Background:Vision and vision-language foundation models,a subset of advanced artificial intelligence(AI)frameworks,have shown transformative potential in various medical fields.In ophthalmology,these models,particular...Background:Vision and vision-language foundation models,a subset of advanced artificial intelligence(AI)frameworks,have shown transformative potential in various medical fields.In ophthalmology,these models,particularly large language models and vision-based models,have demonstrated great potential to improve diagnostic accuracy,enhance treatment planning,and streamline clinical workflows.However,their deployment in ophthalmology has faced several challenges,particularly regarding generalizability and integration into clinical practice.This systematic review aims to summarize the current evidence on the use of vision and visionlanguage foundation models in ophthalmology,identifying key applications,outcomes,and challenges.Main text:A comprehensive search on PubMed,Web of Science,Scopus,and Google Scholar was conducted to identify studies published between January 2020 and July 2025.Studies were included if they developed or applied foundation models,such as vision-based models and large language models,to clinically relevant ophthalmic applications.A total of 10 studies met the inclusion criteria,covering areas such as retinal diseases,glaucoma,and ocular surface tumor.The primary outcome measures are model performance metrics,integration into clinical workflows,and the clinical utility of the models.Additionally,the review explored the limitations of foundation models,such as the reliance on large datasets,computational resources,and interpretability challenges.The majority of studies demonstrated that foundation models could achieve high diagnostic accuracy,with several reports indicating excellent performance comparable to or exceeding those of experienced clinicians.Foundation models achieved high accuracy rates up to 95%for diagnosing retinal diseases,and similar performances for detecting glaucoma progression.Despite promising results,concerns about algorithmic bias,overfitting,and the need for diverse training data were common.High computational demands,EHR compatibility,and the need for clinician validation also posed challenges.Additionally,model interpretability issues hindered clinician trust and adoption.Conclusions:Vision and vision-language foundation models in ophthalmology show significant potential for advancing diagnostic accuracy and treatment strategies,particularly in retinal diseases,glaucoma,and ocular oncology.However,challenges such as data quality,transparency,and ethical considerations must be addressed.Future research should focus on refining model performance,improving interpretability and generalizability,and exploring strategies for integrating these models into routine clinical practice to maximize their impact in clinical ophthalmology.展开更多
Background:Health professions education(HPE)in underserved and resource-constrained regions faces persistent challenges,including limited faculty development opportunities and the absence of context-specific curricula...Background:Health professions education(HPE)in underserved and resource-constrained regions faces persistent challenges,including limited faculty development opportunities and the absence of context-specific curricula.The growing need to increase access to cataract surgery and reduce avoidable blindness underscores the urgency of training more competent cataract surgeons.Developing a standardized,nationally endorsed,outcome-based curriculum for simulation-based training in cataract surgery represents a strategic solution.This study explores integrating online active and constructivist social learning strategies within team projects to address these educational gaps,emphasizing equitable international partnerships between experienced global ophthalmological societies(GOS)in HPE,and national ophthalmological societies(NOS)especially in underserved regions.Methods:We conducted an non-experimental investigation involving the Mozambican College of Ophthalmology(NOS),comprising ten senior ophthalmologist educators,including the President(A.B.),each with over ten years of postgraduate teaching leadership experience.To promote inclusivity and foster future leadership,six early-career ophthalmologists with under five years of experience were invited to join.The GOS was represented by two ophthalmologist educators(K.G.and H.P.F.)affiliated with the Ophthalmology Foundation and experienced in international HPE.Together,both organizations formed an equitable and culturally adapted partnership,led by the NOS,to co-design an outcome-based curriculum for cataract surgery simulation training.The collaborative process used a group mentor-facilitated model integrating design thinking,and social constructivist strategies.A virtual community of practice(vCoP),sustained through WhatsApp,enabled continuous peer support and knowledge exchange.The project spanned eight monthly 90-minute videoconferences via Zoom,incorporating online group mentoring and a virtual jigsaw exercise.Results:The collaboration resulted in the development of a competency-based,simulation-enhanced small incision cataract surgery curriculum structured around the Ophthalmic Simulated Surgical Competency Assessment Rubric(Sim-OSSCAR).The curriculum followed Kern’s six-step framework and was organized into four modular components covering the full range of surgical steps.The vCoP emerged as a key platform for sustained faculty development,collaborative problem-solving,and shared expertise,enhancing institutional capacity within the NOS.Participants anecdotally reported increased confidence in curriculum design,strengthened mentoring relationships,and greater engagement through active learning methodologies.The model demonstrated scalability and adaptability,indicating potential for broader application across other medical specialties and contexts.Conclusions:This study highlights the transformative potential of combining design thinking,active and social learning strategies,and digital tools in HPE.By fostering equitable,structured international collaborations,this approach supports sustainable faculty development and contextually relevant educational innovation.The creation of a dynamic vCoP was instrumental in promoting shared ownership and collaboration,ultimately advancing competency-based,simulation-enhanced training in ophthalmology.These findings suggest similar team-based,technology-enabled strategies could strengthen training and patient care in other underserved settings and with other disciplines.展开更多
AIM:To evaluate the potential of artificial intelligence(AI)for automating corneal topography interpretation in orthokeratology patients,aiming to enhance diagnostic precision,efficiency,and clinical decision-making i...AIM:To evaluate the potential of artificial intelligence(AI)for automating corneal topography interpretation in orthokeratology patients,aiming to enhance diagnostic precision,efficiency,and clinical decision-making in myopia management.METHODS:The 1469 corneal topography images from 582 eyes of 326 myopic children treated with orthokeratology lenses over 47mo were collected.Each sample was categorized by decentration,treatment zone size,shape variation,and eye laterality.A multi-task AI model was developed to predict these parameters,with performance measured using area under curve(AUC),accuracy,and F1 scores.We compared AI-only,humanonly,and combined Human+AI approaches on a subset of 100 images.External validation with images from additional hospitals tested model generalizability.RESULTS:The model achieved high accuracy in eyeside prediction(AUC 0.95)and AUC values of 0.52-0.74 for decentration,treatment zone,and shape variation tasks.The combined Human+AI method outperformed AI-only and human-only approaches,achieving the highest accuracy(up to 87%)and fastest processing time(80ms).External validation confirmed robust performance in simple tasks,though accuracy was lower for complex classifications due to imaging variations.CONCLUSION:AI provides efficient routine corneal topography assessments,while complex cases benefit most from a Human+AI approach,particularly in scenarios requiring nuanced clinical interpretation.The model currently functions as an assistive tool.展开更多
AIM:To evaluate the refractive and long-term outcome of eyes filled with silicone oil(SO)undergoing phacoemulsification cataract surgery(PCS).METHODS:This retrospective study evaluated patients with SO tamponade who w...AIM:To evaluate the refractive and long-term outcome of eyes filled with silicone oil(SO)undergoing phacoemulsification cataract surgery(PCS).METHODS:This retrospective study evaluated patients with SO tamponade who were scheduled for PCS.RESULTS:Subjects(n=26)were followed for 29.5±13.9 mo after cataract surgery.The median spherical equivalent refraction(SER)was+5.3 D[interquartile range(IQR)+2.9 to+6.7]before PCS,and+3.4 D(IQR+2.0 to+4.4)after PCS.Within the follow-up period retinal reattachment after SO removal was achieved in 15 out of 26 eyes(57.7%).In 13 eyes assessment of refraction after SO-removal was possible,and showed a myopic shift of-4.6 D(IQR-2.9 to-7.3)in the SER.After SO removal,5 of the 13 eyes(38.5%)were within±1.0 D of the target refraction,while 9 out of the 13 eyes(69.2%)were within±2.0 D.CONCLUSION:In our study,the refraction after PCS for eyes filled with SO manifested low predictability,as did the myopic shift following SO removal.A significant percentage of the eyes that underwent SO administration required a long-term tamponade.展开更多
Father Waclaw Szuniewicz(1891-1963) was a skilled ophthalmic surgeon, missionary, and teacher. For several years he worked in China, afterwards in the United States and in Brazil. The aim of the paper is to present th...Father Waclaw Szuniewicz(1891-1963) was a skilled ophthalmic surgeon, missionary, and teacher. For several years he worked in China, afterwards in the United States and in Brazil. The aim of the paper is to present the unanalyzed issues of Szuniewicz’s research regarding corneal refractive surgery. Szuniewicz performed experiments on changing the corneal curvature with anterior, posterior and full-thickness incisions. The results of modifying the anterior and posterior corneal curvature were satisfactory, however, diminished significantly within months after surgery. Corneal band resections were superior in terms of efficacy, however, such an intervention commonly led to complications in animal studies. Szuniewicz’s work was not published during his life. Nevertheless, as a result of strong impact of his personality and ideas, he is frequently considered as a pioneer of corneal refractive surgery.展开更多
December 2013Dear Xiuwen,Thank you.Your generous support of the ICOFoundation this past year helped the International Council of Ophthalmology(ICO)enhance ophthalmic education,which will ultimately help reduce avoidab...December 2013Dear Xiuwen,Thank you.Your generous support of the ICOFoundation this past year helped the International Council of Ophthalmology(ICO)enhance ophthalmic education,which will ultimately help reduce avoidable vision loss around the world.You have set an admirable example for others to follow.As President of the ICO and a proud representative of the ICOFoundation,I am very pleased to thank you again for your gift and to tell you what you and other donors have enabled us to do this year:展开更多
Background:Enhanced depth-of-focus intraocular lenses(EDOF IOL)have filled the gap between monofocal and multifocal intraocular implants with optical qualities of monofocal lenses and usually minor dysphotopsias typic...Background:Enhanced depth-of-focus intraocular lenses(EDOF IOL)have filled the gap between monofocal and multifocal intraocular implants with optical qualities of monofocal lenses and usually minor dysphotopsias typical for multifocal lenses.The purpose of this study was to evaluate visual outcomes after bilateral implantation of a new EDOF IOL in patients with requirements for perfect near and intermediate vision.Methods:The study included 15 patients(29 eyes as one was amblyopic)with bilateral implantation of LUXSMART EDOF IOL(Bausch&Lomb)with a targeted myopia(between-0.25 and-0.50D)in both eyes.Monocular corrected and uncorrected visual acuity for far,intermediate and near as well as refractive outcomes were evaluated at 1,3,6 and 12 months after the surgery.Additionally,binocular visual acuity,contrast sensitivity and defocus curve were measured at the final follow-up visit.At 12 months’visit patients completed a questionnaire evaluating patient satisfaction,spectacle independence and presence of dysphotopsias.Results:Binocular uncorrected visual acuities at 12 month’s visit were 0.13±0.16,0.06±0.08,0.07±0.09 and 0.15±0.09 logMAR for far distance,80 cm,66 cm and 40 cm respectively.Corrected binocular visual acuities at 12 months were 0.00±0.00,0.05±0.07,0.05±0.06,0.13±0.16 respectively for distance,80 cm,66 cm and 40 cm.Automated refraction spherical equivalent at 12 months’visit stood at-0.70±0.48D,which was 0.46D less than calculated biometric target,however spherical equivalent of subjective refraction at 12 months equaled–0.49±0.46D,which was closer to preoperative biometric target.Defocus curve had gentle shape without peaks typical for monofocal IOLs.Binocular contrast sensitivity results were superior to average results for that age group and equaled 1.78±0.16 logMAR without correction and 1.81±0.13 logMAR with correction.Spectacle independence for near and intermediate distances was achieved in all patients and for far distance in 73.3%of patients.Burdensome dysphotopsias were not reported in any case.Conclusions:EDOF IOLs targeted bilaterally at low myopia can provide excellent near and intermediate visual acuity and independence of any optical correction in majority of cases.This approach can be used in selected patients who are focused on stationary activities.展开更多
Background:The convergence of smartphone technology and artificial intelligence(AI)has revolutionized the landscape of ophthalmic care,offering unprecedented opportunities for diagnosis,monitoring,and management of oc...Background:The convergence of smartphone technology and artificial intelligence(AI)has revolutionized the landscape of ophthalmic care,offering unprecedented opportunities for diagnosis,monitoring,and management of ocular conditions.Nevertheless,there is a lack of systematic studies on discussing the integration of smart-phone and AI in this field.Main text:This review includes 52 studies,and explores the integration of smartphones and AI in ophthalmology,delineating its collective impact on screening methodologies,disease detection,telemedicine initiatives,and patient management.The collective findings from the curated studies indicate promising performance of the smartphone-based AI screening for various ocular diseases which encompass major retinal diseases,glaucoma,cataract,visual impairment in children and ocular surface diseases.Moreover,the utilization of smartphone-based imaging modalities,coupled with AI algorithms,is able to provide timely,efficient and cost-effective screening for ocular pathologies.This modality can also facilitate patient self-monitoring,remote patient monitoring and enhancing accessibility to eye care services,particularly in underserved regions.Challenges involving data pri-vacy,algorithm validation,regulatory frameworks and issues of trust are still need to be addressed.Furthermore,evaluation on real-world implementation is imperative as well,and real-world prospective studies are currently lacking.Conclusions:Smartphone ocular imaging merged with AI enables earlier,precise diagnoses,personalized treat-ments,and enhanced service accessibility in eye care.Collaboration is crucial to navigate ethical and data security challenges while responsibly leveraging these innovations,promising a potential revolution in care access and global eye health equity.展开更多
Purpose:Subthreshold micropulse laser(SML)and photodynamic therapy(PDT)are among the most effective therapeutic modalities applied to central serous chorioretinopathy(CSCR).This study aimed to evaluate the ef-ficacy a...Purpose:Subthreshold micropulse laser(SML)and photodynamic therapy(PDT)are among the most effective therapeutic modalities applied to central serous chorioretinopathy(CSCR).This study aimed to evaluate the ef-ficacy and durability of PDT in CSCR cases unresponsive to at least two SML treatments.Methods:The study included 26 consecutive eyes of 24 patients(21 males and three females)with chronic CSCR.In all cases,a lack of reduction in subretinal fluid(SRF)levels was noted after at least two consecutive SML sessions.The parameters of best corrected visual acuity(BCVA)and spectral domain optical coherence tomog-raphy(SD-OCT)were evaluated at baseline and 1,3 and 12 months post-PDT.Results:The mean duration of symptoms in the group was 53.81±39.48 months,the mean age of the patients was 49.26±12.91 years,and the mean subfoveal choroidal thickness(SFCT)was 572.11±116.21 mm.Complete resorption of SRF was observed in 21 out of 26 eyes(80.77%)at 1 month and sustained in 18 cases(69.23%)at 12 months.At 12 months,in the sustained group,BCVA improved significantly from 0.39±0.18 to 0.19±0.2 logMAR(P=0.01),central subfoveal thickness(CST)reduced from 316.44±75.83 mm to 197.67±22.99 mm(P<0.0001),and SFCT reduced from 579.28 mm to 446.78 mm(P<0.0001).Conclusions:PDT provides the opportunity for the successful treatment of CSCR unresponsive to SML treatment.Improvements are possible even in cases with a long duration of symptoms and significant alterations in retinal morphology.Thus,PDT should be considered for patients with prominently increased choroidal thickness.展开更多
1.Introduction Ophthalmology focuses on relating structural changes to function and disease.From biomicroscopy,ophthalmoscopy and fundus photography,to electroretinography and visual evoked potentials the clinical pur...1.Introduction Ophthalmology focuses on relating structural changes to function and disease.From biomicroscopy,ophthalmoscopy and fundus photography,to electroretinography and visual evoked potentials the clinical purpose is to objectively assess visual function.However,these techniques are macroscopic and only grossly related to visual acuity.With the development of optical coherence tomography(OCT)in vivo histological resolution of the retina has become routine.展开更多
基金supported by Natural Science Foundation of China(grant number 82201195).
文摘Background:Vision and vision-language foundation models,a subset of advanced artificial intelligence(AI)frameworks,have shown transformative potential in various medical fields.In ophthalmology,these models,particularly large language models and vision-based models,have demonstrated great potential to improve diagnostic accuracy,enhance treatment planning,and streamline clinical workflows.However,their deployment in ophthalmology has faced several challenges,particularly regarding generalizability and integration into clinical practice.This systematic review aims to summarize the current evidence on the use of vision and visionlanguage foundation models in ophthalmology,identifying key applications,outcomes,and challenges.Main text:A comprehensive search on PubMed,Web of Science,Scopus,and Google Scholar was conducted to identify studies published between January 2020 and July 2025.Studies were included if they developed or applied foundation models,such as vision-based models and large language models,to clinically relevant ophthalmic applications.A total of 10 studies met the inclusion criteria,covering areas such as retinal diseases,glaucoma,and ocular surface tumor.The primary outcome measures are model performance metrics,integration into clinical workflows,and the clinical utility of the models.Additionally,the review explored the limitations of foundation models,such as the reliance on large datasets,computational resources,and interpretability challenges.The majority of studies demonstrated that foundation models could achieve high diagnostic accuracy,with several reports indicating excellent performance comparable to or exceeding those of experienced clinicians.Foundation models achieved high accuracy rates up to 95%for diagnosing retinal diseases,and similar performances for detecting glaucoma progression.Despite promising results,concerns about algorithmic bias,overfitting,and the need for diverse training data were common.High computational demands,EHR compatibility,and the need for clinician validation also posed challenges.Additionally,model interpretability issues hindered clinician trust and adoption.Conclusions:Vision and vision-language foundation models in ophthalmology show significant potential for advancing diagnostic accuracy and treatment strategies,particularly in retinal diseases,glaucoma,and ocular oncology.However,challenges such as data quality,transparency,and ethical considerations must be addressed.Future research should focus on refining model performance,improving interpretability and generalizability,and exploring strategies for integrating these models into routine clinical practice to maximize their impact in clinical ophthalmology.
文摘Background:Health professions education(HPE)in underserved and resource-constrained regions faces persistent challenges,including limited faculty development opportunities and the absence of context-specific curricula.The growing need to increase access to cataract surgery and reduce avoidable blindness underscores the urgency of training more competent cataract surgeons.Developing a standardized,nationally endorsed,outcome-based curriculum for simulation-based training in cataract surgery represents a strategic solution.This study explores integrating online active and constructivist social learning strategies within team projects to address these educational gaps,emphasizing equitable international partnerships between experienced global ophthalmological societies(GOS)in HPE,and national ophthalmological societies(NOS)especially in underserved regions.Methods:We conducted an non-experimental investigation involving the Mozambican College of Ophthalmology(NOS),comprising ten senior ophthalmologist educators,including the President(A.B.),each with over ten years of postgraduate teaching leadership experience.To promote inclusivity and foster future leadership,six early-career ophthalmologists with under five years of experience were invited to join.The GOS was represented by two ophthalmologist educators(K.G.and H.P.F.)affiliated with the Ophthalmology Foundation and experienced in international HPE.Together,both organizations formed an equitable and culturally adapted partnership,led by the NOS,to co-design an outcome-based curriculum for cataract surgery simulation training.The collaborative process used a group mentor-facilitated model integrating design thinking,and social constructivist strategies.A virtual community of practice(vCoP),sustained through WhatsApp,enabled continuous peer support and knowledge exchange.The project spanned eight monthly 90-minute videoconferences via Zoom,incorporating online group mentoring and a virtual jigsaw exercise.Results:The collaboration resulted in the development of a competency-based,simulation-enhanced small incision cataract surgery curriculum structured around the Ophthalmic Simulated Surgical Competency Assessment Rubric(Sim-OSSCAR).The curriculum followed Kern’s six-step framework and was organized into four modular components covering the full range of surgical steps.The vCoP emerged as a key platform for sustained faculty development,collaborative problem-solving,and shared expertise,enhancing institutional capacity within the NOS.Participants anecdotally reported increased confidence in curriculum design,strengthened mentoring relationships,and greater engagement through active learning methodologies.The model demonstrated scalability and adaptability,indicating potential for broader application across other medical specialties and contexts.Conclusions:This study highlights the transformative potential of combining design thinking,active and social learning strategies,and digital tools in HPE.By fostering equitable,structured international collaborations,this approach supports sustainable faculty development and contextually relevant educational innovation.The creation of a dynamic vCoP was instrumental in promoting shared ownership and collaboration,ultimately advancing competency-based,simulation-enhanced training in ophthalmology.These findings suggest similar team-based,technology-enabled strategies could strengthen training and patient care in other underserved settings and with other disciplines.
基金Supported by the National Natural Science Foundation of China(No.82201195).
文摘AIM:To evaluate the potential of artificial intelligence(AI)for automating corneal topography interpretation in orthokeratology patients,aiming to enhance diagnostic precision,efficiency,and clinical decision-making in myopia management.METHODS:The 1469 corneal topography images from 582 eyes of 326 myopic children treated with orthokeratology lenses over 47mo were collected.Each sample was categorized by decentration,treatment zone size,shape variation,and eye laterality.A multi-task AI model was developed to predict these parameters,with performance measured using area under curve(AUC),accuracy,and F1 scores.We compared AI-only,humanonly,and combined Human+AI approaches on a subset of 100 images.External validation with images from additional hospitals tested model generalizability.RESULTS:The model achieved high accuracy in eyeside prediction(AUC 0.95)and AUC values of 0.52-0.74 for decentration,treatment zone,and shape variation tasks.The combined Human+AI method outperformed AI-only and human-only approaches,achieving the highest accuracy(up to 87%)and fastest processing time(80ms).External validation confirmed robust performance in simple tasks,though accuracy was lower for complex classifications due to imaging variations.CONCLUSION:AI provides efficient routine corneal topography assessments,while complex cases benefit most from a Human+AI approach,particularly in scenarios requiring nuanced clinical interpretation.The model currently functions as an assistive tool.
文摘AIM:To evaluate the refractive and long-term outcome of eyes filled with silicone oil(SO)undergoing phacoemulsification cataract surgery(PCS).METHODS:This retrospective study evaluated patients with SO tamponade who were scheduled for PCS.RESULTS:Subjects(n=26)were followed for 29.5±13.9 mo after cataract surgery.The median spherical equivalent refraction(SER)was+5.3 D[interquartile range(IQR)+2.9 to+6.7]before PCS,and+3.4 D(IQR+2.0 to+4.4)after PCS.Within the follow-up period retinal reattachment after SO removal was achieved in 15 out of 26 eyes(57.7%).In 13 eyes assessment of refraction after SO-removal was possible,and showed a myopic shift of-4.6 D(IQR-2.9 to-7.3)in the SER.After SO removal,5 of the 13 eyes(38.5%)were within±1.0 D of the target refraction,while 9 out of the 13 eyes(69.2%)were within±2.0 D.CONCLUSION:In our study,the refraction after PCS for eyes filled with SO manifested low predictability,as did the myopic shift following SO removal.A significant percentage of the eyes that underwent SO administration required a long-term tamponade.
文摘Father Waclaw Szuniewicz(1891-1963) was a skilled ophthalmic surgeon, missionary, and teacher. For several years he worked in China, afterwards in the United States and in Brazil. The aim of the paper is to present the unanalyzed issues of Szuniewicz’s research regarding corneal refractive surgery. Szuniewicz performed experiments on changing the corneal curvature with anterior, posterior and full-thickness incisions. The results of modifying the anterior and posterior corneal curvature were satisfactory, however, diminished significantly within months after surgery. Corneal band resections were superior in terms of efficacy, however, such an intervention commonly led to complications in animal studies. Szuniewicz’s work was not published during his life. Nevertheless, as a result of strong impact of his personality and ideas, he is frequently considered as a pioneer of corneal refractive surgery.
文摘December 2013Dear Xiuwen,Thank you.Your generous support of the ICOFoundation this past year helped the International Council of Ophthalmology(ICO)enhance ophthalmic education,which will ultimately help reduce avoidable vision loss around the world.You have set an admirable example for others to follow.As President of the ICO and a proud representative of the ICOFoundation,I am very pleased to thank you again for your gift and to tell you what you and other donors have enabled us to do this year:
文摘Background:Enhanced depth-of-focus intraocular lenses(EDOF IOL)have filled the gap between monofocal and multifocal intraocular implants with optical qualities of monofocal lenses and usually minor dysphotopsias typical for multifocal lenses.The purpose of this study was to evaluate visual outcomes after bilateral implantation of a new EDOF IOL in patients with requirements for perfect near and intermediate vision.Methods:The study included 15 patients(29 eyes as one was amblyopic)with bilateral implantation of LUXSMART EDOF IOL(Bausch&Lomb)with a targeted myopia(between-0.25 and-0.50D)in both eyes.Monocular corrected and uncorrected visual acuity for far,intermediate and near as well as refractive outcomes were evaluated at 1,3,6 and 12 months after the surgery.Additionally,binocular visual acuity,contrast sensitivity and defocus curve were measured at the final follow-up visit.At 12 months’visit patients completed a questionnaire evaluating patient satisfaction,spectacle independence and presence of dysphotopsias.Results:Binocular uncorrected visual acuities at 12 month’s visit were 0.13±0.16,0.06±0.08,0.07±0.09 and 0.15±0.09 logMAR for far distance,80 cm,66 cm and 40 cm respectively.Corrected binocular visual acuities at 12 months were 0.00±0.00,0.05±0.07,0.05±0.06,0.13±0.16 respectively for distance,80 cm,66 cm and 40 cm.Automated refraction spherical equivalent at 12 months’visit stood at-0.70±0.48D,which was 0.46D less than calculated biometric target,however spherical equivalent of subjective refraction at 12 months equaled–0.49±0.46D,which was closer to preoperative biometric target.Defocus curve had gentle shape without peaks typical for monofocal IOLs.Binocular contrast sensitivity results were superior to average results for that age group and equaled 1.78±0.16 logMAR without correction and 1.81±0.13 logMAR with correction.Spectacle independence for near and intermediate distances was achieved in all patients and for far distance in 73.3%of patients.Burdensome dysphotopsias were not reported in any case.Conclusions:EDOF IOLs targeted bilaterally at low myopia can provide excellent near and intermediate visual acuity and independence of any optical correction in majority of cases.This approach can be used in selected patients who are focused on stationary activities.
基金supported by Natural Science Foundation of China(grant number 82201195)Clinical Medical Research Center for Eye Diseases of Zhejiang Province(grant number 2021E50007).
文摘Background:The convergence of smartphone technology and artificial intelligence(AI)has revolutionized the landscape of ophthalmic care,offering unprecedented opportunities for diagnosis,monitoring,and management of ocular conditions.Nevertheless,there is a lack of systematic studies on discussing the integration of smart-phone and AI in this field.Main text:This review includes 52 studies,and explores the integration of smartphones and AI in ophthalmology,delineating its collective impact on screening methodologies,disease detection,telemedicine initiatives,and patient management.The collective findings from the curated studies indicate promising performance of the smartphone-based AI screening for various ocular diseases which encompass major retinal diseases,glaucoma,cataract,visual impairment in children and ocular surface diseases.Moreover,the utilization of smartphone-based imaging modalities,coupled with AI algorithms,is able to provide timely,efficient and cost-effective screening for ocular pathologies.This modality can also facilitate patient self-monitoring,remote patient monitoring and enhancing accessibility to eye care services,particularly in underserved regions.Challenges involving data pri-vacy,algorithm validation,regulatory frameworks and issues of trust are still need to be addressed.Furthermore,evaluation on real-world implementation is imperative as well,and real-world prospective studies are currently lacking.Conclusions:Smartphone ocular imaging merged with AI enables earlier,precise diagnoses,personalized treat-ments,and enhanced service accessibility in eye care.Collaboration is crucial to navigate ethical and data security challenges while responsibly leveraging these innovations,promising a potential revolution in care access and global eye health equity.
基金approved by the local bioethics committee of Okrę-gowa Izba Lekarska w Gdansku(approval no.KB-35/23)on August 16,2023 and conducted according to the guidelines of the Declaration of Helsinki.
文摘Purpose:Subthreshold micropulse laser(SML)and photodynamic therapy(PDT)are among the most effective therapeutic modalities applied to central serous chorioretinopathy(CSCR).This study aimed to evaluate the ef-ficacy and durability of PDT in CSCR cases unresponsive to at least two SML treatments.Methods:The study included 26 consecutive eyes of 24 patients(21 males and three females)with chronic CSCR.In all cases,a lack of reduction in subretinal fluid(SRF)levels was noted after at least two consecutive SML sessions.The parameters of best corrected visual acuity(BCVA)and spectral domain optical coherence tomog-raphy(SD-OCT)were evaluated at baseline and 1,3 and 12 months post-PDT.Results:The mean duration of symptoms in the group was 53.81±39.48 months,the mean age of the patients was 49.26±12.91 years,and the mean subfoveal choroidal thickness(SFCT)was 572.11±116.21 mm.Complete resorption of SRF was observed in 21 out of 26 eyes(80.77%)at 1 month and sustained in 18 cases(69.23%)at 12 months.At 12 months,in the sustained group,BCVA improved significantly from 0.39±0.18 to 0.19±0.2 logMAR(P=0.01),central subfoveal thickness(CST)reduced from 316.44±75.83 mm to 197.67±22.99 mm(P<0.0001),and SFCT reduced from 579.28 mm to 446.78 mm(P<0.0001).Conclusions:PDT provides the opportunity for the successful treatment of CSCR unresponsive to SML treatment.Improvements are possible even in cases with a long duration of symptoms and significant alterations in retinal morphology.Thus,PDT should be considered for patients with prominently increased choroidal thickness.
文摘1.Introduction Ophthalmology focuses on relating structural changes to function and disease.From biomicroscopy,ophthalmoscopy and fundus photography,to electroretinography and visual evoked potentials the clinical purpose is to objectively assess visual function.However,these techniques are macroscopic and only grossly related to visual acuity.With the development of optical coherence tomography(OCT)in vivo histological resolution of the retina has become routine.
