Objective: To evaluate the efficiency of large language models (LLMs) such as ChatGPT to assist in diagnosing neuro-ophthalmic diseases based on detailed case descriptions. Methods: We selected 22 different case reports of neuro-ophthalmic diseases from a publicly available online database. These cases included a wide range of chronic and acute diseases that are commonly seen by neuro-ophthalmic sub-specialists. We inserted the text from each case as a new prompt into both ChatGPT v3.5 and ChatGPT Plus v4.0 and asked for the most probable diagnosis. We then presented the exact information to two neuro-ophthalmologists and recorded their diagnoses followed by comparison to responses from both versions of ChatGPT. Results: ChatGPT v3.5, ChatGPT Plus v4.0, and the two neuro-ophthalmologists were correct in 13 (59%), 18 (82%), 19 (86%), and 19 (86%) out of 22 cases, respectively. The agreement between the various diagnostic sources were as follows: ChatGPT v3.5 and ChatGPT Plus v4.0, 13 (59%); ChatGPT v3.5 and the first neuro-ophthalmologist, 12 (55%); ChatGPT v3.5 and the second neuro-ophthalmologist, 12 (55%); ChatGPT Plus v4.0 and the first neuro-ophthalmologist, 17 (77%); ChatGPT P
In 2004, Dai, Lathrop, Lutz, and Mayordomo defined and investigated the finite-state dimension (a finite-state version of algorithmic dimension) of a sequence $S \in Σ^\infty$ and, in 2018, Case and Lutz defined and investigated the mutual (algorithmic) dimension between two sequences $S \in Σ^\infty$ and $T \in Σ^\infty$. In this paper, we propose a definition for the lower and upper finite-state mutual dimensions $mdim_{FS}(S:T)$ and $Mdim_{FS}(S:T)$ between two sequences $S \in Σ^\infty$ and $T \in Σ^\infty$ over an alphabet $Σ$. Intuitively, the finite-state dimension of a sequence $S \in Σ^\infty$ represents the density of finite-state information contained within $S$, while the finite-state mutual dimension between two sequences $S \in Σ^\infty$ and $T \in Σ^\infty$ represents the density of finite-state information shared by $S$ and $T$. Thus ``finite-state mutual dimension'' can be viewed as a ``finite-state'' version of mutual dimension and as a ``mutual'' version of finite-state dimension. The main results of this investigation are as follows. First, we show that finite-state mutual dimension, defined using information-lossless finite-state compressors, has all of the pro
Quantum technologies are rapidly advancing across multiple research domains, with a growing impact on biomedical imaging and sensing. We examine their emerging role in ophthalmology through four complementary directions: photon-limited retinal imaging, correlation based imaging, nanoscale optical probes, and quantum-limited visual perception. Advances in optical coherence tomography and single-photon detection enable imaging under strict photon budget constraints, reducing phototoxicity while preserving image quality. Correlation-based approaches, including ghost imaging, offer alternative strategies for image formation in low-light and scattering environments, although practical implementation remains limited by detection efficiency and acquisition time. In parallel, nanoscale optical platforms such as quantum dots provide tunable and photostable probes for enhanced contrast and targeted delivery, with ongoing challenges related to biocompatibility and clinical translation. Finally, experiments at the single-photon level and with structured light fields demonstrate how the visual system itself operates near physical detection limits and can be probed using controlled optical state
Artificial intelligence has shown promise in medical imaging, yet most existing systems lack flexibility, interpretability, and adaptability - challenges especially pronounced in ophthalmology, where diverse imaging modalities are essential. We present EyeAgent, the first agentic AI framework for comprehensive and interpretable clinical decision support in ophthalmology. Using a large language model (DeepSeek-V3) as its central reasoning engine, EyeAgent interprets user queries and dynamically orchestrates 53 validated ophthalmic tools across 23 imaging modalities for diverse tasks including classification, segmentation, detection, image/report generation, and quantitative analysis. Stepwise ablation analysis demonstrated a progressive improvement in diagnostic accuracy, rising from a baseline of 69.71% (using only 5 general tools) to 80.79% when the full suite of 53 specialized tools was integrated. In an expert rating study on 200 real-world clinical cases, EyeAgent achieved 93.7% tool selection accuracy and received expert ratings of more than 88% across accuracy, completeness, safety, reasoning, and interpretability. In human-AI collaboration, EyeAgent matched or exceeded the p
Vision impairment affects millions globally, and early detection is critical to preventing irreversible vision loss. Ophthalmology workflows require clinicians to integrate medical images, structured clinical data, and free-text notes to determine disease severity and management, which is time-consuming and burdensome. Recent multimodal large language models (MLLMs) show promise, but existing general and medical MLLMs perform poorly in ophthalmology, and few ophthalmology-specific MLLMs are openly available. We present VOLMO (Versatile and Open Large Models for Ophthalmology), a model-agnostic, data-open framework for developing ophthalmology-specific MLLMs. VOLMO includes three stages: ophthalmology knowledge pretraining on 86,965 image-text pairs from 26,569 articles across 82 journals; domain task fine-tuning on 26,929 annotated instances spanning 12 eye conditions for disease screening and severity classification; and multi-step clinical reasoning on 913 patient case reports for assessment, planning, and follow-up care. Using this framework, we trained a compact 2B-parameter MLLM and compared it with strong baselines, including InternVL-2B, LLaVA-Med-7B, MedGemma-4B, MedGemma-2
Precision medicine in ophthalmology requires accurate longitudinal predictions, but the fragmented nature of multimodal clinical data remains a barrier to forecasting. We introduce OphthaDT, an LLM-based digital twin for ophthalmology that serializes longitudinal patient histories from 3,220 patients across four Phase III clinical trials into structured narratives to forecast best corrected visual acuity (BCVA). In benchmarks spanning up to 100 weeks, OphthaDT demonstrated the lowest prediction error in neovascular age-related macular degeneration (nAMD), achieving an average mean absolute error (MAE) reduction of 6.0% compared to all baselines. In diabetic macular edema (DME), OphthaDT demonstrated competitive performance against all baselines while outperforming Random Forest and XGBoost by an average MAE reduction of 2.6% and 6.9%, respectively. Results reveal that OphthaDT's predictive advantage scales with trajectory complexity: whereas linear models remain effective for the more stable treatment responses of DME, OphthaDT's capacity is better suited for capturing the high longitudinal variability of nAMD. Finally, OphthaDT handles irregular sampling without imputation, positi
We report results of the CASE 2022 Shared Task 1 on Multilingual Protest Event Detection. This task is a continuation of CASE 2021 that consists of four subtasks that are i) document classification, ii) sentence classification, iii) event sentence coreference identification, and iv) event extraction. The CASE 2022 extension consists of expanding the test data with more data in previously available languages, namely, English, Hindi, Portuguese, and Spanish, and adding new test data in Mandarin, Turkish, and Urdu for Sub-task 1, document classification. The training data from CASE 2021 in English, Portuguese and Spanish were utilized. Therefore, predicting document labels in Hindi, Mandarin, Turkish, and Urdu occurs in a zero-shot setting. The CASE 2022 workshop accepts reports on systems developed for predicting test data of CASE 2021 as well. We observe that the best systems submitted by CASE 2022 participants achieve between 79.71 and 84.06 F1-macro for new languages in a zero-shot setting. The winning approaches are mainly ensembling models and merging data in multiple languages. The best two submissions on CASE 2021 data outperform submissions from last year for Subtask 1 and Su
Purpose: To evaluate the accuracy and reasoning ability of DeepSeek-R1 and three other recently released large language models (LLMs) in bilingual complex ophthalmology cases. Methods: A total of 130 multiple-choice questions (MCQs) related to diagnosis (n = 39) and management (n = 91) were collected from the Chinese ophthalmology senior professional title examination and categorized into six topics. These MCQs were translated into English using DeepSeek-R1. The responses of DeepSeek-R1, Gemini 2.0 Pro, OpenAI o1 and o3-mini were generated under default configurations between February 15 and February 20, 2025. Accuracy was calculated as the proportion of correctly answered questions, with omissions and extra answers considered incorrect. Reasoning ability was evaluated through analyzing reasoning logic and the causes of reasoning error. Results: DeepSeek-R1 demonstrated the highest overall accuracy, achieving 0.862 in Chinese MCQs and 0.808 in English MCQs. Gemini 2.0 Pro, OpenAI o1, and OpenAI o3-mini attained accuracies of 0.715, 0.685, and 0.692 in Chinese MCQs (all P<0.001 compared with DeepSeek-R1), and 0.746 (P=0.115), 0.723 (P=0.027), and 0.577 (P<0.001) in English MCQ
A set $S\subseteq V$ is a dominating set of $G$ if every vertex in $V - S$ is adjacent to at least one vertex in $S$. The domination number $γ(G)$ of $G$ equals the minimum cardinality of a dominating set $S$ in $G$; we say that such a set $S$ is a $γ$-set. A generalization of this is partial domination which was introduced in 2017 by Case, Hedetniemi, Laskar, and Lipman [3,2] . In partial domination a set $S$ is a $p$-dominating set if it dominates a proportion $p$ of the vertices in $V$. The p-domination number $γ_{p}(G)$ is the minimum cardinality of a $p$-dominating set in $G$. In this paper, we investigate further properties of partial dominating sets, particularly ones related to graph products and locating partial dominating sets. We also introduce the concept of a $p$-influencing set as the union of all $p$-dominating sets for a fixed $p$ and investigate some of its properties.
Purpose: We investigated the utilization of privacy-preserving, locally-deployed, open-source Large Language Models (LLMs) to extract diagnostic information from free-text cardiovascular magnetic resonance (CMR) reports. Materials and Methods: We evaluated nine open-source LLMs on their ability to identify diagnoses and classify patients into various cardiac diagnostic categories based on descriptive findings in 109 clinical CMR reports. Performance was quantified using standard classification metrics including accuracy, precision, recall, and F1 score. We also employed confusion matrices to examine patterns of misclassification across models. Results: Most open-source LLMs demonstrated exceptional performance in classifying reports into different diagnostic categories. Google's Gemma2 model achieved the highest average F1 score of 0.98, followed by Qwen2.5:32B and DeepseekR1-32B with F1 scores of 0.96 and 0.95, respectively. All other evaluated models attained average scores above 0.93, with Mistral and DeepseekR1-7B being the only exceptions. The top four LLMs outperformed our board-certified cardiologist (F1 score of 0.94) across all evaluation metrics in analyzing CMR reports.
The need for improved diagnostic methods in ophthalmology is acute, especially in the underdeveloped regions with limited access to specialists and advanced equipment. Therefore, we introduce VisionUnite, a novel vision-language foundation model for ophthalmology enhanced with clinical knowledge. VisionUnite has been pretrained on an extensive dataset comprising 1.24 million image-text pairs, and further refined using our proposed MMFundus dataset, which includes 296,379 high-quality fundus image-text pairs and 889,137 simulated doctor-patient dialogue instances. Our experiments indicate that VisionUnite outperforms existing generative foundation models such as GPT-4V and Gemini Pro. It also demonstrates diagnostic capabilities comparable to junior ophthalmologists. VisionUnite performs well in various clinical scenarios including open-ended multi-disease diagnosis, clinical explanation, and patient interaction, making it a highly versatile tool for initial ophthalmic disease screening. VisionUnite can also serve as an educational aid for junior ophthalmologists, accelerating their acquisition of knowledge regarding both common and underrepresented ophthalmic conditions. VisionUnit
Vision impairment and blindness are a major global health challenge where gaps in the ophthalmology workforce limit access to specialist care. We evaluate AMIE, a medically fine-tuned conversational system based on Gemini with integrated web search and self-critique reasoning, using real-world clinical vignettes that reflect scenarios a general ophthalmologist would be expected to manage. We conducted two complementary evaluations: (1) a human-AI interactive diagnostic reasoning study in which ophthalmologists recorded initial differentials and plans, then reviewed AMIE's structured output and revised their answers; and (2) a masked preference and quality study comparing AMIE's narrative outputs with case author reference answers using a predefined rubric. AMIE showed standalone diagnostic performance comparable to clinicians at baseline. Crucially, after reviewing AMIE's responses, ophthalmologists tended to rank the correct diagnosis higher, reached greater agreement with one another, and enriched their investigation and management plans. Improvements were observed even when AMIE's top choice differed from or underperformed the clinician baseline, consistent with a complementary
In the face of an infectious disease, a key epidemiological measure is the basic reproduction number, which quantifies the average secondary infections caused by a single case in a susceptible population. In practice, the effective reproduction number, denoted as $R_t$, is widely used to assess the transmissibility of the disease at a given time $t$. Real-time estimating this metric is vital for understanding and managing disease outbreaks. Traditional statistical inference often relies on two assumptions. One is that samples are assumed to be drawn from a homogeneous population distribution, neglecting significant variations in individual transmission rates. The other is the ideal case reporting assumption, disregarding time delays between infection and reporting. In this paper, we thoroughly investigate these critical factors and assess their impact on estimating $R_t$. We first introduce negative binomial and Weibull distributions to characterize transmission rates and reporting delays, respectively, based on which observation and state equations are formulated. Then, we employ a Bayesian filtering for estimating $R_t$. Finally, validation using synthetic and empirical data demo
Current benchmarks evaluating large language models (LLMs) in ophthalmology are limited in scope and disproportionately prioritise accuracy. We introduce BELO (BEnchmarking LLMs for Ophthalmology), a standardized and comprehensive evaluation benchmark developed through multiple rounds of expert checking by 13 ophthalmologists. BELO assesses ophthalmology-related clinical accuracy and reasoning quality. Using keyword matching and a fine-tuned PubMedBERT model, we curated ophthalmology-specific multiple-choice-questions (MCQs) from diverse medical datasets (BCSC, MedMCQA, MedQA, BioASQ, and PubMedQA). The dataset underwent multiple rounds of expert checking. Duplicate and substandard questions were systematically removed. Ten ophthalmologists refined the explanations of each MCQ's correct answer. This was further adjudicated by three senior ophthalmologists. To illustrate BELO's utility, we evaluated six LLMs (OpenAI o1, o3-mini, GPT-4o, DeepSeek-R1, Llama-3-8B, and Gemini 1.5 Pro) using accuracy, macro-F1, and five text-generation metrics (ROUGE-L, BERTScore, BARTScore, METEOR, and AlignScore). In a further evaluation involving human experts, two ophthalmologists qualitatively revie
Large language models (LLMs) have shown significant promise across various medical applications, with ophthalmology being a notable area of focus. Many ophthalmic tasks have shown substantial improvement through the integration of LLMs. However, before these models can be widely adopted in clinical practice, evaluating their capabilities and identifying their limitations is crucial. To address this research gap and support the real-world application of LLMs, we introduce the OphthBench, a specialized benchmark designed to assess LLM performance within the context of Chinese ophthalmic practices. This benchmark systematically divides a typical ophthalmic clinical workflow into five key scenarios: Education, Triage, Diagnosis, Treatment, and Prognosis. For each scenario, we developed multiple tasks featuring diverse question types, resulting in a comprehensive benchmark comprising 9 tasks and 591 questions. This comprehensive framework allows for a thorough assessment of LLMs' capabilities and provides insights into their practical application in Chinese ophthalmology. Using this benchmark, we conducted extensive experiments and analyzed the results from 39 popular LLMs. Our evaluati
We introduce an annotated corpus of 600 ophthalmology notes labeled with detailed spatial and contextual information of ophthalmic entities. We extend our previously proposed frame semantics-based spatial representation schema, Rad-SpatialNet, to represent spatial language in ophthalmology text, resulting in the Eye-SpatialNet schema. The spatially-grounded entities are findings, procedures, and drugs. To accurately capture all spatial details, we add some domain-specific elements in Eye-SpatialNet. The annotated corpus contains 1715 spatial triggers, 7308 findings, 2424 anatomies, and 9914 descriptors. To automatically extract the spatial information, we employ a two-turn question answering approach based on the transformer language model BERT. The results are promising, with F1 scores of 89.31, 74.86, and 88.47 for spatial triggers, Figure, and Ground frame elements, respectively. This is the first work to represent and extract a wide variety of clinical information in ophthalmology. Extracting detailed information can benefit ophthalmology applications and research targeted toward disease progression and screening.
Vision-threatening eye diseases pose a major global health burden, with timely diagnosis limited by workforce shortages and restricted access to specialized care. While multimodal large language models (MLLMs) show promise for medical image interpretation, advancing MLLMs for ophthalmology is hindered by the lack of comprehensive benchmark datasets suitable for evaluating generative models. We present a large-scale multimodal ophthalmology benchmark comprising 32,633 instances with multi-granular annotations across 12 common ophthalmic conditions and 5 imaging modalities. The dataset integrates imaging, anatomical structures, demographics, and free-text annotations, supporting anatomical structure recognition, disease screening, disease staging, and demographic prediction for bias evaluation. This work extends our preliminary LMOD benchmark with three major enhancements: (1) nearly 50% dataset expansion with substantial enlargement of color fundus photography; (2) broadened task coverage including binary disease diagnosis, multi-class diagnosis, severity classification with international grading standards, and demographic prediction; and (3) systematic evaluation of 24 state-of-the
Deep learning has recently gained high interest in ophthalmology, due to its ability to detect clinically significant features for diagnosis and prognosis. Despite these significant advances, little is known about the ability of various deep learning systems to be embedded within ophthalmic imaging devices, allowing automated image acquisition. In this work, we will review the existing and future directions for "active acquisition" embedded deep learning, leading to as high quality images with little intervention by the human operator. In clinical practice, the improved image quality should translate into more robust deep learning-based clinical diagnostics. Embedded deep learning will be enabled by the constantly improving hardware performance with low cost. We will briefly review possible computation methods in larger clinical systems. Briefly, they can be included in a three-layer framework composed of edge, fog and cloud layers, the former being performed at a device-level. Improved edge layer performance via "active acquisition" serves as an automatic data curation operator translating to better quality data in electronic health records (EHRs), as well as on the cloud layer, f
With the growth of global maritime transportation, energy optimization has become crucial for reducing costs and ensuring operational efficiency. Shaft power is the mechanical power transmitted from the engine to the shaft and directly impacts fuel consumption, making its accurate prediction a paramount step in optimizing vessel performance. Power consumption is highly correlated with ship parameters such as speed and shaft rotation per minute, as well as weather and sea conditions. Frequent access to this operational data can improve prediction accuracy. However, obtaining high-quality sensor data is often infeasible and costly, making alternative sources such as noon reports a viable option. In this paper, we propose a transfer learning-based approach for predicting vessels shaft power, where a model is initially trained on high-frequency data from a vessel and then fine-tuned with low-frequency daily noon reports from other vessels. We tested our approach on sister vessels (identical dimensions and configurations), a similar vessel (slightly larger with a different engine), and a different vessel (distinct dimensions and configurations). The experiments showed that the mean abso
The prevalence of vision-threatening eye diseases is a significant global burden, with many cases remaining undiagnosed or diagnosed too late for effective treatment. Large vision-language models (LVLMs) have the potential to assist in understanding anatomical information, diagnosing eye diseases, and drafting interpretations and follow-up plans, thereby reducing the burden on clinicians and improving access to eye care. However, limited benchmarks are available to assess LVLMs' performance in ophthalmology-specific applications. In this study, we introduce LMOD, a large-scale multimodal ophthalmology benchmark consisting of 21,993 instances across (1) five ophthalmic imaging modalities: optical coherence tomography, color fundus photographs, scanning laser ophthalmoscopy, lens photographs, and surgical scenes; (2) free-text, demographic, and disease biomarker information; and (3) primary ophthalmology-specific applications such as anatomical information understanding, disease diagnosis, and subgroup analysis. In addition, we benchmarked 13 state-of-the-art LVLM representatives from closed-source, open-source, and medical domains. The results demonstrate a significant performance d