Research In Ophthalmology Research Articles

The Agreement of Intraocular Pressure Measurement in Healthy Merinos Sheep Using Rebound Tonometer (Tonovet®) and Applanation Tonometer (Tono-Pen VetTM)

The assessment of intraocular pressure (IOP) holds significant importance in ophthalmology as a crucial diagnostic tool for various ocular disorders. In the realm of comparative ophthalmology research, investigating ocular examination in sheep, particularly Merinos, is of considerable interest. This study aimed to evaluate the agreement between rebound (TonoVet®, TV) and applanation (Tono-Pen Vet™, TPV) tonometers in measuring IOP in healthy Merino sheep. 155 healthy Merinos (80 males, 75 females) with a mean weight of 54.4 ± 8.7 kg, aged 24 ± 6 months, were included in the study. IOP was measured between 9:00 and 11:00 am using both the rebound and applanation tonometers. The rebound tonometer was utilized first, followed by the applanation tonometer. A total of 620 readings (310 readings per eye) were obtained from the two devices. No statistical differences were noted between the mean IOP measurements of the right and left eyes for both tonometers (P > 0.05). However, there was a significant difference in the mean IOP measurements between the TV (11.8 ± 2.3 mmHg) and the TPV (13.9 ± 2.9 mmHg) tonometers (P < 0.001). The concordance correlation coefficient indicated weak agreement strength (ρc = 0.319, CI 95% = -0.169 to 0.455) between the TV and TPV. The mean difference in bias and the 95% limits of agreement for the differences between TV and TPV were -2.1 mmHg (-9.0 to 3.5 mmHg). The regression equation derived from a Bland-Altman plot, describing the relationship between the two tonometers, was Y = 1.43 - 0.33X (Y = TV and X = TPV). In conclusion, the TPV measured higher IOP values compared to the TV, and due to the significant bias and limits of agreement, the two tonometers should not be used interchangeably for IOP measurement in Merino sheep.

Vision language models in ophthalmology.

Vision Language Models are an emerging paradigm in artificial intelligence that offers the potential to natively analyze both image and textual data simultaneously, within a single model. The fusion of these two modalities is of particular relevance to ophthalmology, which has historically involved specialized imaging techniques such as angiography, optical coherence tomography, and fundus photography, while also interfacing with electronic health records that include free text descriptions. This review then surveys the fast-evolving field of Vision Language Models as they apply to current ophthalmologic research and practice. Although models incorporating both image and text data have a long provenance in ophthalmology, effective multimodal Vision Language Models are a recent development exploiting advances in technologies such as transformer and autoencoder models. Vision Language Models offer the potential to assist and streamline the existing clinical workflow in ophthalmology, whether previsit, during, or post-visit. There are, however, also important challenges to be overcome, particularly regarding patient privacy and explainability of model recommendations.

Research Trends and Hotspots of Big Data in Ophthalmology: A Bibliometric Analysis and Visualization

ABSTRACT Purpose The burst of modern information has significantly promoted the development of global medicine into a new era of big data healthcare. Ophthalmology is one of the most prominent medical specialties driven by big data analytics. This study aimed to describe the development status and research hotspots of big data in ophthalmology. Methods English articles and reviews related to big data in ophthalmology published from January 1, 1999, to April 30, 2024, were retrieved from the Web of Science Core Collection. The relevant information was analyzed and visualized using VOSviewer and CiteSpace software. Results A total of 406 qualified documents were included in the analysis. The annual number of publications on big data in ophthalmology reached a rapidly increasing stage since 2019. The United States (n = 147) led in the number of publications, followed by India (n = 77) and China (n = 69). The L.V. Prasad Eye Institute in India was the most productive institution (n = 50), and Anthony Vipin Das was the most influential author with the most relevant literature (n = 45). The electronic medical records were the primary source of ophthalmic big data, and artificial intelligence served as the principal analytics tool. Diabetic retinopathy, glaucoma, and myopia are currently the main topics of interest in this field. Conclusions The application of big data in ophthalmology has experienced rapid growth in recent years. Big data is expected to play an increasingly significant role in shaping the future of research and clinical practice in ophthalmology.

Advances and prospects of multi-modal ophthalmic artificial intelligence based on deep learning: a review.

In recent years, ophthalmology has emerged as a new frontier in medical artificial intelligence (AI) with multi-modal AI in ophthalmology garnering significant attention across interdisciplinary research. This integration of various types and data models holds paramount importance as it enables the provision of detailed and precise information for diagnosing eye and vision diseases. By leveraging multi-modal ophthalmology AI techniques, clinicians can enhance the accuracy and efficiency of diagnoses, and thus reduce the risks associated with misdiagnosis and oversight while also enabling more precise management of eye and vision health. However, the widespread adoption of multi-modal ophthalmology poses significant challenges. In this review, we first summarize comprehensively the concept of modalities in the field of ophthalmology, the forms of fusion between modalities, and the progress of multi-modal ophthalmic AI technology. Finally, we discuss the challenges of current multi-modal AI technology applications in ophthalmology and future feasible research directions. In the field of ophthalmic AI, evidence suggests that when utilizing multi-modal data, deep learning-based multi-modal AI technology exhibits excellent diagnostic efficacy in assisting the diagnosis of various ophthalmic diseases. Particularly, in the current era marked by the proliferation of large-scale models, multi-modal techniques represent the most promising and advantageous solution for addressing the diagnosis of various ophthalmic diseases from a comprehensive perspective. However, it must be acknowledged that there are still numerous challenges associated with the application of multi-modal techniques in ophthalmic AI before they can be effectively employed in the clinical setting.

Review of emerging trends and projection of future developments in large language models research in ophthalmology

BackgroundLarge language models (LLMs) are fast emerging as potent tools in healthcare, including ophthalmology. This systematic review offers a twofold contribution: it summarises current trends in ophthalmology-related LLM research and...

A comprehensive dataset of pattern electroretinograms for ocular electrophysiology research

The Pattern Electroretinogram (PERG) is an essential tool in ophthalmic electrophysiology, providing an objective assessment of the central retinal function. It quantifies the activity of cells in the macula and the ganglion cells of the retina, assisting in the differentiation of macular and optic nerve conditions. In this study, we present the IOBA-PERG dataset, an extensive collection of 1354 transient PERG responses accessible on the PhysioNet repository. These recordings were conducted at the Institute of Applied Ophthalmobiology (IOBA) at University of Valladolid, over an extended period spanning nearly two decades, from 2003 to 2022. The dataset includes 336 records, ensuring at least one PERG signal per eye. The dataset thoughtfully includes demographic and clinical data, comprising information such as age, gender, visual acuity measurements, and expert diagnoses. This comprehensive dataset fills a gap in ocular electrophysiological repositories, enhancing ophthalmology research. Researchers can explore a broad range of eye-related conditions and diseases, leading to enhanced diagnostic accuracy, innovative treatment strategies, methodological advancements, and a deeper understanding of ocular electrophysiology.

Preserving Brilliance: Uniting Against Plagiarism in Ophthalmology Research

Preserving Brilliance: Uniting Against Plagiarism in Ophthalmology Research

Assessment of Missing Data on Glaucoma Severity among Participants in the NIH All of Us Research Program of the United States.

There were statistically significant differences across multiple socioeconomic characteristics and self-reported barriers to care among primary glaucoma patients with severity staging data versus those missing this data in the NIH All of Us database. To characterize missing data among glaucoma patients within All of Us. We used diagnosis codes to define cohorts of primary glaucoma patients with and without severity staging specified. Descriptive analyses were conducted by presence of disease severity stage. Analysis of missing data was conducted using a set intersection plot and Little's Test of Missing Completely at Random. T-tests were performed to evaluate differences. Of 2982 participants, 1714 (57%) did not have glaucoma severity stage specified, and 11 of 23 analyzed variables had missing data. Little's Test indicated data was not missing completely at random (P<0.001). Significant differences existed between the two cohorts with respect to age, age of first glaucoma diagnosis, gender, ethnicity, education, income, insurance, history of glaucoma surgery and medication use, and answers regarding ability to afford eyeglasses and having seen an eye care provider in the last 12 months (all P values≤0.01). There were significant differences between glaucoma participants with glaucoma severity stage specified versus those with unstaged disease across multiple socioeconomic characteristics and self-reported barriers to care. Glaucoma severity staging data was not missing completely at random. The unstaged cohort included higher rates of multiple underrepresented communities, which may potentially contribute to bias in ophthalmology research as participants from vulnerable populations may be disproportionately excluded from electronic health records or claims data studies where diagnosis codes with severity/staging levels are used to examine risk factors for disease, progression, and treatment efficacy.

Ophthalmological Disorders and Laboratory and Clinical Indicators in Women with Hypertensive Pregnancy Complications

Introduction. Hypertensive disorders during pregnancy, despite many epidemiological studies, scientific developments, and the improvement of laboratory and instrumental techniques for searching for predictors of preeclampsia, are a serious problem of perinatal obstetrics. One of these areas may be an in-depth ophthalmological examination.The aim of the work is to perform an analysis of ophthalmological disorders and laboratory, clinical parameters in women with hypertensive complications of pregnancy.Materials and methods. A retrospective analysis of 573 cases of hypertensive pregnancy complications was performed. The age of the patients ranged from 15 to 50 years. All patients received a standard general clinical and obstetric examination, examined by an ophthalmologist. A correlation analysis of some laboratory and clinical signs of arterial hypertension (AH) and preeclampsia (PE), including ophthalmological signs of PE, was carried out. Results: PE was accompanied by retinal angiopathy in 67 % of cases. In 9 cases (1.86 %), peripapillary edema was detected in PE. In the presence of peripapillary edema, earlier delivery dates and a lower Apgar score were observed in the newborn. Macular edema was registered in 3 cases (0.62 %) against the background of gestational diabetes mellitus.Conclusion. Comparative analysis has shown the presence of correlations between signs of hypertensive complications of pregnancy and changes in the organ of vision. The expansion of ophthalmological research may provide new markers-indicators for the differential diagnosis of hypertensive complications of pregnancy, assessment of the severity of the condition, dynamic monitoring and choice of management tactics for patients with hypertensive complications of pregnancy.

Subpixel motion artifacts correction and motion estimation for 3D-OCT.

A number of hardware-based and software-based strategies have been suggested to eliminate motion artifacts for improvement of 3D-optical coherence tomography (OCT) image quality. However, the hardware-based strategies have to employ additional hardware to record motion compensation information. Many software-based strategies have to need additional scanning for motion correction at the expense of longer acquisition time. To address this issue, we propose a motion artifacts correction and motion estimation method for OCT volumetric imaging of anterior segment, without requirements of additional hardware and redundant scanning. The motion correction effect with subpixel accuracy for in vivo 3D-OCT has been demonstrated in experiments. Moreover, the physiological information of imaging object, including respiratory curve and respiratory rate, has been experimentally extracted using the proposed method. The proposed method offers a powerful tool for scientific research and clinical diagnosis in ophthalmology and may be further extended for other biomedical volumetric imaging applications.

Geographical Trends in Global Ophthalmology Research from 2002-2022

PurposeCharacterize geographical trends in ophthalmology research between 2002-2022 and explore associations between study locations, designs, and funding sources DesignTrend study MethodsAnalysis of 4199 publications from American Journal of Ophthalmology, British Journal of Ophthalmology, Investigative Ophthalmology and Visual Science, JAMA Ophthalmology, and Ophthalmology. All original full-length publications from 2002, 2012, and 2022 were included. Exclusion criteria were meta-analyses, literature reviews, and case reports. Main outcome measures were publication years, locations, study designs, and funding sources. ResultsPublications from North America (45.8%), Europe (30.7%), and Asia (28.9%) were the most common, whereas Africa (0.8%) and South America (1.4%) were least represented. North American research decreased by 10.6% (p < 0.001), whereas Asian research increased by 25.4% (p < 0.001). The USA contributed 42.3% of research but experienced a 11.3% decline from 2002-2022 (p < 0.001). USA publications received 5.8% more industry funding from 2002-2022 (p = 0.006). China's research grew by 17.0% and had the highest proportion of government (83.1%) or intramural (24.2%) funding (p < 0.001), with government-funded studies increasing by 46.7% (p < 0.001). Japan was less associated with all funding types (p ≤ 0.001). Singapore, Iceland, and Switzerland were top performers when adjusted for population size. ConclusionsWithin the examined journals, the USA remains the primary research contributor, with China witnessing rapid growth and Japan facing stagnation. Despite the USA's declining research proportion, North America and Europe continue to maintain a disproportionately high presence in prestigious academic journals. Publications from Africa and South America are limited.

Ophthalmological research in Germany: suggestions by an international expert panel.

To evaluate the research performance in ophthalmology in Germany based on the findings of the recent research map of the German Ophthalmological Society (DOG) and to suggest strategies for future improvements on anational level both to DOG as well as to politics. The focus is on preclinical and translational clinical research. International expert panel evaluation and discussion organized by the Task Force Research of the German Ophthalmological Society (DOG). The international view on the German ophthalmological research landscape was generally positive. The value for money relationship was judged as very good. As Germany is facing an aging society and vision impairment will create an ever-increasing socioeconomic burden, the reviewers suggested several lines of future activities: an increased activity of securing intellectual property, more lay audience lobbying, intensified collaboration and critical mass building between "lighthouses" of ophthalmic research in Germany, as well as the establishment of aGerman national eye institute equivalent. The ophthalmological research performance in Germany was rated to be very good by an international expert panel. Nonetheless significant improvements were requested in the fields of translation (clinical trials, IP), synergy between specialized institutions and governmental funding for aGerman center for eye research.

Ryzumvi: pioneering advances in countering drug-induced mydriasis

This article discusses the prevalence and impact of pharmacologically-induced mydriasis, a condition where the pupil becomes excessively dilated due to certain drugs. It highlights the challenges faced by medical professionals in dealing with this condition and the limitations of current treatments, like pilocarpine and dapiprazole, which come with systemic side effects and specific contraindications, limiting their regular use. The article introduces Ryzumvi, a novel ophthalmic solution approved by the US FDA, which effectively reverses mydriasis caused by adrenergic agonists and antimuscarinic drugs. The article provides insights into its mechanism of action, clinical efficacy, pharmacokinetics, safety, and tolerance based on extensive clinical trials. It emphasizes its rapid onset of action and effectiveness in restoring pupils to their initial size. It also underlines the potential for expanded applications, including in pediatric patients, solidifying its importance in the field of ophthalmology. Furthermore, Ryzumvi represents a promising advancement in managing pharmacologically-induced mydriasis, offering swift and effective relief while highlighting the importance of adhering to safety precautions and the continuous research and development efforts in ophthalmology to comprehensively address vision-related disorders and enhance patient outcomes.

Implementation and Execution of Big Data-based Studies in Ophthalmology within the Framework of the GDPR.

The processing of the retrospective data pool for ophthalmology holds huge potential, especially for the research sector. "Big Data" enables medical science to draw conclusions for the future from historical data. Based on the evaluation of such data, algorithms could be trained, for instance, that are capable of making decisions with the help of artificial intelligence. As a result, the medical decision-making process on certain issues could be accelerated, enriched in qualitative and quantitative terms, or even completely be taken over. Ophthalmology is a rapidly evolving field. Due to the multitude of partly automated medical imaging technologies and the predestined accessibility of the eye for such technologies, ophthalmology, similarly to radiology or dermatology, is well suited for artificial intelligence-assisted image data analysis and the frequently associated initiation of diagnosis and therapy. Meanwhile, numerous studies exist based on AI-assisted image data analysis of ophthalmological image data. To the extent that the algorithms filter out results from the data pools by means of calculation rules and are even capable of making independent decisions on the basis of decision trees, the enormous benefit and, simultaneously, the profit for scientific research is quite obvious. Accordingly, it would be desirable to have unrestricted and comprehensive possibility of corresponding data processing of these health data for ophthalmological research. In spite of the potential for ophthalmology, for which there is only fragmentary evidence, the question of practical feasibility arises. In particular, the legal requirements and limits of European and national data protection law must be taken into account, prior to any unreflected processing of personal (health) data. Only by doing so can we circumvent existing obstacles and pitfalls, which can lead to severe fines. Most important are to date the requirements of two legal texts: The General Data Protection Regulation (GDPR) and the Federal Data Protection Act (BDSG). This article provides an overview of the relevant legal requirements applicable in the field of ophthalmology and highlights the major pitfalls and implementation requirements.

The UK clinical eye research strategy: refreshing research priorities for clinical eye research in the UK

ObjectivesTo validate and update the 2013 James Lind Alliance (JLA) Sight Loss and Vision Priority Setting Partnership (PSP)’s research priorities for Ophthalmology, as part of the UK Clinical Eye Research Strategy.MethodsTwelve ophthalmology research themes were identified from the JLA report. They were allocated to five Clinical Study Groups of diverse stakeholders who reviewed the top 10 research priorities for each theme. Using an online survey (April 2021-February 2023), respondents were invited to complete one or more of nine subspecialty surveys. Respondents indicated which of the research questions they considered important and subsequently ranked them.ResultsIn total, 2240 people responded to the survey (mean age, 59.3 years), from across the UK. 68.1% were female. 68.2% were patients, 22.3% healthcare professionals or vision researchers, 7.1% carers, and 2.1% were charity support workers. Highest ranked questions by subspecialty: Cataract (prevention), Cornea (improving microbial keratitis treatment), Optometric (impact of integration of ophthalmic primary and secondary care via community optometric care pathways), Refractive (factors influencing development and/or progression of refractive error), Childhood onset (improving early detection of visual disorders), Glaucoma (effective and improved treatments), Neuro-ophthalmology (improvements in prevention, diagnosis and treatment of neurodegeneration affecting vision), Retina (improving prevention, diagnosis and treatment of dry age-related macular degeneration), Uveitis (effective treatments for ocular and orbital inflammatory diseases).ConclusionsA decade after the initial PSP, the results refocus the most important research questions for each subspecialty, and prime targeted research proposals within Ophthalmology, a chronically underfunded specialty given the substantial burden of disability caused by eye disease.

Ophthalmological research in Germany: evaluation by an international expert panel

To evaluate the research performance in ophthalmology in Germany based on the findings of the recent research map of the German Ophthalmological Society ( DOG) and to suggest strategies for future improvements on anational level both to DOG as well as to politics. The focus is on preclinical and translational clinical research. International expert panel evaluation and discussion organized by the Task Force Research of the German Ophthalmological Society (DOG). The international view on the German ophthalmological research landscape was generally positive. The value for money relationship was judged as very good. As Germany is facing an aging society and vision impairment will create an ever-increasing socioeconomic burden, the reviewers suggested several lines of future activities: an increased activity of securing intellectual property, more lay audience lobbying, intensified collaboration and critical mass building between "lighthouses" of ophthalmic research in Germany, as well as the establishment of aGerman national eye institute equivalent. The ophthalmological research performance in Germany was rated to be very good by an international expert panel. Nonetheless significant improvements were requested in the fields of translation (clinical trials, IP), synergy between specialized institutions and governmental funding for aGerman center for eye research.

Isolation of Primary Porcine Retinal Pigment Epithelial Cells for In Vitro Modeling.

The retinal pigment epithelium (RPE) is a crucial monolayer in the outer retina responsible for supporting photoreceptors. RPE degeneration commonly occurs in diseases marked by progressive vision loss, such as age-related macular degeneration (AMD). Research on AMD often relies on human donor eyes or induced pluripotent stem cells (iPSCs) to represent the RPE. However, these RPE sources require extended differentiation periods and substantial expertise for culturing. Additionally, some research institutions, particularly those in rural areas, lack easy access to donor eyes. While a commercially available immortalized RPE cell line (ARPE-19) exists, it lacks essential in vivo RPE features and is not widely accepted in many ophthalmology research publications. There is a pressing need to obtain representative primary RPE cells from a more readily available and cost-effective source. This protocol elucidates the isolation and subculture of primary RPE cells obtained post-mortem from porcine eyes, which can be sourced locally from commercial or academic suppliers. This protocol necessitates common materials typically found in tissue culture labs. The result is a primary, differentiated, and cost-effective alternative to iPSCs, human donor eyes, and ARPE-19 cells.

Academic Productivity in Ophthalmology and Its Correlation to National Economic Indicators Among the OECD Countries: A Bibliometric Analysis

ABSTRACT Purpose Prompted by the clinical concern that limited healthcare resources allocation affects physicians’ research productivity, this study examines the association between bibliometric indices of ophthalmologic research and national economic indicators in Organisation for Economic Co-operation and Development (OECD) countries. Methods The Scimago Journal and Country rank source was searched for research productivity data in ophthalmology among OECD countries between 1996 and 2019. Bibliometric indices included: documents number, number and percent of citable documents, citations number, citations per document, and H-index. The updated economic indicators of each country (gross domestic product [GDP] per capita, health spending as percent of GDP (health expenditure), gross domestic expenditure on research, and development as percent of GDP [GERD]) were collected from the World Bank and the OECD websites. Correlation between economic and bibliometric metrics and multivariate linear regression analyses were performed. Results Among 267,444 documents analyzed, correlation analysis found a strong correlation between health expenditure and H index (r = 0.711, p < 0.001); a moderate correlation between health expenditure and documents number (r = 0.589, p < 0.001), number of citable document (r = 0.593, p < 0.001) and citations number (r = 0.673, p < 0.001); and a moderate correlation between GERD and H index (r = 0.564, p < 0.001). Multivariate regression analysis controlling for economic factors, population and language showed the independent association of these parameters with bibliometric indices. Conclusions This study demonstrates a positive correlation between bibliometric indicators of ophthalmology research and economic factors, particularly health expenditure, among the OECD countries. Our results suggest an advantage of domestic investment in health to expand academic productivity in the field of ophthalmology.

Advances in aqueous humor proteomics for biomarker discovery and disease mechanisms exploration: a spotlight on primary open angle glaucoma.

Altered protein levels in the aqueous humor (AH) may be a valuable source of novel biomarkers in neurodegenerative retinal disease. The proximity of this body fluid to the disease focus, and its corresponding enrichment for tissue specific proteins, renders it an excellent matrix to study underlying molecular mechanisms. Novel proteomic methods accordingly hold large potential for insight into pathologies based on the composition of the AH proteome, including primary open angle glaucoma (POAG). Recent mass spectrometry-based studies use novel approaches to tackle the challenges arising from the combination of low available sample volume and protein concentration, thereby increasing proteome coverage. But despite significant improvements in mass spectrometry (MS), a different class of proteomic technologies is poised to majorly impact the analysis of ocular biofluids. Affinity proteomic workflows, having become available commercially recently, have started to complement data obtained by MS and likely will grow into a crucial tool for ophthalmological biomarker research. This review highlights corresponding approaches in proteome analysis of aqueous humor and discusses recent findings on alterations of the AH proteome in POAG.

A Look into Ocular Diseases: The Pivotal Role of Omics Sciences in Ophthalmology Research.

Precision medicine is a new medical approach which considers both population characteristics and individual variability to provide customized healthcare. The transition from traditional reactive medicine to personalized medicine is based on a biomarker-driven process and a deep knowledge of biological mechanisms according to which the development of diseases occurs. In this context, the advancements in high-throughput omics technologies represent a unique opportunity to discover novel biomarkers and to provide an unbiased picture of the biological system. One of the medical fields in which omics science has started to be recently applied is that of ophthalmology. Ocular diseases are very common, and some of them could be highly disabling, thus leading to vision loss and blindness. The pathogenic mechanism of most ocular diseases may be dependent on various genetic and environmental factors, whose effect has not been yet completely understood. In this context, large-scale omics approaches are fundamental to have a comprehensive evaluation of the whole system and represent an essential tool for the development of novel therapies. This Review summarizes the recent advancements in omics science applied to ophthalmology in the last ten years, in particular by focusing on proteomics, metabolomics and lipidomics applications from an analytical perspective. The role of high-efficiency separation techniques coupled to (high-resolution) mass spectrometry ((HR)MS) is also discussed, as well as the impact of sampling, sample preparation and data analysis as integrating parts of the analytical workflow.