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Article ; Online: Performance of ChatGPT on Ophthalmology-Related Questions Across Various Examination Levels: Observational Study.

Haddad, Firas / Saade, Joanna S

JMIR medical education

2024 Volume 10, Page(s) e50842

Abstract: Background: ChatGPT and language learning models have gained attention recently for their ability to answer questions on various examinations across various disciplines. The question of whether ChatGPT could be used to aid in medical education is yet to ...

Abstract	Background: ChatGPT and language learning models have gained attention recently for their ability to answer questions on various examinations across various disciplines. The question of whether ChatGPT could be used to aid in medical education is yet to be answered, particularly in the field of ophthalmology. Objective: The aim of this study is to assess the ability of ChatGPT-3.5 (GPT-3.5) and ChatGPT-4.0 (GPT-4.0) to answer ophthalmology-related questions across different levels of ophthalmology training. Methods: Questions from the United States Medical Licensing Examination (USMLE) steps 1 (n=44), 2 (n=60), and 3 (n=28) were extracted from AMBOSS, and 248 questions (64 easy, 122 medium, and 62 difficult questions) were extracted from the book, Ophthalmology Board Review Q&A, for the Ophthalmic Knowledge Assessment Program and the Board of Ophthalmology (OB) Written Qualifying Examination (WQE). Questions were prompted identically and inputted to GPT-3.5 and GPT-4.0. Results: GPT-3.5 achieved a total of 55% (n=210) of correct answers, while GPT-4.0 achieved a total of 70% (n=270) of correct answers. GPT-3.5 answered 75% (n=33) of questions correctly in USMLE step 1, 73.33% (n=44) in USMLE step 2, 60.71% (n=17) in USMLE step 3, and 46.77% (n=116) in the OB-WQE. GPT-4.0 answered 70.45% (n=31) of questions correctly in USMLE step 1, 90.32% (n=56) in USMLE step 2, 96.43% (n=27) in USMLE step 3, and 62.90% (n=156) in the OB-WQE. GPT-3.5 performed poorer as examination levels advanced (P<.001), while GPT-4.0 performed better on USMLE steps 2 and 3 and worse on USMLE step 1 and the OB-WQE (P<.001). The coefficient of correlation (r) between ChatGPT answering correctly and human users answering correctly was 0.21 (P=.01) for GPT-3.5 as compared to -0.31 (P<.001) for GPT-4.0. GPT-3.5 performed similarly across difficulty levels, while GPT-4.0 performed more poorly with an increase in the difficulty level. Both GPT models performed significantly better on certain topics than on others. Conclusions: ChatGPT is far from being considered a part of mainstream medical education. Future models with higher accuracy are needed for the platform to be effective in medical education.
MeSH term(s)	Humans ; Ophthalmology ; Books ; Education, Medical ; Eye ; Face
Language	English
Publishing date	2024-01-18
Publishing country	Canada
Document type	Observational Study ; Journal Article
ISSN	2369-3762
ISSN (online)	2369-3762
DOI	10.2196/50842
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Performance of ChatGPT on Ophthalmology-Related Questions Across Various Examination Levels

Firas Haddad / Joanna S Saade

JMIR Medical Education, Vol 10, p e

Observational Study

2024 Volume 50842

Abstract: BackgroundChatGPT and language learning models have gained attention recently for their ability to answer questions on various examinations across various disciplines. The question of whether ChatGPT could be used to aid in medical education is yet to be ...

Abstract	BackgroundChatGPT and language learning models have gained attention recently for their ability to answer questions on various examinations across various disciplines. The question of whether ChatGPT could be used to aid in medical education is yet to be answered, particularly in the field of ophthalmology. ObjectiveThe aim of this study is to assess the ability of ChatGPT-3.5 (GPT-3.5) and ChatGPT-4.0 (GPT-4.0) to answer ophthalmology-related questions across different levels of ophthalmology training. MethodsQuestions from the United States Medical Licensing Examination (USMLE) steps 1 (n=44), 2 (n=60), and 3 (n=28) were extracted from AMBOSS, and 248 questions (64 easy, 122 medium, and 62 difficult questions) were extracted from the book, Ophthalmology Board Review Q&A, for the Ophthalmic Knowledge Assessment Program and the Board of Ophthalmology (OB) Written Qualifying Examination (WQE). Questions were prompted identically and inputted to GPT-3.5 and GPT-4.0. ResultsGPT-3.5 achieved a total of 55% (n=210) of correct answers, while GPT-4.0 achieved a total of 70% (n=270) of correct answers. GPT-3.5 answered 75% (n=33) of questions correctly in USMLE step 1, 73.33% (n=44) in USMLE step 2, 60.71% (n=17) in USMLE step 3, and 46.77% (n=116) in the OB-WQE. GPT-4.0 answered 70.45% (n=31) of questions correctly in USMLE step 1, 90.32% (n=56) in USMLE step 2, 96.43% (n=27) in USMLE step 3, and 62.90% (n=156) in the OB-WQE. GPT-3.5 performed poorer as examination levels advanced (P<.001), while GPT-4.0 performed better on USMLE steps 2 and 3 and worse on USMLE step 1 and the OB-WQE (P<.001). The coefficient of correlation (r) between ChatGPT answering correctly and human users answering correctly was 0.21 (P=.01) for GPT-3.5 as compared to –0.31 (P<.001) for GPT-4.0. GPT-3.5 performed similarly across difficulty levels, while GPT-4.0 performed more poorly with an increase in the difficulty level. Both GPT models performed significantly better on certain topics than on others. ConclusionsChatGPT is far ...
Keywords	Special aspects of education ; LC8-6691 ; Medicine (General) ; R5-920
Subject code	370
Language	English
Publishing date	2024-01-01T00:00:00Z
Publisher	JMIR Publications
Document type	Article ; Online
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Article: Corneal Deposits: A Presentation of Arthrobacter Keratitis.

Saade, Joanna S / Noureddine, Baha' N / Ibrahim, Hanadi A

Case reports in ophthalmology

2024 Volume 15, Issue 1, Page(s) 353–357

Abstract: Introduction: Infectious keratitis, an inflammatory condition of the cornea, poses a significant public health concern globally. Bacterial keratitis, the most common type, primarily involves : Case presentation: This case report presents a 78-year- ... ...

Abstract	Introduction: Infectious keratitis, an inflammatory condition of the cornea, poses a significant public health concern globally. Bacterial keratitis, the most common type, primarily involves Case presentation: This case report presents a 78-year-old male patient with a burning sensation persisting for 1 week. The patient was diagnosed with keratitis caused by Arthrobacter, a Gram-positive coccobacillus commonly found in the environment. While the literature reports a few cases of Arthrobacter species keratitis, limited data exist regarding its clinical course and outcomes. Treatment with ciprofloxacin eye drops resulted in complete resolution of symptoms and a clear cornea upon final follow-up. Conclusion: Arthrobacter, a rare causative agent of keratitis, requires early suspicion for accurate diagnosis and treatment. Despite the limited literature on Arthrobacter keratitis, this case highlights the importance of considering uncommon pathogens in corneal infections. Further research is necessary to understand the prevalence and clinical course of Arthrobacter keratitis.
Language	English
Publishing date	2024-04-15
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2577666-6
ISSN	1663-2699
ISSN	1663-2699
DOI	10.1159/000538474
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Article: An Emerging Ophthalmology Challenge: A Narrative Review of TikTok Trends Impacting Eye Health Among Children and Adolescents.

Al Hassan, Sally / Bou Ghannam, Alaa / S Saade, Joanna

Ophthalmology and therapy

2024 Volume 13, Issue 4, Page(s) 895–902

Abstract: In today's digital age, children and teenagers are deeply entrenched in the world of personal ... of TikTok's user base consists of adolescents, with approximately 41% falling in the 16-24 age group and ...

Abstract	In today's digital age, children and teenagers are deeply entrenched in the world of personal electronic devices including laptops, tablets, and smartphones. These serve as gateways to captivate online content. With children as young as 4 years old having access to these gadgets, the potential benefits of technology coexist with many possible risks. One such risk is the growing global issue of myopia. TikTok, a mobile application that gained immense popularity since its inception in 2016, has garnered 1.7 billion active monthly users in 2023 and is expected to reach two billion in 2024. A significant portion of TikTok's user base consists of adolescents, with approximately 41% falling in the 16-24 age group and a third aged 14 or younger. This social media platform has given rise to the phenomenon of "internet challenges," where users complete and share various tasks through videos. While most of these challenges are harmless, some pose serious risks to teenagers who eagerly seek validation and attention from their peers. This manuscript sheds light on a specific subset of TikTok challenges, namely those related to ophthalmological risks. These challenges include "rubbing castor oil trend," "bleach/bright eye challenge," "mucus fishing challenge," "eggsplosions", "beezin challenge", "Orbeez challenge", "blow-drying eyelashes", "sun gazing," and "popping styes". The manuscript emphasizes the importance of monitoring and regulating potentially dangerous content on social media platforms like TikTok. While these platforms offer educational opportunities, they can also promote life-threatening actions, necessitating efforts to protect vulnerable young users and promote safe online engagement.
Language	English
Publishing date	2024-02-05
Publishing country	England
Document type	Journal Article ; Review
ISSN	2193-8245
ISSN	2193-8245
DOI	10.1007/s40123-024-00885-3
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Article: Nontraumatic Epithelial Ingrowth 15 Years Post Laser In Situ Keratomileusis.

Saade, Joanna S / Noureddin, Baha' / Awwad, Shady T

Case reports in ophthalmological medicine

2019 Volume 2019, Page(s) 5270636

Abstract: Purpose. ...

Abstract	Purpose.
Language	English
Publishing date	2019-10-07
Publishing country	United States
Document type	Case Reports
ZDB-ID	2659091-8
ISSN	2090-6730 ; 2090-6722
ISSN (online)	2090-6730
ISSN	2090-6722
DOI	10.1155/2019/5270636
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Article ; Online: Bromfenac 0.09% for the Treatment of Macular Edema Secondary to Noninfectious Uveitis.

Saade, Joanna S / Istambouli, Rachid / AbdulAal, Marwan / Antonios, Rafic / Hamam, Rola N

Middle East African journal of ophthalmology

2021 Volume 28, Issue 2, Page(s) 98–103

Abstract: Purpose: The topical nonsteroidal anti-inflammatory drug bromfenac 0.09% has a potential benefit in uveitic macular edema (UME) with a safe side effect profile. The aim of the study is to assess the efficacy of bromfenac sodium solution in the treatment ...

Abstract	Purpose: The topical nonsteroidal anti-inflammatory drug bromfenac 0.09% has a potential benefit in uveitic macular edema (UME) with a safe side effect profile. The aim of the study is to assess the efficacy of bromfenac sodium solution in the treatment of UME. Methods: The charts of 10 patients with macular edema due to noninfectious uveitis treated with bromfenac 0.09% were reviewed retrospectively. The main outcomes studied were the best-corrected visual acuity (BCVA) and the central retinal thickness (CRT) compared 4 months before bromfenac initiation, at the time of its initiation, and 4 months later. Results: Twelve eyes of 10 patients were included. BCVA and CRT were unchanged 4 months befoew bromfenac compared to the time of bromfenac initiation ( Conclusion: Bromfenac may be a useful addition to the treatment of UME.
MeSH term(s)	Benzophenones ; Bromobenzenes ; Humans ; Macular Edema/diagnosis ; Macular Edema/drug therapy ; Macular Edema/etiology ; Retrospective Studies ; Tomography, Optical Coherence ; Uveitis/complications ; Uveitis/drug therapy ; Visual Acuity
Chemical Substances	Benzophenones ; Bromobenzenes ; bromfenac (864P0921DW)
Language	English
Publishing date	2021-09-25
Publishing country	India
Document type	Journal Article
ZDB-ID	2545467-5
ISSN	0975-1599 ; 0975-1599
ISSN (online)	0975-1599
ISSN	0975-1599
DOI	10.4103/meajo.meajo_134_21
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Article: Perceived Surgeon Stress During No-Sedation Topical Phacoemulsification.

Mansour, Ahmad / Stewart, Michael W / Charbaji, Abdul Razzak / El Jawhari, Khalil M / El Zein, Lulwa / Mansour, Mohamad A / Saade, Joanna S

Clinical ophthalmology (Auckland, N.Z.)

2020 Volume 14, Page(s) 2373–2381

Abstract: Purpose: To determine the patient-related factors that contribute to surgeon stress during phacoemulsification cataract extraction (PCE) performed under unassisted topical anesthesia.: Methods: This is a prospective study of perceived surgeon stress ... ...

Abstract	Purpose: To determine the patient-related factors that contribute to surgeon stress during phacoemulsification cataract extraction (PCE) performed under unassisted topical anesthesia. Methods: This is a prospective study of perceived surgeon stress during phacoemulsification by a single surgeon of consecutive patients undergoing PCE. At the conclusion of each procedure, the surgeon recorded the perceived stress according to the following three indices: surgeon score, qualitative score (yes or no), and total score (sum of itemized causes of stress). Patient variables included in the analysis included gender, age, diabetes mellitus, morbid obesity, intake of oral alpha blockers, floppy iris, laterality, pseudo-exfoliation, intraocular lens power, and initial visual acuity. Results: During the 10-year study, 1097 eyes underwent surgery. The following patient variables were seen frequently: floppy iris syndrome (92), pseudo-exfoliation (72), and morbid obesity (36). Surgeon identified stress was reported after 250 procedures. On multivariable analysis, the following patient characteristics were associated with surgeon stress: age >80 years; morbid obesity; floppy iris syndrome; severe nuclear sclerosis; and poor baseline distance corrected visual acuity. Conclusion: Several ocular and systemic patient-related characteristics contribute to surgeon stress during PCE.
Language	English
Publishing date	2020-08-18
Publishing country	New Zealand
Document type	Journal Article
ISSN	1177-5467
ISSN	1177-5467
DOI	10.2147/OPTH.S266516
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Article ; Online: Instability of TCF4 Triplet Repeat Expansion With Parent-Child Transmission in Fuchs' Endothelial Corneal Dystrophy.

Saade, Joanna S / Xing, Chao / Gong, Xin / Zhou, Zhengyang / Mootha, V Vinod

Investigative ophthalmology & visual science

2018 Volume 59, Issue 10, Page(s) 4065–4070

Abstract: Purpose: Fuchs' endothelial corneal dystrophy (FECD) caused by the CTG triplet repeat expansion in the TCF4 gene (CTG18.1 locus) is the most common repeat expansion disorder. Intergenerational instability of expanded repeats and clinical anticipation ... ...

Abstract	Purpose: Fuchs' endothelial corneal dystrophy (FECD) caused by the CTG triplet repeat expansion in the TCF4 gene (CTG18.1 locus) is the most common repeat expansion disorder. Intergenerational instability of expanded repeats and clinical anticipation are hallmarks of other repeat expansion disorders. In this study, we examine stability of triplet repeat allele length and FECD disease severity in parent-child transmission of the expanded CTG18.1 allele. Methods: We studied 44 parent-child transmissions of the mutant expanded CTG18.1 allele from 26 FECD families. The CTG18.1 polymorphism was genotyped using short tandem repeat analysis, triplet repeat primed PCR assay, and Southern blot analysis. FECD severity was assessed using modified Krachmer grading (KG) system. Triplet repeat length of mutant allele and KG severity were compared between generations. Results: Instability of the expanded allele was seen in 14 of 44 (31.8%) parent-child transmissions, and the likelihood of an unstable event increased with the size of the parental allele (P = 5.9 x 10^-3). A tendency for contraction was seen in transmission of large alleles (repeat length > 120), whereas intermediate alleles (repeat length between 77 and 120) had predilection for further expansion (P = 1.3 x 10^ - 3). Although we noted increased KG severity in the offspring in three pairs, none of these transmissions were associated with allele instability. Conclusions: We observed instability of the TCF4 triplet repeat expansion in nearly a third of parent-child transmissions. Large mutant CTG18.1 alleles are prone to contraction, whereas intermediate mutant alleles tend to expand when unstably transmitted. Intergenerational instability of TCF4 repeat expansion has implications on FECD disease inheritance.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Alleles ; Female ; Fuchs' Endothelial Dystrophy/genetics ; Genetic Predisposition to Disease/genetics ; Genomic Instability/genetics ; Genotype ; Humans ; Male ; Middle Aged ; Polymorphism, Genetic ; Transcription Factor 4/genetics ; Trinucleotide Repeat Expansion
Chemical Substances	Transcription Factor 4
Language	English
Publishing date	2018-08-10
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	391794-0
ISSN	1552-5783 ; 0146-0404
ISSN (online)	1552-5783
ISSN	0146-0404
DOI	10.1167/iovs.18-24119
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Article: Ocular Rosacea Causing Corneal Melt in an African American Patient and a Hispanic Patient.

Saade, Joanna S / Abiad, Bachir / Jan, Jonathan / Saadeh, Dana / McCulley, James P / Bartley, Jeremy

Case reports in ophthalmological medicine

2017 Volume 2017, Page(s) 2834031

Abstract: ... full thickness tectonic corneal patch graft was done. The patient's bilateral eye symptoms improved one ...

Abstract	Purpose: To discuss two rare presentations of ocular rosacea in a Hispanic patient and an African American patient with unusual ocular manifestations. Case report: Case 1: a 43-year-old Hispanic woman presented with right eye corneal perforation. Her prior medical history was significant for rosacea only, diagnosed clinically by a dermatologist. Her eye exam showed signs of bilateral ocular rosacea. An emergent full thickness tectonic corneal patch graft was done. The patient's bilateral eye symptoms improved one month after initiating rosacea treatment. Case 2: a 51-year-old African American man with long standing history of untreated rosacea presented with bilateral peripheral corneal thinning with neovascularization that led to right eye corneal perforation. Glue and bandage contact lens were applied. The patient did well 4 weeks after starting antibacterial, oral steroids, and rosacea treatment. Discussion: Ocular rosacea can present in Hispanic and African American patients with severe manifestations such as corneal perforation.
Language	English
Publishing date	2017-10-11
Publishing country	United States
Document type	Case Reports
ZDB-ID	2659091-8
ISSN	2090-6730 ; 2090-6722
ISSN (online)	2090-6730
ISSN	2090-6722
DOI	10.1155/2017/2834031
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Article ; Online: Iritis, glaucoma and corneal decompensation associated with BrightOcular cosmetic iris implant.

Mansour, Ahmad M / Ahmed, Iqbal Ike K / Eadie, Brennan / Chelala, Elias / Saade, Joanna S / Slade, Stephen G / Mearza, Ali A / Parmar, Dipak / Ghabra, Marwan / Luk, Sheila / Kelly, Alla / Kaufman, Stephen C

The British journal of ophthalmology

2016 Volume 100, Issue 8, Page(s) 1098–1101

Abstract: Purpose: NewColorIris cosmetic iris implants have a record of high ocular morbidity and are no longer in use. Newer generation of iris implants, BrightOcular, have patented posterior grooves in order to decrease iris touch and facilitate aqueous flow ... ...

Abstract	Purpose: NewColorIris cosmetic iris implants have a record of high ocular morbidity and are no longer in use. Newer generation of iris implants, BrightOcular, have patented posterior grooves in order to decrease iris touch and facilitate aqueous flow around the implant. However, little is known about their safety despite their implantations in 10 countries. Methods: Collaborative case series of patients who had bilateral implantation of cosmetic iris implants solely for cosmetic reasons. Results: 12 cases were collected being distributed as Caucasian (10) and Asian (2), women (11) and man (1) and with a mean age of 32 years. Ocular manifestations were present in 11 subjects and included anterior uveitis (10 of 12; 83.3%), glaucoma (7 of 12; 58.3%) and corneal decompensation (6 of 12; 50%). Visual acuity was normal in seven, decreased in five with two having visual recovery following explantation of the implant. Glaucoma could not be controlled medically in two patients. Conclusions: Cosmetic iris implants carry the risk of ocular damage when implanted in the anterior chamber of normal phakic eyes.
MeSH term(s)	Adult ; Corneal Endothelial Cell Loss/diagnosis ; Corneal Endothelial Cell Loss/etiology ; Device Removal ; Eye Color ; Female ; Glaucoma/diagnosis ; Glaucoma/etiology ; Humans ; Intraocular Pressure ; Iris/surgery ; Iritis/diagnosis ; Iritis/etiology ; Male ; Postoperative Complications ; Prostheses and Implants/adverse effects ; Prosthesis Failure ; Visual Acuity ; Young Adult
Language	English
Publishing date	2016-08
Publishing country	England
Document type	Journal Article
ZDB-ID	80078-8
ISSN	1468-2079 ; 0007-1161
ISSN (online)	1468-2079
ISSN	0007-1161
DOI	10.1136/bjophthalmol-2015-307295
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