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Article ; Online: Mini-Review: Clinical Features and Management of Granular Corneal Dystrophy Type 2.

Chang, Myung Soo / Jun, Ikhyun / Kim, Eung Kweon

2023 Volume 37, Issue 4, Page(s) 340–347

Abstract: Granular corneal dystrophy type 2 (GCD2) is an autosomal dominant corneal stromal dystrophy that is caused by p.Arg124His mutation of transforming growth factor β induced (TGFBI) gene. It is characterized by well demarcated granular shaped opacities in ... ...

Abstract	Granular corneal dystrophy type 2 (GCD2) is an autosomal dominant corneal stromal dystrophy that is caused by p.Arg124His mutation of transforming growth factor β induced (TGFBI) gene. It is characterized by well demarcated granular shaped opacities in central anterior stroma and as the disease progresses, extrusion of the deposits results in ocular pain due to corneal epithelial erosion. Also, diffuse corneal haze which appears late, causes decrease in visual acuity. The prevalence of GCD2 is high in East Asia including Korea. Homozygous patients show a severe phenotype from an early age, and the heterozygote phenotype varies among patients, depending on several types of compound heterozygous TGFBI mutations. In the initial stage, conservative treatments such as artificial tears, antibiotic eye drops, and bandage contact lenses are used to treat corneal erosion. Different surgical methods are used depending on the depth and extent of the stromal deposits. Phototherapeutic keratectomy removes anterior opacities and is advantageous in terms of its applicability and repeatability. For deeper lesions, deep anterior lamellar keratoplasty can be used as the endothelial layer is not always affected. Recurrence following these treatments are reported within a wide range of rates in different studies due to varying definition of recurrence and follow-up period. In patients who have undergone corneal laser vision-correction surgeries such as photorefractive keratectomy, LASEK, or LASIK including SMILE surgery, corneal opacity exacerbates rapidly with severe deterioration of visual acuity. Further investigations on new treatments of GCD2 are necessary.
MeSH term(s)	Humans ; Corneal Dystrophies, Hereditary/diagnosis ; Corneal Dystrophies, Hereditary/genetics ; Corneal Dystrophies, Hereditary/therapy ; Cornea/pathology ; Photorefractive Keratectomy/methods ; Keratomileusis, Laser In Situ/adverse effects ; Corneal Opacity/diagnosis ; Corneal Opacity/etiology ; Corneal Opacity/therapy ; Corneal Ulcer/surgery ; Transforming Growth Factor beta/genetics
Chemical Substances	Transforming Growth Factor beta
Language	English
Publishing date	2023-06-19
Publishing country	Korea (South)
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639346-9
ISSN	2092-9382 ; 1011-8942
ISSN (online)	2092-9382
ISSN	1011-8942
DOI	10.3341/kjo.2023.0032
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Article ; Online: Reduced OPA1, Mitochondrial Fragmentation and Increased Susceptibility to Apoptosis in Granular Corneal Dystrophy Type 2 Corneal Fibroblasts

Choi, Seung-Il / Lee, Ga-Hyun / Woo, Jong-Hwan / Jun, Ikhyun / Kim, Eung Kweon

Genes (Basel). 2023 Feb. 24, v. 14, no. 3

2023

Abstract: The progressive degeneration of granular corneal dystrophy type 2 (GCD2) corneal fibroblasts is associated with altered mitochondrial function, but the underlying mechanisms are incompletely understood. We investigated whether an imbalance of ... ...

Abstract	The progressive degeneration of granular corneal dystrophy type 2 (GCD2) corneal fibroblasts is associated with altered mitochondrial function, but the underlying mechanisms are incompletely understood. We investigated whether an imbalance of mitochondrial dynamics contributes to mitochondrial dysfunction of GCD2 corneal fibroblasts. Transmission electron microscopy revealed several small, structurally abnormal mitochondria with altered cristae morphology in GCD2 corneal fibroblasts. Confocal microscopy showed enhanced mitochondrial fission and fragmented mitochondrial tubular networks. Western blotting revealed higher levels of MFN1, MFN2, and pDRP1 and decreased levels of OPA1 and FIS1 in GCD2. OPA1 reduction by short hairpin RNA (shRNA) resulted in fragmented mitochondrial tubular networks and increased susceptibility to mitochondrial stress-induced apoptosis. A decrease in the mitochondrial biogenesis-related transcription factors NRF1 and PGC1α was observed, while there was an increase in the mitochondrial membrane proteins TOM20 and TIM23. Additionally, reduced levels of mitochondrial DNA (mtDNA) were exhibited in GCD2 corneal fibroblasts. These observations suggest that altered mitochondrial fission/fusion and biogenesis are the critical molecular mechanisms that cause mitochondrial dysfunction contributing to the degeneration of GCD2 corneal fibroblasts.
Keywords	apoptosis ; biogenesis ; confocal microscopy ; cornea ; fibroblasts ; mitochondria ; mitochondrial DNA ; mitochondrial membrane ; small interfering RNA ; transmission electron microscopy
Language	English
Dates of publication	2023-0224
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article ; Online
ZDB-ID	2527218-4
ISSN	2073-4425
ISSN	2073-4425
DOI	10.3390/genes14030566
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Reduced OPA1, Mitochondrial Fragmentation and Increased Susceptibility to Apoptosis in Granular Corneal Dystrophy Type 2 Corneal Fibroblasts.

Choi, Seung-Il / Lee, Ga-Hyun / Woo, Jong-Hwan / Jun, Ikhyun / Kim, Eung Kweon

Genes

2023 Volume 14, Issue 3

Abstract	The progressive degeneration of granular corneal dystrophy type 2 (GCD2) corneal fibroblasts is associated with altered mitochondrial function, but the underlying mechanisms are incompletely understood. We investigated whether an imbalance of mitochondrial dynamics contributes to mitochondrial dysfunction of GCD2 corneal fibroblasts. Transmission electron microscopy revealed several small, structurally abnormal mitochondria with altered cristae morphology in GCD2 corneal fibroblasts. Confocal microscopy showed enhanced mitochondrial fission and fragmented mitochondrial tubular networks. Western blotting revealed higher levels of MFN1, MFN2, and pDRP1 and decreased levels of OPA1 and FIS1 in GCD2. OPA1 reduction by short hairpin RNA (shRNA) resulted in fragmented mitochondrial tubular networks and increased susceptibility to mitochondrial stress-induced apoptosis. A decrease in the mitochondrial biogenesis-related transcription factors NRF1 and PGC1α was observed, while there was an increase in the mitochondrial membrane proteins TOM20 and TIM23. Additionally, reduced levels of mitochondrial DNA (mtDNA) were exhibited in GCD2 corneal fibroblasts. These observations suggest that altered mitochondrial fission/fusion and biogenesis are the critical molecular mechanisms that cause mitochondrial dysfunction contributing to the degeneration of GCD2 corneal fibroblasts.
MeSH term(s)	Humans ; Apoptosis/genetics ; Corneal Dystrophies, Hereditary/genetics ; Fibroblasts/metabolism ; GTP Phosphohydrolases/genetics ; GTP Phosphohydrolases/metabolism ; Mitochondria/genetics ; Mitochondria/metabolism
Chemical Substances	GTP Phosphohydrolases (EC 3.6.1.-) ; OPA1 protein, human (EC 3.6.1.-)
Language	English
Publishing date	2023-02-24
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2527218-4
ISSN	2073-4425 ; 2073-4425
ISSN (online)	2073-4425
ISSN	2073-4425
DOI	10.3390/genes14030566
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Article ; Online: SLAMF1 contributes to cell survival through the AKT signaling pathway in Farage cells.

Yoon, Heejei / Kim, Eung Kweon / Ko, Young Hyeh

PloS one

2020 Volume 15, Issue 9, Page(s) e0238791

Abstract: SLAMF1 is often overexpressed in Epstein Barr virus (EBV)-infected B cell tumors. However, its role in the pathogenesis of EBV-infected B cell tumors remains largely unknown. Here, we generated SLAMF1-deficient EBV+ tumor cells and examined the effect of ...

Abstract	SLAMF1 is often overexpressed in Epstein Barr virus (EBV)-infected B cell tumors. However, its role in the pathogenesis of EBV-infected B cell tumors remains largely unknown. Here, we generated SLAMF1-deficient EBV+ tumor cells and examined the effect of its deficiency on cell proliferation and cell survival. There were no significant differences in cell proliferation and cell cycle distribution for short periods between the SLAMF1-deficient and wild-type cells. However, the deficient cells were more resistant to an AKT inhibitor (MK-2206). When the both cells were co-cultured and repeatedly exposed to the limitations in nutrition and growth factors, the SLAMF1-deficient cells were gradually decreased. We observed that levels of phospho-AKT were differentially regulated according to the nutritional status between the SLAMF1-deficient and wild-type cells. A decrease in phospho-AKT was observed in SLAMF1-deficient cells as well as an increase in pro-apoptotic Bim just before cell passage, which may have been due to the loss of SLAMF1 under poor growth condition. Overall, SLAMF1 is not a strong survival factor, but it seems to be necessary for cell survival in unfavorable growth condition.
MeSH term(s)	B-Lymphocytes/metabolism ; Cell Survival ; Herpesvirus 4, Human/metabolism ; Humans ; Proto-Oncogene Proteins c-akt/metabolism ; Signal Transduction ; Signaling Lymphocytic Activation Molecule Family Member 1/metabolism ; Tumor Cells, Cultured
Chemical Substances	Signaling Lymphocytic Activation Molecule Family Member 1 (169535-43-7) ; Proto-Oncogene Proteins c-akt (EC 2.7.11.1)
Language	English
Publishing date	2020-09-04
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0238791
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Article ; Online: Uptake of cell debris and enhanced expression of inflammatory factors in response to dead cells in corneal fibroblast cells.

Yoon, Heejei / Choi, Seung-Il / Kim, Eung Kweon

Experimental eye research

2020 Volume 194, Page(s) 108017

Abstract: Keratocytes synthesize stromal proteins and participate in wound healing through successive differentiation into corneal fibroblasts and myofibroblasts. Cultured keratocytes or corneal fibroblasts are also known as non-professional phagocytes and innate ... ...

Abstract	Keratocytes synthesize stromal proteins and participate in wound healing through successive differentiation into corneal fibroblasts and myofibroblasts. Cultured keratocytes or corneal fibroblasts are also known as non-professional phagocytes and innate immune cells. However, whether the corneal fibroblasts phagocytize their dead cells and whether the associated innate immunity is enhanced remains unknown. We initially characterized immortalized corneal fibroblast cells with the expression of specific genes. The corneal fibroblasts strongly expressed extracellular matrix molecules (FN and COL1A1) and low or medium levels of macrophage markers (CD14, CD68, and CD36), inflammatory cytokines (IL1A, IL1B, and IL6), and chemokines (IL8 and CCL2), but not CD11b, suggesting that corneal fibroblasts are macrophage-like fibroblasts. We confirmed the phagocytic activity of the corneal fibroblasts with fluorescent dye labeled-dead E. coli and S. aureus bacteria using confocal microscopy and flow cytometry. To test corneal fibroblast phagocytosis of apoptotic and necrotic cells we co-cultured corneal fibroblasts with fluorescent dye labeled-apoptotic and -necrotic cells and analyzed their uptake using fluorescence and confocal microscopy. We observed that corneal fibroblasts can engulf digested or processed cellular debris and entire dead cells. Co-cultured dying and dead cells strongly enhanced the expression of cytokine (IL1A, IL1B, and IL6), chemokine (CCL2, CCL5, CCL20, IL8, and CXCL10), and MMP (MMP1, MMP3, and MMP9) genes through the NF-κB signaling pathway. Our findings suggest that dying and dead cells stimulate corneal fibroblasts to further induce inflammatory factors and that corneal fibroblasts contribute to the clearing of cell debris as non-professional phagocytes.
MeSH term(s)	Apoptosis ; Blotting, Western ; Cell Differentiation ; Cell Line ; Chemokines/biosynthesis ; Corneal Stroma/metabolism ; Corneal Stroma/pathology ; Enzyme-Linked Immunosorbent Assay ; Fibroblasts/metabolism ; Fibroblasts/pathology ; Humans ; Signal Transduction
Chemical Substances	Chemokines
Language	English
Publishing date	2020-03-23
Publishing country	England
Document type	Journal Article
ZDB-ID	80122-7
ISSN	1096-0007 ; 0014-4835
ISSN (online)	1096-0007
ISSN	0014-4835
DOI	10.1016/j.exer.2020.108017
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Article ; Online: Lysosomal dysfunction of corneal fibroblasts underlies the pathogenesis of Granular Corneal Dystrophy Type 2 and can be rescued by TFEB.

Choi, Seung-Il / Woo, Jong Hwan / Kim, Eung Kweon

Journal of cellular and molecular medicine

2020 Volume 24, Issue 18, Page(s) 10343–10355

Abstract: Granular corneal dystrophy type 2 (GCD2) is the most common form of transforming growth factor β-induced (TGFBI) gene-linked corneal dystrophy and is pathologically characterized by the corneal deposition of mutant-TGFBIp. The defective autophagic ... ...

Abstract	Granular corneal dystrophy type 2 (GCD2) is the most common form of transforming growth factor β-induced (TGFBI) gene-linked corneal dystrophy and is pathologically characterized by the corneal deposition of mutant-TGFBIp. The defective autophagic degradation of pathogenic mutant-TGFBIp has been shown in GCD2; however, its exact mechanisms are unknown. To address this, we investigated lysosomal functions using corneal fibroblasts. Levels of cathepsins K and L (CTSK and CTSL) were significantly decreased in GCD2 cells, but of cathepsins B and D (CTSB and CTSD) did not change. The maturation of the pro-enzymes to their active forms (CTSB, CTSK and CTSL) was inhibited in GCD2 cells. CTSL enzymes directly degraded both LC3 (autophagosomes marker) and mutant-TGFBIp. Exogenous CTSL expression dramatically reduced mutant-TGFBIp in GCD2 cells, but not TGFBIp in WT cells. An increased lysosomal pH and clustered lysosomal perinuclear position were found in GCD2 cells. Transcription factor EB (TFEB) levels were significantly reduced in GCD2 cells, compared to WT. Notably, exogenous TFEB expression improved mutant-TGFBIp clearance and lysosomal abnormalities in GCD2 cells. Taken together, lysosomal dysfunction in the corneal fibroblasts underlies the pathogenesis of GCD2, and TFEB has a therapeutic potential in the treatment of GCD2.
MeSH term(s)	Apoptosis ; Basic Helix-Loop-Helix Leucine Zipper Transcription Factors/metabolism ; Cathepsins/metabolism ; Cell Nucleus/metabolism ; Cornea/pathology ; Corneal Dystrophies, Hereditary/pathology ; Extracellular Matrix Proteins/metabolism ; Fibroblasts/metabolism ; Fibroblasts/pathology ; Humans ; Lysosomes/metabolism ; Mutant Proteins/metabolism ; Transforming Growth Factor beta/metabolism
Chemical Substances	Basic Helix-Loop-Helix Leucine Zipper Transcription Factors ; Extracellular Matrix Proteins ; Mutant Proteins ; TFEB protein, human ; Transforming Growth Factor beta ; betaIG-H3 protein (148710-76-3) ; Cathepsins (EC 3.4.-)
Language	English
Publishing date	2020-07-15
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2074559-X
ISSN	1582-4934 ; 1582-4934 ; 1582-1838
ISSN (online)	1582-4934
ISSN	1582-4934 ; 1582-1838
DOI	10.1111/jcmm.15646
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Article ; Online: Femtosecond laser-assisted cataract surgery after corneal refractive surgery.

Ahn, Hyunmin / Jun, Ikhyun / Seo, Kyoung Yul / Kim, Eung Kweon / Kim, Tae-Im

Scientific reports

2022 Volume 12, Issue 1, Page(s) 4263

Abstract: Cataract is the leading cause of blindness worldwide, and advanced cataract techniques such as femtosecond laser-assisted cataract surgery (FLACS) have been commercially available. Corneal refractive surgery (CRS) is one of the most popular surgeries for ...

Abstract	Cataract is the leading cause of blindness worldwide, and advanced cataract techniques such as femtosecond laser-assisted cataract surgery (FLACS) have been commercially available. Corneal refractive surgery (CRS) is one of the most popular surgeries for the correction of refractive errors. CRS changes the cornea not only anatomically but also pathophysiologically. However, there has been no clinical research analyzing the refractive and safety outcomes of FLACS after CRS. The aim of this retrospective chart review and comparative study is to evaluate the effect and safety of FLACS after CRS comparing with conventional PCS. Participants with a previous CRS history who underwent FLACS or conventional PCS were included in this study. The visual outcomes and the refractive outcomes including refractive, corneal, and ocular residual astigmatism were compared. The safety outcomes were then studied intraoperatively and postoperatively. A total of 102 patients with age-related cataract were enrolled. At 3 months postoperatively, UCVA, BCVA, and predictive error were not significantly different between the FLACS and conventional PCS groups. Reduction of refractive astigmatism was higher in FLACS. Postoperative ORA was significant lower in FLACS. Reduction of ORA was higher in FLACS. The intraoperative and postoperative complications were also not significantly different between the two groups. FLACS could effectively change refractive astigmatism and ORA; without more complications than conventional PCS. FLACS' competitive edge in postoperative ORA may provide better visual quality than conventional PCS in patients with a previous history of CRS.
MeSH term(s)	Astigmatism/complications ; Astigmatism/surgery ; Cataract/complications ; Cataract Extraction/adverse effects ; Cataract Extraction/methods ; Cornea/surgery ; Humans ; Laser Therapy/adverse effects ; Laser Therapy/methods ; Lasers ; Phacoemulsification/methods ; Retrospective Studies
Language	English
Publishing date	2022-03-11
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-022-08297-8
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Article: Femtosecond laser-assisted arcuate keratotomy for the management of corneal astigmatism in patients undergoing cataract surgery: Comparison with conventional cataract surgery.

Ahn, Hyunmin / Jun, Ikhyun / Seo, Kyoung Yul / Kim, Eung Kweon / Kim, Tae-Im

Frontiers in medicine

2022 Volume 9, Page(s) 914504

Abstract: Purpose: To assess the effects of femtosecond laser arcuate keratotomy with femtosecond laser-assisted cataract surgery in the management of corneal astigmatism, compared with conventional phacoemulsification cataract surgery.: Design: Retrospective ... ...

Abstract	Purpose: To assess the effects of femtosecond laser arcuate keratotomy with femtosecond laser-assisted cataract surgery in the management of corneal astigmatism, compared with conventional phacoemulsification cataract surgery. Design: Retrospective comparative interventional case series. Methods: A total of 2,498 eyes of consecutive patients who presented with 3.00 diopters (D) or under of astigmatism were included. The patients were treated with conventional phacoemulsification cataract surgery (conventional group) and femtosecond laser arcuate keratotomy with femtosecond laser-assisted cataract surgery (femtosecond group). Results: Surgically induced astigmatism (SIA) was higher in the femtosecond group than the conventional group (0.215, Conclusion: Femtosecond laser arcuate keratotomy in cataract surgery was effective in SIA between 0.75 to 3.00 D of corneal astigmatism. However, the overcorrection in the lower astigmatism and angle of error in the higher astigmatism were due to the postoperative corneal astigmatism not decreasing as much as SIA. Overcoming these challenges will lead to better management of corneal astigmatism.
Language	English
Publishing date	2022-08-25
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2775999-4
ISSN	2296-858X
ISSN	2296-858X
DOI	10.3389/fmed.2022.914504
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Article: Artificial Intelligence for the Estimation of Visual Acuity Using Multi-Source Anterior Segment Optical Coherence Tomographic Images in Senile Cataract.

Ahn, Hyunmin / Jun, Ikhyun / Seo, Kyoung Yul / Kim, Eung Kweon / Kim, Tae-Im

Frontiers in medicine

2022 Volume 9, Page(s) 871382

Abstract: Purpose: To investigate an artificial intelligence (AI) model performance using multi-source anterior segment optical coherence tomographic (OCT) images in estimating the preoperative best-corrected visual acuity (BCVA) in patients with senile cataract.! ...

Abstract	Purpose: To investigate an artificial intelligence (AI) model performance using multi-source anterior segment optical coherence tomographic (OCT) images in estimating the preoperative best-corrected visual acuity (BCVA) in patients with senile cataract. Design: Retrospective, cross-instrument validation study. Subjects: A total of 2,332 anterior segment images obtained using swept-source OCT, optical biometry for intraocular lens calculation, and a femtosecond laser platform in patients with senile cataract and postoperative BCVA ≥ 0.0 logMAR were included in the training/validation dataset. A total of 1,002 images obtained using optical biometry and another femtosecond laser platform in patients who underwent cataract surgery in 2021 were used for the test dataset. Methods: AI modeling was based on an ensemble model of Inception-v4 and ResNet. The BCVA training/validation dataset was used for model training. The model performance was evaluated using the test dataset. Analysis of absolute error (AE) was performed by comparing the difference between true preoperative BCVA and estimated preoperative BCVA, as ≥0.1 logMAR (AE Outcome measurements: Mean absolute error (MAE), root mean square error (RMSE), mean percentage error (MPE), and correlation coefficient between true preoperative BCVA and estimated preoperative BCVA. Results: The test dataset MAE, RMSE, and MPE were 0.050 ± 0.130 logMAR, 0.140 ± 0.134 logMAR, and 1.3 ± 13.9%, respectively. The correlation coefficient was 0.969 ( Conclusions: The AI model achieved high-level visual acuity estimation in patients with senile cataract. This quantification method encompassed both visual acuity and cataract severity of OCT image, which are the main indications for cataract surgery, showing the potential to objectively evaluate cataract severity.
Language	English
Publishing date	2022-05-17
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2775999-4
ISSN	2296-858X
ISSN	2296-858X
DOI	10.3389/fmed.2022.871382
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Article: Artificial intelligence approach for recommendation of pupil dilation test using medical interview and basic ophthalmologic examinations.

Ahn, Hyunmin / Jun, Ikhyun / Seo, Kyoung Yul / Kim, Eung Kweon / Kim, Tae-Im

Frontiers in medicine

2022 Volume 9, Page(s) 967710

Abstract: Purpose: To evaluate the value of artificial intelligence (AI) for recommendation of pupil dilation test using medical interview and basic ophthalmologic examinations.: Design: Retrospective, cross-sectional study.: Subjects: Medical records of 56, ...

Abstract	Purpose: To evaluate the value of artificial intelligence (AI) for recommendation of pupil dilation test using medical interview and basic ophthalmologic examinations. Design: Retrospective, cross-sectional study. Subjects: Medical records of 56,811 patients who visited our outpatient clinic for the first time between 2017 and 2020 were included in the training dataset. Patients who visited the clinic in 2021 were included in the test dataset. Among these, 3,885 asymptomatic patients, including eye check-up patients, were initially included in test dataset I. Subsequently, 14,199 symptomatic patients who visited the clinic in 2021 were included in test dataset II. Methods: All patients underwent a medical interview and basic ophthalmologic examinations such as uncorrected distance visual acuity, corrected distance visual acuity, non-contact tonometry, auto-keratometry, slit-lamp examination, dilated pupil test, and fundus examination. A clinically significant lesion in the lens, vitreous, and fundus was defined by subspecialists, and the need for a pupil dilation test was determined when the participants had one or more clinically significant lesions in any eye. Input variables of AI consisted of a medical interview and basic ophthalmologic examinations, and the AI was evaluated with predictive performance for the need of a pupil dilation test. Main outcome measures: Accuracy, sensitivity, specificity, and positive predictive value. Results: Clinically significant lesions were present in 26.5 and 59.1% of patients in test datasets I and II, respectively. In test dataset I, the model performances were as follows: accuracy, 0.908 (95% confidence interval (CI): 0.880-0.936); sensitivity, 0.757 (95% CI: 0.713-0.801); specificity, 0.962 (95% CI: 0.947-0.977); positive predictive value, 0.878 (95% CI: 0.834-0.922); and F1 score, 0.813. In test dataset II, the model had an accuracy of 0.949 (95% CI: 0.934-0.964), a sensitivity of 0.942 (95% CI: 0.928-956), a specificity of 0.960 (95% CI: 0.927-0.993), a positive predictive value of 0.971 (95% CI: 0.957-0.985), and a F1 score of 0.956. Conclusion: The AI model performing a medical interview and basic ophthalmologic examinations to determine the need for a pupil dilation test had good sensitivity and specificity for symptomatic patients, although there was a limitation in identifying asymptomatic patients.
Language	English
Publishing date	2022-09-13
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2775999-4
ISSN	2296-858X
ISSN	2296-858X
DOI	10.3389/fmed.2022.967710
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