In the modern era, patients often resort to the internet for answers to their health-related concerns, and clinics face challenges to providing timely response to patient concerns. This has led to a need to investigate the capabilities of AI chatbots for ophthalmic diagnosis and triage. In this in silico study, 80 simulated patient complaints in ophthalmology with varying urgency levels and clinical descriptors were entered into both ChatGPT and Bard in a systematic 3-step submission process asking chatbots to triage, diagnose, and evaluate urgency. Three ophthalmologists graded chatbot responses. Chatbots were significantly better at ophthalmic triage than diagnosis (90.0% appropriate triage vs. 48.8% correct leading diagnosis; p < 0.001), and GPT-4 performed better than Bard for appropriate triage recommendations (96.3% vs. 83.8%; p = 0.008), grader satisfaction for patient use (81.3% vs. 55.0%; p < 0.001), and lower potential harm rates (6.3% vs. 20.0%; p = 0.010). More descriptors improved the accuracy of diagnosis for both GPT-4 and Bard. These results indicate that chatbots may not need to recognize the correct diagnosis to provide appropriate ophthalmic triage, and there is a potential utility of these tools in aiding patients or triage staff; however, they are not a replacement for professional ophthalmic evaluation or advice.

To report optical coherence tomography angiography (OCTA) findings pre- and post-thermal laser therapy of a rare, asymptomatic, unilateral, isolated retinal hemangioblastoma. A 40-year-old asymptomatic Caucasian man was found to have an isolated, unilateral retinal hemangioblastoma after referral for possible retinal hole. Comparison of OCTAs pre- and post-thermal laser therapy demonstrated a significant reduction of blood flow toward and within the lesion, in addition to contraction of the lesion and constriction of the accompanying feeder vessels. A 4-month follow-up OCTA showed marked reduction of lesion size, and caliber of treated vessels. Non-invasive OCTA imaging of a retinal hemangioblastoma demonstrated decreased blood flow signal and vessel caliber after treatment. OCTA shows potential as a new tool to improve our understanding of the effectiveness of therapy in these lesions.

Purpose: To present a case report in which fundus autofluorescence (FAF) helped to diagnose and monitor the clinical course of a patient diagnosed with punctate inner choroidopathy (PIC). Methods: Retrospective chart review of patient data. Results: FAF showed multiple hypoautofluorescent spots in the posterior pole.It also showed an area of hypoautofluorescence surrounded by a ring of hyperautofluorescence, which corresponded to a larger lesion seen clinically. As the disease became inactive, the number of hypoautofluorescent spots decreased. The rim of hyperautofluorescence surrounding the macular lesion became attenuated.Persistent hypofluorescent areas grew in size. Conclusions: FAF is a useful imaging modality to better visualize and delineate the extent of damaged retinal pigment epithelium (RPE) in PIC. FAF also helps the clinician to assess the resolution of the disease by the appearance of the RPE.