Artificial intelligence chatbot performance in triage of ophthalmic conditions.

BACKGROUND: Timely access to human expertise for affordable and efficient triage of ophthalmic conditions is inconsistent. With recent advancements in publicly available artificial intelligence (AI) chatbots, the lay public may turn to these tools for triage of ophthalmic complaints. Validation studies are necessary to evaluate the performance of AI chatbots as triage tools and inform the public regarding their safety. OBJECTIVE: To evaluate the triage performance of AI chatbots for ophthalmic conditions. DESIGN: Cross-sectional study. SETTING: Single centre. PARTICIPANTS: Ophthalmology trainees, OpenAI ChatGPT (GPT-4), Bing Chat, and WebMD Symptom Checker. METHODS: Forty-four clinical vignettes representing common ophthalmic complaints were developed, and a standardized pathway of prompts was presented to each tool in March 2023. Primary outcomes were proportion of responses with the correct diagnosis listed in the top 3 possible diagnoses and proportion with correct triage urgency. Ancillary outcomes included presence of grossly inaccurate statements, mean reading grade level, mean response word count, proportion with attribution, and most common sources cited. RESULTS: The ophthalmologists in training, ChatGPT, Bing Chat, and the WebMD Symptom Checker listed the appropriate diagnosis among the top 3 suggestions in 42 (95%), 41 (93%), 34 (77%), and 8 (33%) cases, respectively. Triage urgency was appropriate in 38 (86%), 43 (98%), and 37 (84%) cases for ophthalmology trainees, ChatGPT, and Bing Chat, correspondingly. CONCLUSIONS: ChatGPT using the GPT-4 model offered high diagnostic and triage accuracy that was comparable with that of ophthalmology trainees with no grossly inaccurate statements. Bing Chat had lower accuracy and a tendency to overestimate triage urgency.

Occlusive retinal vasculitis: novel insights into causes, pathogenesis and treatment.

PURPOSE OF REVIEW: Occlusive retinal vasculitis (ORV) has a large differential diagnosis and varied therapeutic approaches. This review highlights existing and novel causes and treatment options for ORV. RECENT FINDINGS: Mutations in CAPN5, TREX1, and TNFAIP3 have been associated with dominantly inherited forms of ORV. Various intraocular therapeutics have been shown to occasionally cause ORV; the most recent medications associated with ORV are vancomycin and brolucizumab. In cases of ORV linked to Behçet's disease, clinical trials support the use of tumor necrosis factor alpha inhibitors. SUMMARY: Identification of the underlying etiology of ORV is critical to help guide treatment. Treatment in ORV involves both treatment any underlying infection or autoimmune condition, cessation of the any offending causative agent and local treatment of neovascular complications.