Artificial intelligence has undergone a rapid evolution and large language models (LLMs) have become promising tools for healthcare, with the ability of providing human-like responses to questions. The capabilities of these tools in addressing questions related to keratoconus (KCN) have not been previously explored. In this study, the responses were evaluated from three LLMs - ChatGPT-4, Copilot, and Gemini - to common patient questions regarding KCN. Fifty real-life patient inquiries regarding general information, aetiology, symptoms and diagnosis, progression, and treatment of KCN were presented to the LLMs. Evaluations of the answers were conducted by three ophthalmologists with a 5-point Likert scale ranging from 'strongly disagreed' to 'strongly agreed'. The reliability of the responses provided by LLMs was evaluated using the DISCERN and the Ensuring Quality Information for Patients (EQIP) scales. Readability metrics (Flesch Reading Ease Score, Flesch-Kincaid Grade Level, and Coleman-Liau Index) were calculated to evaluate the complexity of responses. ChatGPT-4 consistently scored 3 points or higher for all (100%) its responses, while Copilot had five (10%) and Gemini had two (4%) responses scoring 2 points or below. ChatGPT-4 achieved a 'strongly agree' rate of 74% across all questions, markedly superior to Copilot at 34% and Gemini at 42% (p < 0.001); and recorded the highest 'strongly agree' rates in general information and symptoms & diagnosis categories (90% for both). The median Likert scores differed among LLMs (p < 0.001), with ChatGPT-4 scoring highest and Copilot scoring lowest. Although ChatGPT-4 exhibited more reliability based on the DISCERN scale, it was characterised by lower readability and higher complexity. While all LLMs provided responses categorised as 'extremely difficult to read', the responses provided by Copilot showed higher readability. Despite the responses provided by ChatGPT-4 exhibiting lower readability and greater complexity, it emerged as the most proficient in answering KCN-related questions.

Toxoplasma chorioretinitis (TC) can exhibit atypical features in immunocompromised patients including bilaterality, extensive spread, multifocal presentation, large areas of retinal necrosis without adjacent retinal scarring, and diffuse necrotizing retinitis resembling the viral retinitis that may cause confusion in the differential diagnosis. The aim of this study was to present the clinical features of four eyes of three immunocompromised patients with active toxoplasma chorioretinitis. Two of the patients were female and one, male. Two patients had hematological malignancies and the remaining patient was under adalimumab treatment for ankylosing spondylitis. Visual complaints began 10 days to four months prior to TC diagnosis. All four eyes had mild-to-moderate anterior chamber cells together with severe vitritis on slit-lamp examination while there were solitary chorioretinitis lesions on fundoscopy. Despite all patients were negative for anti-toxoplasma immunoglobulin M, all were positive for immunoglobulin G. All three patients were successfully treated with a combined treatment of systemic and intravitreal anti-toxoplasmic drugs. Clinicians should be cautious for the possible toxoplasma chorioretinitis besides the other infectious entities when a new uveitis episode is detected in an immunosuppressed patient in order to avoid misdiagnosis and thereby wrong treatment.

Purpose: To analyze the multimodal imaging characteristics of intraretinal macroaneurysms. Patients and Methods: Intraretinal aneurysms larger than 150 μm in diameter on fluorescein angiography were termed as intraretinal macroaneurysm and grouped as primary and secondary according to the absence or presence of any coexisting posterior segment diseases. Results: A total of 20 intraretinal macroaneurysms were observed in 18 eyes of 18 patients. Mean age of the cohort was 65.44 ± 9.14 years (Range; 49– 82 years). Mean diameters of intraretinal macroaneurysms were 238.20 ± 61.12 μm (Range; 163.00– 292.50 μm) and 242.72 ± 49.58 μm (Range; 168.00– 328.00 μm) on fluorescein angiography and optical coherence tomography, respectively. Primary group had 10 eyes with 11 intraretinal macroaneurysms, whereas eight eyes had nine intraretinal macroaneurysms in the secondary group. Three of the eight eyes (37.5%) had diabetic retinopathy, four (50%), retinal vein occlusion, and one (12.5%), posterior uveitis in the secondary group. No statistically significant differences were found between the two groups in terms of age, sex, presence of intraretinal or subretinal fluid, the mean age, the mean central macular thickness, the mean distance of intraretinal macroaneurysms from the fovea, the mean diameter of intraretinal macroaneurysms measured on fluorescein angiography, and the mean diameter of intraretinal macroaneurysms measured on optical coherence tomography. Presence of intraretinal fluid was significantly more frequent than the presence of subretinal fluid in all eyes (p = 0.004). Conclusion: Intraretinal macroaneurysms are diagnosed more and more with the utilization of multimodal imaging techniques. We propose a simple classification system in order to help achieving a standardized terminology and ensure consistent understanding. The classification can be simplified as primary or secondary intraretinal macroaneurysm according to the absence or presence of the associated posterior segment disorders.

A retrospective analysis of 10 consecutive patients who had serologically confirmed ocular syphilis between June 2020 and February 2023 was performed. All cases presented with ocular manifestations. Eight patients were diagnosed with syphilis and two patients with syphilis/human immunodeficiency virus co-infection. Type and duration of antibiotic treatments were diverse among the patients. Four patients had intramuscular benzyl-penicillin G 2.4 million units (MU) weekly for three weeks; four, intravenous ceftriaxone for 14 days; one, intravenous penicillin G 24 MU/day for 14 days; and the remaining patient, intravenous penicillin G 24 MU/day for a week and then oral doxycycline for two weeks. As adjunctive therapy to systemic antibiotics, oral corticosteroids in three patients and intravitreal ceftazidime (2.25 mg/0.1 mL) injections in one patient were administered. In conclusion, ocular syphilis is a re-emerging phenomenon; prompt diagnosis and proper antibiotic treatment can prevent serious ocular complications.