.001）. China （P〈0.01）, Korea （P〈0.01） and India （P〈0.02） demonstrated a significant growth in research output over the study period. The research contribution of these three countries combined is forecasted to overtake that of Europe within ten years, with China expected to be the second-largest contributor within five years. These countries were also among those demonstrating the greatest growth in research expenditure. CONCLUSION： While the USA and European countries are major contributors of ophthalmic research, the productivity of some Asian countries is growing impressively. The contribution of China, Korea and Indiais forecasted to outweigh that of Europe by 2023. Research expenditure is highly correlated with research productivity and these trends reflect the differing economic priorities across the world.
基金All the procedures in this study were approved by the Institutional Review Board of Zhongshan Ophthalmic Center of Sun Yat-sen University(Ethic ID:2016MEKY062).Informed consent was obtained from each student.
文摘Background:The“flipped classroom”is a learner-centered approach that centers on delivering videos,podcasts or slide-based material to learners prior to a lecture or class session.The class session is then dedicated to discussion,analysis,and problem-solving activities.The aim of this study was to investigate whether the flipped classroom could be adapted to medical(ophthalmology)students learning about ocular trauma and to assess the impact of the flipped classroom on those students’performance and attitudes.Methods:Questionnaires(using a 4-point scale)were distributed to 93 fifth-year medical students at Sun Yat-sen University,and the data showed that the majority of students preferred the flipped classroom approach to the traditional lecture method.Results:The results of pre-and post-test scores were 14.35±3.404 and 20.37±4.356,which showed a significant improvement in students’performance after the flipped classroom was introduced(P<0.05).Conclusions:Student response to the flipped classroom strategy was largely positive,indicating that the strategy received a high level of approval in an ophthalmology clerkship course taken by medical students in China.
基金Supported by National Nature Science Foundation of China(No.62306254)SanMing Project of Medicine in Shenzhen(No.SZSM202311012)+1 种基金Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties(No.SZGSP014)Shenzhen Science and Technology Program(No.KCXFZ20211020163813019).
文摘This paper analyzes the current status,technological developments,academic exchange platforms,and future challenges and solutions in the field of intelligent ophthalmology(IO)in China.In terms of technology,significant progress has been made in various areas,including diabetic retinopathy,fundus image analysis,quality assessment of medical artificial intelligence products,clinical research methods,technical evaluation,and industry standards.Researchers continually enhance the safety and standardization of IO technology by formulating a series of clinical application guidelines and standards.The establishment of domestic and international academic exchange platforms provides extensive collaboration opportunities for professionals in various fields,and various academic journals serve as publication platforms for IO research.However,challenges such as technological innovation,data privacy and security,lagging regulations,and talent shortages still pose obstacles to future development.To address these issues,future efforts should focus on strengthening technological research and development,regulatory framework construction,talent cultivation,and increasing patient awareness and acceptance of new technologies.By comprehensively addressing these challenges,IO in China is poised to further lead the industry’s development on a global scale,bringing more innovation and convenience to the field of ophthalmic healthcare.
文摘Objective:To explore the application effect of the Eyesi surgical simulator in the teaching of cataract surgery for professional ophthalmology postgraduate students.Methods:The professional postgraduate students who were trained in the third year of ophthalmology at the First Affiliated Hospital of Xi’an Medical University were selected as the research objects.After passing the theoretical examination,they were randomly divided into the pig eyeball group,Eyesi group,and pig eye+Eyesi group,with 5 students in each group.The pig eyeball,Eyesi surgery simulator,and pig eye+Eyesi surgery simulator were used for microscopic technique operation and cataract surgery steps training,respectively.After the training,the overall training effects of the three groups of postgraduates were scored,and questionnaires were used to objectively evaluate the three training methods.Results:The scores of the students in the pig eye+Eyesi group were better than those in the Eyesi group,and the students in the Eyesi group were better than those in the pig eyeball group.Conclusion:The Eyesi surgical simulation training system can evaluate the microsurgical skills of professional masters and improve their surgical skills.This system is of great significance for the training of the cataract surgery skills of professional masters.
文摘AIM: To examine the publication trend of oculoplastic articles throughout the last decade in general ophthalmology journals.METHODS: A review of all abstracts published between Januar y 2010 to December 2019 in general, clinical ophthalmic journals was conducted. Articles that were categorized as original articles in general and clinical journals were included in the study.RESULTS: Totally 10 281 abstracts were included. Of them 465(4.5%) were oculoplastic publications. The mean number of annual-publications was 46.5 and the mean annual-rate of oculoplastic publications was 4.51%. A significant decreasing trend in the number of oculoplastic publication in the last decade was found(P<0.01, R^(2)=0.770). However, there was no significant change in the annual-rate of oculoplastic publications during the last decade(P=0.191, R2=0.203). From the 465 oculoplastic articles: 179(38.5%) were articles about eyelid diseases, 160(34.40%) were about orbit diseases, 92(19.80%) were about lacrimal diseases and 34(7.30%) were about thyroid eye disease(TED). A significant decreasing trends in the number of orbital and eyelids publications were found(P<0.01, P<0.01). However, there were no significant changes in the annual-rate of orbital, eyelids, TED and lacrimal-diseases publications throughout the last decade.CONCLUSION: Oculoplastic subspecialty deals with a wide range of pathologies in different ages. However, less than 5% of the articles in general, clinical, high impact factor ophthalmology journals are about oculoplastic diseases. One of the best way for ophthalmologists from different subspecilties, nowadays, to be updated, is to read highimpact-factor, general ophthalmology journals. Therefore, it is important that those journals will include articles about breakthroughs in oculoplastic.
文摘AIM:To review international guidelines and to share our infection control experience during the coronavirus disease 2019(COVID-19)pandemic at a tertiary eye centre in Hong Kong.METHODS:Infection control guidelines and recommendations from international ophthalmological bodies are reviewed and discussed.The measures at our hospital were drawn up as per international and local health authorities’guidelines and implemented with the collaboration of doctors,nurses and administrative staff.RESULTS:The aims of our infection control measures are to 1)minimize cross-infection within the hospital;2)protect and support hospital staff;3)ensure environmental control.To minimize the risk of cross-infection,outpatient attendance and elective surgery have been reduced by 40%,and general anesthesia procedures were reduced by 90%.Patients entering the hospital are screened for fever,travel history,contact and cluster history,and COVID-19 related symptoms.To protect and support hospital staff,we ensure provision of adequate personal protective equipment(PPE)and provide clear guidelines on the level of PPE needed,depending on the clinical situation.Other protective measures include provision of work uniforms,easy access to alcohol-based hand rub,opening new lunch areas,implementation of self-monitoring and self-reporting systems,and communication via online education and updates.Finally,environmental control is achieved by ensuring regular disinfection of the hospital premise,enhancing ventilation,and usage of disposable ophthalmic instruments.CONCLUSION:Our multi-pronged approach to infection control is,so far,successful in minimizing infection risks,while allowing the maintenance of essential ophthalmic services.
基金Supported by National Social Science Foundation of China(No.15BTQ059)National Key Technology Support Program of China(No.2015BAH25F01)
文摘AIM：To investigate the published papers of ophthalmology in past ten years and explore the development of ophthalmology.METHORDS：The data of this study retrieved from Science Citation Index Expanded and downloaded online in November 2017,including all the papers with publication year from 2007-2016 were analyzed.The papers were based on the Web of Science category and the journals were based on the Journal Citation Report category.RESULTS：The number of ophthalmology papers increased from 7450 to 9089 during 2007 to 2017.The average rate increased 2.2% annually.USA accounts for one thirds of the total and two thirds of the highly cited papers.In Asia,China,Japan and South Korea were in Top 10 by the number of ophthalmology papers.UK,Germany,Japan and Australia also had great impact in global ophthalmology.The hot spots included endothelial growth factor,optical coherence tomography and open-angle glaucoma.CONCLUSION：USA is in the leading position in global ophthalmology.Part of Asian countries play an important role in the development of ophthalmology,but the impact needs to be improved.
文摘AIM:To evaluate residents’perceptions and attitudes toward the various aspects of a comprehensive ophthalmic examination,and to determine if these factors correlate with their choices for fellowship and future career plans.METHODS:This is a cross-sectional study.A questionnaire on the perception of the ophthalmic exam was sent via SurveyMonkey to ophthalmology residents throughout Israel.Eighty of them(one-half of all ophthalmology residents in 2019)completed it.The first part related to how they perceived each component of the ophthalmic evaluation.The second part related to their future fellowship plans.The Chi-squared test was used to compare categorical variables and Student’s t-test and One-way ANOVA were used to compare continuous variables.Multivariate logistic regression analysis was applied as needed to detect interactions between variables and to exclude confounder effects.RESULTS:Slit-lamp examination of the anterior and posterior segments ranked as the most likeable aspects,whereas gonioscopy,ocular motility examination and visual acuity assessment were least likeable.Anterior segment and retina subspecialties were the ones most sought after.Forty-nine respondents(61.3%)noted a direct correlation between their preferred parts of comprehensive ophthalmic evaluations and their choice of subspecialty.Perceptions of selected components of those evaluations were significantly associated with responders’intentions to pursue anterior segment,retina,or oculoplastic fellowships(P<0.05).CONCLUSION:Perspectives of residents toward the ophthalmic examination,and most specifically its individual components,play an important role in their choice of subspecialty training.
文摘Optical coherence tomography(OCT)is a widely used non-invasive medical imaging technology that has revolutionized clinical care in ophthalmology.New developments,such as OCT angiography(OCTA)are expected to contribute even further to the widespread use of OCT-based imaging devices in the diagnosis and monitoring of patients with ophthalmic diseases.In recent years,many of the disadvantages such as limited field of view and imaging artefacts have been substantially reduced.Similar to the progress achieved in the assessment of retinal disorders,OCT is expected to change the approach to patients seen in the neuro-ophthalmology clinic.In this article,we review the technical features of OCT and OCT-based imaging techniques,highlighting the specific factors that should be taken into account when interpreting OCT in the field of neuro-ophthalmology.
文摘Welcome to the World Journal of Ophthalmology （WJO）, a new general ophthalmology journal from Baishideng Publishing Group. The aim of the journal is to promote high quality research for and from eye-care practitio-ners all over the world. The WJO is a new member of the World Journal series of peer-reviewed, international English-language, open-access journals that are de-signed to provide a fast peer review process for all sub-mitted manuscripts. We intended to provide the most up-to-date electronic means of articles in all fields of ophthalmology. New journal that is available on internet for everyone will provide a forum for publication and free access of high quality scientifc papers document-ing clinical and experimental advances in the areas of ophthalmology. All subspecialties within ophthalmol-ogy, visual sciences, pharmacology and drug therapy in eye diseases, primary and secondary eye care, patient safety reports, surgical techniques, and improvements in quality of care will be accepted for publication. We look forward in the future to your fascinating contribu-tions to the WJO.
文摘Pediatric neuro-ophthalmology is a subspecialty within neuro-ophthalmology.Pediatric neuro-ophthalmic diseases must be considered separate from their adult counterparts,due to the distinctive nature of the examination,clinical presentations,and management choices.This manuscript will highlight four common pediatric neuro-ophthalmic disorders by describing common clinical presentations,recommended management,and highlighting recent developments.Diseases discussed include pediatric idiopathic intracranial hypertension(IIH),pseudopapilledema,optic neuritis(ON)and optic pathway gliomas(OPG).The demographics,diagnosis and management of common pediatric neuro-ophthalmic disease require a working knowledge of the current research presented herein.Special attention should be placed on the differences between pediatric and adult entities such that children can be appropriately diagnosed and treated.
