An eyecare foundation model for clinical assistance: a randomized controlled trial.

In the context of an increasing need for clinical assessments of foundation models, we developed EyeFM, a multimodal vision-language eyecare copilot, and conducted a multifaceted evaluation, including retrospective validations, multicountry efficacy validation as a clinical copilot and a double-masked randomized controlled trial (RCT). EyeFM was pretrained on 14.5 million ocular images from five imaging modalities paired with clinical texts from global, multiethnic datasets.

SD-OCT-based biomarkers in predicting treatment outcomes of macular oedema secondary to retinal vein occlusion treated with anti-VEGF therapy.

Purpose: To investigate the role of spectral domain optical coherence tomography (SD-OCT)-based biomarkers in predicting treatment response of macular oedema (MO) secondary to retinal vein occlusion (RVO) to anti-vascular endothelial growth factor (VEGF) therapy.

Methods: Retrospective cohort study including consecutive cases of RVO associated MO who received anti-VEGF injections between January 2020 and April 2021. LogMAR visual acuity (VA) at baseline, 12 and 24 months was correlated with a panel of SD-OCT-based biomarkers, including vitreomacular status, size of intra-retinal cysts (IRC), presence of disorganization of retinal inner layers (DRIL), hyper-reflective foci (HRF) in the retina, integrity of the external limiting membrane (ELM), ellipsoid zone (EZ), cone outer segment tip (COST) and presence of subretinal fluid (SRF).

Risk Factors for Visual Field Progression in Primary Angle Closure Disease Over 10 Years: The CUPAL Study.

Purpose: To identify associated long-term risk factors of visual field (VF) progression among eyes of primary angle-closure disease (PACD), including primary angle-closure suspect (PACS), primary angle-closure (PAC), and primary angle-closure glaucoma (PACG).

Methods: PACD eyes with at least a 10-year follow-up duration were included. VF was tested every 6 months using the 24-2 pattern standard on the Humphrey Field Analyzer.

Indirect clinical validation for predictive biomarkers in oncology: International Quality Network for Pathology (IQN Path) Position Paper.

Validation of biomarker assays is mandatory not only for their applications in clinical trials but also for their subsequent transfer to clinical laboratories in routine clinical care. There are two critical components relevant to their transfer to clinical practice: regulatory oversight and methodology transfer. Both aspects are simplified where companion diagnostic (CDx) assays relevant to a given indication are being implemented in clinical laboratories.

Evaluation and comparison of large language models' responses to questions related optic neuritis.

Objectives: Large language models (LLMs) show promise as clinical consultation tools and may assist optic neuritis patients, though research on their performance in this area is limited. Our study aims to assess and compare the performance of four commonly used LLM-Chatbots-Claude-2, ChatGPT-3.5, ChatGPT-4.

Enhancing diagnostic accuracy in rare and common fundus diseases with a knowledge-rich vision-language model.

Previous foundation models for fundus images were pre-trained with limited disease categories and knowledge base. Here we introduce RetiZero, a vision-language model that incorporates knowledge from over 400 fundus diseases. The model is pre-trained on 341,896 fundus images with accompanying text descriptions gathered from diverse sources across multiple ethnicities and countries.

The acceptance of ophthalmic artificial intelligence for eye diseases: a literature review and qualitative analysis.

Thorough investigations of end-users' awareness, acceptance, and concerns about ophthalmic artificial intelligence (AI) are essential to ensure its successful implementation. We conducted a literature review on the acceptance of ophthalmic AI to provide an overall insight and qualitatively analysed the quality of eligible studies using a psychological model. We identified sixteen studies and evaluated these studies based on four primary factors (i.

A deep learning system for detecting silent brain infarction and predicting stroke risk.

Current brain imaging to detect silent brain infarctions (SBIs) is not feasible for the general population. Here, to overcome this challenge, we developed a retinal image-based deep learning system, DeepRETStroke, to detect SBI and refine stroke risk. We use 895,640 retinal photographs to pretrain the DeepRETStroke system, which encodes a domain-specific foundation model for representing eye-brain connections.

Management of chronic-phase CML in later lines: a Hong Kong consensus recommendation.

Chronic myeloid leukemia (CML) usually requires long-term therapy with tyrosine kinase inhibitors (TKIs). While these agents have markedly advanced the clinical management and prognosis of CML, a subset of patients experience treatment resistance or suboptimal response, necessitating multiple lines of TKI therapy. Few treatment options exist for patients who are resistant or intolerant to first- and second-line therapies.

Association of Retinal Microvasculature With Myopia Progression in Children: The Hong Kong Children Eye Study.

Purpose: To investigate the associations between optical coherence tomography angiography (OCT-A) metrics and myopia progression in children.

Methods: This prospective, longitudinal cohort study recruited children ages 6 to 8 years for 2- to 6-year follow-ups. OCT-A captured macular images from the superficial capillary plexus (SCP) and deep capillary plexus (DCP).

AI image generation technology in ophthalmology: Use, misuse and future applications.

Background: AI-powered image generation technology holds the potential to reshape medical practice, yet it remains an unfamiliar technology for both medical researchers and clinicians alike. Given the adoption of this technology relies on clinician understanding and acceptance, we sought to demystify its use in ophthalmology. To this end, we present a literature review on image generation technology in ophthalmology, examining both its theoretical applications and future role in clinical practice.

Oculomics: Current concepts and evidence.

The eye provides novel insights into general health, as well as pathogenesis and development of systemic diseases. In the past decade, growing evidence has demonstrated that the eye's structure and function mirror multiple systemic health conditions, especially in cardiovascular diseases, neurodegenerative disorders, and kidney impairments. This has given rise to the field of oculomics-the application of ophthalmic biomarkers to understand mechanisms, detect and predict disease.

Retinal vascular changes are associated with PET-based biomarkers of Alzheimer's disease: A pilot study.

Background: Retina is a non-invasive channel for assessing changes in brain microvasculature, which has been implicated in the pathophysiology of Alzheimer's disease (AD). Previous studies revealed significant relationship between clinically diagnosed AD and retinal vasculature. However, clinical diagnosis has limited sensitivity and specificity, and those investigations were conducted from traditional retinal fundus photographs which only captured a narrow section of the fundus.

Unpaired Optical Coherence Tomography Angiography Image Super-Resolution via Frequency-Aware Inverse-Consistency GAN.

For optical coherence tomography angiography (OCTA) images, the limited scanning rate leads to a trade-off between field-of-view (FOV) and imaging resolution. Although larger FOV images may reveal more parafoveal vascular lesions, their application is hampered due to lower resolution. To increase the resolution, previous works only achieved satisfactory performance by using paired data for training, but real-world applications are limited by the challenge of collecting large-scale paired images.

Diagnostic accuracy and clinical outcomes of patients diagnosed with clear cell papillary renal cell tumour at renal mass biopsy.

Background: Clear cell papillary renal cell tumour (CCPRCT) is a clinically indolent neoplasm. The diagnosis of CCPRCT at renal mass biopsy (RMB) may facilitate conservative management; however, this can be challenging in small samples and there are limited data on the outcome of patients managed conservatively. This study aimed to: (1) evaluate concordance between RMB and nephrectomy for the diagnosis of CCPRCT, and (2) determine the clinical outcomes of patients with CCPRCT, particularly those who have undergone conservative management.

Large language models for diabetes training: a prospective study.

Diabetes poses a considerable global health challenge, with varying levels of diabetes knowledge among healthcare professionals, highlighting the importance of diabetes training. Large Language Models (LLMs) provide new insights into diabetes training, but their performance in diabetes-related queries remains uncertain, especially outside the English language like Chinese. We first evaluated the performance of ten LLMs: ChatGPT-3.

Relationship of OCT-Based Diabetic Retinal Neurodegeneration to the Development and Progression of Diabetic Retinopathy: A Cohort Study.

Purpose: To evaluate the relationship between diabetic retinal neurodegeneration (DRN), as quantified by optical coherence tomography (OCT), to the development of diabetic retinopathy (DR), progression of DR, and development of proliferative DR (PDR).

Methods: This was a prospective cohort study, including 385 eyes with no DR or nonproliferative DR at baseline. The thicknesses of the macular ganglion cell-inner plexiform layer (m-GCIPL), macular retinal nerve fiber layer, and peripapillary RNFL (p-RNFL) were measured using Cirrus OCT (Carl Zeiss Meditec, Dublin, CA, USA).

The evolution of diabetic retinopathy screening.

Diabetic retinopathy (DR) is a leading cause of preventable blindness and has emerged as a global health challenge, necessitating the development of robust management strategies. As DR prevalence continues to rise, advancements in screening methods have become increasingly critical for timely detection and intervention. This review examines three key advancements in DR screening: a shift from specialist to generalist approach, the adoption of telemedicine strategies for expanded access and enhanced efficiency, and the integration of artificial intelligence (AI).

Clinical Outcomes of Stage IIA/IIB Seminoma Treated With Radiation Therapy and Chemotherapy: Should Regional Therapy be Considered the Preferred Treatment Approach?

Purpose: The optimal management of patients with de novo clinical stage IIA/B (CSIIA/B) or relapsed CSIIA/B (Rel-CSIIA/B) seminoma remains debated because of a lack of randomized evidence. Here, we sought to evaluate outcomes after radiation therapy and chemotherapy in this setting.

Methods And Materials: A prospectively maintained single-institutional database was retrospectively queried for patients diagnosed between 1995 and 2016 with de novo or Rel-CSIIA/B.

Canadian Consensus Recommendations for Predictive Biomarker Testing in Gastric and Gastroesophageal Junction Adenocarcinoma.

Gastric cancer is common globally and has a generally poor prognosis with a low 5-year survival rate. Targeted therapies and immunotherapies have improved the treatment landscape, providing more options for efficacious treatment. The use of these therapies requires predictive biomarker testing to identify patients who can benefit from their use.

Effects of Physical Activity and Inactivity on Microvasculature in Children: The Hong Kong Children Eye Study.

Purpose: The purpose of this study was to investigate the effects of physical activity and inactivity on the microvasculature in children, as measured from retinal photographs.

Methods: All participants were from the Hong Kong Children Eye Study, a population-based cross-sectional study of children aged 6 to 8 years. They received comprehensive ophthalmic examinations and retinal photography.