Search Results (653)

Visual search behavior, influenced by expertise, prior knowledge, training, and visual fatigue, is crucial in ophthalmic diagnostics. This study investigates differences in eye-tracking strategies between novice and experienced eye care practitioners during fundus image interpretation. Forty-seven participants, including 37 novices (first- to fourth-year optometry students) and 10 experienced optometrists (≥2 years of experience), viewed 20 fundus images (10 normal, 10 abnormal) while their eye movements were recorded using an Eyelink1000 Plus gaze tracker (2000 Hz). Diagnostic and laterality accuracy were assessed, and statistical analyses were conducted using Sigma Plot 12.0. Results showed that experienced practitioners had significantly higher diagnostic accuracy (83 ± 6.3%) than novices (70 ± 12.9%, p < 0.005). Significant differences in oculomotor behavior were observed, including median latency (p < 0.001), while no significant differences were found in median peak velocity (p = 0.11) or laterality accuracy (p = 0.97). Diagnostic accuracy correlated with fixation count in novices (r = 0.54, p < 0.001), while laterality accuracy correlated with total dwelling time (r = −0.62, p < 0.005). The experienced practitioners demonstrated systematic and focused visual search patterns, whereas the novices exhibited unorganized scan paths. Enhancing training with visual feedback could improve fundus image analysis accuracy in novice clinicians. Full article

This study evaluates whether an AI-built DeFi website case can match professionally developed DeFi platforms in digital marketing performance, innovation-related strategic behavior, and entrepreneurial impact. Using a multi-method design, we compare five established DeFi websites (Aave, Lido, Curve, MakerDAO, Uniswap) against one AI-built interface (Nexus Protocol). The analysis is designed as a five-platform benchmarking study of established professional DeFi websites, complemented by one AI-built case (Nexus Protocol) used as an illustrative comparison rather than a representative class of AI-built interface. The objectives are to (i) test differences in traffic composition and acquisition strategies, (ii) quantify how engagement signals predict authority and branded traffic, (iii) examine cognitive processing and trust-cue attention via eye tracking, and (iv) model emergent engagement and authority dynamics using agent-based simulation (ABM). Web analytics (March–October 2025) show significant variation in traffic composition across professional platforms (ANOVA F = 3.41, p = 0.0205), while regression models indicate that time on site and pages per visit positively predict Authority Score (R² = 0.61) and Branded Traffic (R² = 0.55), with bounce rate exerting an adverse effect. PCA and k-means clustering identify three strategic archetypes (innovation-driven, balanced-growth, efficiency-focused). Eye-tracking results show that professional interfaces generate tighter fixation clusters and shorter scan paths, indicating higher cognitive efficiency. In contrast, fixation on key UI elements and trust cues is comparable across interface types. ABM outputs further suggest that reduced engagement depth in the AI-built interface yields weaker long-run branded-traffic and authority trajectories. Overall, the study provides an integrated evaluation framework and evidence-based implications for AI-driven interface design in high-trust fintech environments. Full article

While multi-view visualization systems are widely used for mining vehicle teleoperation, they often impose high cognitive load and restrict operator attention. To explore a more efficient alternative, this study evaluated a merged-view interface that integrates multiple camera perspectives into a single coherent display. In a controlled experiment, 35 participants navigated a teleoperated robot along a 50 m lab-scale path representative of an underground mine under both multi-view and merged-view conditions. Task performance and eye-tracking data—including completion time, path adherence, and speed-limit violations—were collected for comparison. The merged-view system enabled 6% faster completion times, 21% higher path adherence, and 28% fewer speed-limit violations. Eye-tracking metrics indicated more efficient and distributed attention: blink rate decreased by 29%, fixation duration shortened by 18%, saccade amplitude increased by 11%, and normalized gaze-transition entropy rose by 14%, reflecting broader and more adaptive scanning. NASA-TLX scores further showed a 27% reduction in perceived workload. Regression-based sensitivity analysis revealed that gaze entropy was the strongest predictor of efficiency in the multi-view condition, while fixation duration dominated under merged-view visualization. For path adherence, blink rate was most influential in the multi-view setup, whereas fixation duration became key in merged-view operation. Overall, the results indicated that merged-view visualization improved visual attention distribution and reduced cognitive tunneling indicators in a controlled laboratory teleoperation task, offering early-stage, interface-level insights motivated by mining-relevant teleoperation challenges. Full article

Background/Objectives: We aim to develop an image linearization process and a program capable of quantifying vertical and left–right asymmetries observed in macular scans. We then sought to verify its applicability in clinical settings. Methods: In this single-center cross-sectional study, we examined 37 consecutive patients with unilateral open-angle glaucoma and analyzed paired data (glaucomatous eye vs. fellow normal eye). Spectral-domain OCT images were automatically processed by a custom program to align the disc–fovea axis and temporal raphe, and the following parameters were evaluated: (1) mean inner retinal thickness difference (superior–inferior), (2) Vertical Asymmetry Score, and (3) Quadrantal Asymmetry Score. Results: We analyzed 37 healthy eyes and 37 POAG eyes. After linearization, the mean inner retinal thicknesses for the normal and POAG groups were 93.4 µm (interquartile range [IQR]: 90.1–98.5) and 80.3 µm (IQR: 77.3–85.0), respectively. The Vertical Asymmetry Score was 6.80 (IQR: 6.15–7.25) for healthy eyes and 9.69 (IQR: 9.16–11.58) for POAG eyes. The Quadrantal Asymmetry Score was 6.35 (IQR: 5.94–7.19) for healthy eyes and 8.47 (IQR: 8.11–9.63) for POAG eyes. Significant differences were found between groups for all parameters (p < 0.001). The Vertical Asymmetry Score (AUC = 0.967, p < 0.001) and Quadrantal Asymmetry Score (AUC = 0.946, p < 0.001) demonstrated significantly greater accuracy in detecting glaucoma compared to the mean inner retinal thickness (AUC = 0.743). Conclusions: The developed linearization program and asymmetry scores have shown promise as parameters for objectively quantifying macular asymmetry using spectral-domain OCT. External validation in independent cohorts, including bilateral disease, is warranted. Full article

This study evaluated the feasibility, image quality, and referral accuracy of a patient-operated optical coherence tomography (OCT) device (SightSync) compared with technician-acquired Heidelberg OCT. This study was conducted in a Veterans Affairs retina clinic (Cleveland, Ohio), resulting in a predominantly male (98%) study population representative of the local veteran demographics. One hundred patients attempted self-administered OCT imaging after brief instruction, yielding 118 successful scans (59% of eyes) with no significant association between scan success and age, visual acuity, or diagnosis. Quantitative analysis of 142 paired images showed that SightSync produced interpretable scans with comparable sharpness to Heidelberg OCT, though signal- and intensity-based metrics (signal-to-noise ratio; SNR, contrast-to-noise ratio; CNR, entropy, pixel intensity; p90) were lower, consistent with hardware differences between a compact patient-operated prototype and a clinical-grade system. Among 121 high-quality SightSync scans, referral decisions demonstrated strong agreement with Heidelberg OCT, with a sensitivity of 83.9%, specificity of 75.6%, and a negative predictive value of 93.2%, indicating reliable exclusion of clinically significant pathology. These findings demonstrate that patients can independently acquire clinically interpretable OCT images and that SightSync provides safe, conservative triage performance—supporting its potential as a scalable community-based retinal imaging solution—while a review of unsuccessful scans has identified prototype modifications expected to further improve device feasibility. Full article

The article addresses the issue of panoramic photogrammetry for the reconstruction of interior spaces. Such environments often present challenges, including poor lighting conditions and surfaces with variable texture for photogrammetric scanning. In this case study, we reconstruct the interior spaces of the historical house of Samuel Mikovíni, which represents these unfavorable conditions. The 3D reconstruction of interior spaces is performed using the Ricoh Theta Z1 spherical camera (Ricoh Company, Ltd.; Tokyo, Japan) in six variants, each employing a different number of images and different camera networks. Scale is introduced into the reconstructions based on significant dimensions measured with a measuring tape. A comparison is carried out using a point cloud obtained from terrestrial laser scanning and difference point clouds are generated for each variant. Based on the results, reconstructions produced from a reduced number of spherical images can serve as a basic source for simple documentation with accuracy up to 0.15 m. When the number of spherical images is increased and images from different height levels are included, the reconstruction accuracy improves markedly, achieving positional accuracy of up to 0.05 m, even in areas affected by poor lighting conditions or low-texture surfaces. The results confirm that for interior reconstruction, a higher number of images not only increases the density of the reconstructed point cloud but also enhances its positional accuracy. Full article

Background/Objectives: Thyroid eye disease (TED) can lead to structural and microvascular changes in the orbit and retina. This study aimed to investigate the associations between Clinical Activity Score (CAS), orbital magnetic resonance imaging (MRI) measurements, and retinal microvascular changes in TED patients. Methods: This cross-sectional study included 38 patients (76 eyes) with TED. Each patient underwent a comprehensive ophthalmological evaluation, CAS assessment, and a detailed medical history. Optical coherence tomography angiography (OCTA) was performed to quantify vessel density (VD) in the superficial and deep capillary plexus (SCP and DCP). Exophthalmos, extraocular muscle thickness and orbital fat thickness were measured on MRI scans to evaluate structural changes. Laboratory analyses included thyroid hormone levels, thyrotropin receptor antibodies (TRAb), anti-thyroid peroxidase antibodies (anti-TPO), and lipid profile. Results: Active TED patients (CAS ≥ 3) had significantly higher TRAb levels (p < 0.001), while anti-TPO did not differ between groups. Active eyes showed significantly higher DCP VD in the whole image (p = 0.013), parafovea (p = 0.012), and perifovea (p = 0.009) across all quadrants, with no difference in SCP or the foveal avascular zone (FAZ). In linear mixed model regression analyses, after adjusting for previous glucocorticosteroid therapy, higher triglycerides, greater medial rectus thickness, and whole-image DCP VD independently predicted higher CAS values (R² = 42, p < 0.001). After adjusting for age and sex, CAS remained significantly positive predictor of DCP VD in the parafovea (R² = 0.22, p < 0.001). Conclusions: Changes in DCP VD reflect TED activity and structural orbital involvement. Full article

Background/Objectives: Recent advances in large language models (LLMs) have enabled the multimodal interpretation of medical images, but their agreement in ophthalmology issues remains underexplored. This study evaluated the ability of ChatGPT-4o, a multimodal LLM, to classify idiopathic epiretinal membrane (ERM) using optical coherence tomography (OCT) based on the Govetto classification. Methods: This retrospective study included 250 eyes of 250 patients with idiopathic ERM who visited Uonuma Kikan Hospital between June 2015 and April 2025. Horizontal B-scan OCT images were independently classified into four stages by two masked ophthalmologists; cases with disagreement were excluded. ChatGPT-4o was prompted to identify ocular diseases and classify ERM stage. Agreement between ChatGPT-4o and ophthalmologists was evaluated using weighted Cohen’s κ, and logistic regression identified factors associated with disagreement. Results: Among 272 eligible eyes, 250 were analyzed (Stage 1: 87; Stage 2: 76; Stage 3: 63; Stage 4: 24). ChatGPT-4o identified the presence of ERM in 26.4% of cases on the first prompt. The perfect agreement rate for Govetto staging was 46.0%, with a weighted κ of 0.513 (95% CI: 0.420–0.605; p < 0.001), indicating moderate agreement. Disagreement was significantly associated with the presence of ectopic inner foveal layer (EIFL) (OR = 0.528, 95% CI: 0.312–0.893; p = 0.017). Conclusions: ChatGPT-4o showed moderate agreement with ophthalmologists in Govetto classification of idiopathic ERM using OCT images. Although its agreement was limited, the model demonstrated partial ability to recognize retinal structures, providing insight into the current capabilities and limitations of multimodal large language models in ophthalmic image interpretation. Full article

Background: Three-dimensional facial anthropometry is increasingly used in orthodontics and orthognathic surgery. Conventional face scanning systems such as Vectra^® and 3dMD^® are well validated but remain costly and technically demanding. The MetiSmile^® 3D face scanner provides a more affordable and portable alternative, yet its accuracy and reproducibility have not been rigorously evaluated. Methods: Validation was performed on a standardized mannequin head in two phases. Phase 1 assessed mesh reproducibility under artificial lighting (AL), natural lighting (n-AL), and after mesh-refinement (AL-F). Landmark-based pre-registration with Iterative Closest Point refinement was applied; root-mean-square error (RMS) and distance maps were calculated. In phase 2, three observers (student, resident, consultant) performed 14 predefined linear measurements by direct anthropometry (DA) and digital anthropometry (DiA). Intra- and inter-observer reliability was evaluated using intraclass correlation coefficients. Results: Phase 1 yielded mean RMS values of 0.041 mm (AL), 0.043 mm (n-AL), and 0.030 mm (AL-F), with largest deviations near eyes, alar regions, and lip commissures. Phase 2 showed excellent ICCs (≥0.997) and mean absolute DA–DiA differences of 0.25–0.33 mm, with only few differences > 2 mm. Conclusion: The MetiSmile^® scanner generates highly reproducible meshes and clinically acceptable linear measurements on mannequin models. Further validation on live subjects is warranted before routine clinical application. Full article

As an emerging learning support technology, large language model-powered pedagogical agents demonstrate significant potential in enhancing video learning effectiveness, yet the underlying cognitive mechanisms remain inadequately elucidated. This study employed a multimodal approach combining EEG and eye-tracking to investigate the effects of AI-generated mind maps and text summaries on learning performance and cognitive processing. Following data screening, 80 valid datasets from education majors were randomly assigned to three groups: mind map summary (PA-MMS, n = 27), text summary (PA-TS, n = 28), and control (NPA, n = 25). Results showed both experimental groups achieved significantly higher post-test scores than controls, with PA-MMS demonstrating the strongest performance (d = 3.78). EEG evidence indicated pedagogical agents reduced Theta activity (decreased working memory load) while PA-MMS enhanced Alpha activity (superior attention control). Eye-tracking revealed differentiated strategies: PA-MMS exhibited networked fixation patterns facilitating integration; PA-TS demonstrated linear scanning. Delayed testing showed PA-MMS achieved the highest retention (96.8%). Correlations confirmed posttest scores negatively correlated with Theta (r = −0.46) and extraneous load (r = −0.61), positively with germane load (r = 0.54). Mind maps simultaneously reduced extraneous load (d = 1.26) while enhancing germane processing (d = 1.15), representing a shift from static scaffolds to AI-mediated generative support. Full article

Background: Optical coherence tomography (OCT) can quantify the morphology and dimensions of a macular hole for diagnosis and treatment planning. Objective: The aim of this study was to perform automatic segmentation of macular holes (MHs) and cysts from OCT macular volumes using a deep learning-based model and to quantitatively evaluate decision reliability using the model’s focus regions and GradientSHAP-based explainability. Methods: In this study, we automatically segmented MHs and cysts in OCT images from the open-access OIMHS dataset. The dataset comprises 125 eyes from 119 patients and 3859 OCT B-scans. OCT B-scan slices were input to a UNet-48-based model with a 2.5D stacking strategy. Performance was evaluated using Dice and intersection-over-union (IoU), boundary accuracy was evaluated using the 95th-percentile Hausdorff distance (HD95), and calibration was evaluated using the expected calibration error (ECE). Explainability was quantified from GradientSHAP maps using lesion coverage and spatial focus metrics: Attribution Precision in Lesion (APILτ), which is the proportion of attributions (SHAP contributions) falling inside the lesion; Attribution Recall in Lesion (ARILτ), which is the proportion of the true lesion covered by the attributions; and leakage (Leakτ = 1 − APILτ), which is the proportion of attributions falling outside the lesion. Spatial focus was monitored using the center-of-mass distance (COM-dist), which is the Euclidean distance between the attribution center and the segmentation center. All metrics were calculated using the top τ% of the pixels with the highest SHAP values. SHAP features were clustered using PCA and k-means. Explanations were calculated using the clinical mask in ground truth (GT) mode and the model segmentation in prediction (Pred) mode. Results: The Dice/IoU values for holes and cysts were 0.94/0.91 and 0.87/0.81, respectively. Across lesion classes, HD95 = 6 px and ECE = 0.008, indicating good boundary accuracy and calibration. In GT mode (τ = 20), three regimes were observed: (i) retina-dominant: high ARIL (hole: 0.659; cyst: 0.654), high Leak (hole: 0.983; cyst: 0.988), and low COM-dist (hole: 7.84 px; cyst: 6.91 px), with the focus lying within the retina and largely confined to the retinal tissue; (ii) peri-lesional: highest ARIL (hole: 0.684; cyst: 0.719), relatively lower Leak (hole: 0.917; cyst: 0.940), and medium/high COM-dist (hole: 16.22 px; cyst: 10.17 px), with the focus located around the lesion; (iii) narrow-coverage: primarily seen for cysts in GT mode (ARIL: 0.494; Leak: 1.000; COM-dist: 52.02 px), with markedly reduced coverage. In Pred mode, the ARIL20 for holes increased in the retina-dominant cluster (0.758) and COM-dist decreased (6.24 px), indicating better agreement with the model segmentation. Conclusions: The model exhibited high accuracy and good calibration for MH and cyst segmentation in OCT images. Quantitative characterization of SHAP validated the model results. In the clinic, peri-lesion and narrow-coverage conditions are the key situations that require careful interpretation. Full article

Objectives: The aim of this study was to evaluate changes in corneal topography, wavefront aberrations, and densitometry after superficial keratectomy (SK) for Salzmann nodular degeneration (SND). Methods: This was an observational retrospective study. Pre- and post-operative data, including best spectacle-corrected visual acuity (BCVA), refraction, and Pentacam^® topography scans, were analysed. Changes in keratometry (K), wavefront aberrations, and corneal optical densitometry (COD) were evaluated. Results: A total of 21 eyes of 17 patients who underwent SK for SND were included. At an average follow-up of 6.3 ± 4.4 months, there was a significant reduction in RMS (root mean square) values for total wavefront aberrations after surgery (mean reduction: −3.89 ± 4.08 μm, p = 0.001), lower-order aberrations (mean reduction: −3.47 ± 3.52 μm, p = 0.001), and higher-order aberrations (mean: −0.42 ± 0.58 μm, p < 0.001). There was a significant improvement in BCVA (mean change: 0.27 ± 0.31 logMAR, p < 0.001) and spherical equivalent (mean change: −2.09 ± 2.73 D, p = 0.002), and a reduction in refractive cylinder (mean reduction: −0.85 ± 1.14 D, p = 0.008). There was a significant reduction in corneal astigmatism (mean reduction 1.04 ± 2.88 D; p = 0.041), and an increase in flat keratometry (mean change 1.46 ± 3.10 D; p = 0.029). Lastly, there was a significant decrease in total COD values in all zones except for the central 2 mm (p < 0.05) and in the overall total 12 mm cornea (p = 0.035). Conclusions: SK for SND resulted in better visual acuity and potentially improved quality as suggested by the reduction in corneal aberrations and improvement in corneal regularity and transparency. Full article

Background/Objectives: The influence of the vitreoretinal interface on neovascular age-related macular degeneration (nAMD) remains poorly characterized. Most previous studies relied solely on macular optical coherence tomography (OCT), which provides limited information about global posterior vitreous detachment (PVD). This study evaluated (1) whether ultrasonography-defined PVD status differs between nAMD eyes and healthy controls, and (2) whether baseline PVD influences macular neovascularization (MNV) phenotype and functional outcomes following anti-vascular endothelial growth factor (anti-VEGF) therapy. Methods: In this prospective longitudinal study, treatment-naïve nAMD eyes and population-based healthy controls underwent dynamic B-scan ultrasonography and spectral-domain OCT. PVD was categorized as absent, partial, or complete. nAMD eyes received intravitreal aflibercept according to a treat-and-extend protocol and were followed for 12 months. Structural parameters—including subretinal fluid (SRF), intraretinal fluid (IRF), and central foveal thickness—along with best-corrected visual acuity (BCVA) were recorded. A multivariable linear regression model was performed to assess whether PVD independently predicted BCVA gain after adjusting for age, baseline BCVA, MNV subtype, SRF, atrophy, and number of injections. Results: Absence of PVD was significantly more frequent in nAMD eyes than in controls (p < 0.001), whereas complete PVD prevalence was comparable. In nAMD, absence of PVD was associated with a higher prevalence of MNV type 2 (p = 0.032), while partial/complete PVD correlated with type 1 lesions. After 12 months, eyes without PVD achieved the greatest visual improvement (mean BCVA gain +0.34 ± 0.26), outperforming eyes with complete PVD (p = 0.026). A multivariable model confirmed that absence of PVD was an independent predictor of greater BCVA gain (β = −0.27; 95% CI −0.42 to −0.12; p = 0.0008). Eyes with complete PVD required more injections (p = 0.046). SRF and foveal-thickness reductions occurred across groups, whereas IRF changes were similar. Conclusions: Ultrasonography-defined PVD status differs markedly between nAMD and healthy eyes and independently influences neovascular phenotype and functional response to anti-VEGF therapy. These findings underscore the physiological importance of the vitreoretinal interface and support the use of ocular ultrasonography as an adjunct tool for assessing global vitreous status in selected nAMD settings. Full article

This study compares the roles of eye-tracking and verbal reports (think-alouds and retrospective verbal reports, RVRs) in L2 reading process research through three qualitative studies. Findings indicate that eye-tracking provided precise, quantitative data on visual attention and reading patterns (e.g., fixation duration, gaze plots) and choice-making during gap-filling. Based on our mapping, it was mostly effective in identifying 13 out of 47 reading processing strategies, primarily those involving skimming or scanning that had distinctive eye-movement signatures. Verbal reports, while less exact in measurement, offered direct access to cognitive processes (e.g., strategy use, reasoning) and uncovered content-specific thoughts inaccessible to eye-tracking. Both methods exhibited reactivity: eye-tracking could cause physical discomfort or altered reading behavior, whereas think-alouds could disrupt task flow or enhance reflection. This study reveals the respective strengths and limitations of eye-tracking and verbal reports in L2 reading research. It facilitates a more informed selection and application of these methodological approaches in alignment with specific research objectives, whether employed in isolation or in an integrated manner. Full article

Background/Objectives: Pigment migration is a key biomarker of progression in age-related macular degeneration (AMD). This study assessed the diagnostic performance of ring aperture Retro mode (RAR) imaging for detecting pigment migration and compared its performance with established multimodal imaging techniques. Methods: This retrospective study included 80 eyes from 61 consecutive patients with AMD who underwent multimodal imaging with color fundus images (CFIs), fundus autofluorescence (FAF), RAR imaging (Mirante, NIDEK), and en face optical coherence tomography (OCT) with B-scans (Cirrus HD-OCT 5000, Zeiss). Two independent retina specialists graded the AMD stage and the presence of pigment migration across modalities. Sensitivity and positive predictive value (PPV) of RAR were calculated using en face OCT as the reference standard. Results: RAR demonstrated high diagnostic performance, with a sensitivity of 94.7% and a PPV of 93.4% relative to en face OCT. RAR frequently identified pigment migration that was not visible on CFI or FAF, particularly in early AMD and in eyes with media opacity. Distinct morphologic patterns—including hyperreflective foci, thickened retinal pigment epithelium, refractile drusen, and cuticular drusen—were consistently identifiable on RAR. In four eyes with geographic atrophy, RAR detected perifoveal pigment redistribution at least six months before foveal involvement was confirmed by OCT and FAF. Conclusions: RAR imaging is a rapid, sensitive, and clinically practical technique for detecting pigment migration in AMD. By complementing en face OCT and enhancing visualization in cases where standard imaging is limited, RAR may strengthen early disease surveillance, support prognostic assessment, and improve multimodal diagnostic workflows in routine practice. Full article