Generative Artificial Intelligence Through ChatGPT and Other Large Language Models in Ophthalmology: Clinical Applications and Challenges

Ting Fang Tan; Arun James Thirunavukarasu; J Peter Campbell; Pearse A Keane; Louis R Pasquale; Michael D Abramoff; Jayashree Kalpathy-Cramer; Flora Lum; Judy E Kim; Sally L Baxter; Daniel Shu Wei Ting

doi:10.1016/j.xops.2023.100394

Generative Artificial Intelligence Through ChatGPT and Other Large Language Models in Ophthalmology: Clinical Applications and Challenges

Ophthalmol Sci. 2023 Sep 9;3(4):100394. doi: 10.1016/j.xops.2023.100394. eCollection 2023 Dec.

Authors

Ting Fang Tan¹, Arun James Thirunavukarasu^{2

3}, J Peter Campbell⁴, Pearse A Keane⁵, Louis R Pasquale⁶, Michael D Abramoff^{7

8

9}, Jayashree Kalpathy-Cramer¹⁰, Flora Lum¹¹, Judy E Kim¹², Sally L Baxter^{13

14}, Daniel Shu Wei Ting^{1

15}

Affiliations

¹ Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.
² University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom.
³ Corpus Christi College, University of Cambridge, Cambridge, United Kingdom.
⁴ Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, Portland, Oregon.
⁵ Moorfields Eye Hospital, University of College London, London, United Kingdom.
⁶ Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York City, New York.
⁷ American Medical Association's Digital Medicine Payment Advisory Group (DMPAG) Artificial Intelligence Workgroup, American Medical Association, Chicago, Illinois.
⁸ Department of Ophthalmology, University of Iowa, Iowa City, Iowa.
⁹ Digital Diagnostics, Inc, Coralville, Iowa.
¹⁰ Department of Ophthalmology, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
¹¹ American Academy of Ophthalmology, San Francisco, California.
¹² Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin.
¹³ Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, La Jolla, California.
¹⁴ Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California.
¹⁵ Byers Eye Institute, Stanford University, Stanford, California.

Abstract

The rapid progress of large language models (LLMs) driving generative artificial intelligence applications heralds the potential of opportunities in health care. We conducted a review up to April 2023 on Google Scholar, Embase, MEDLINE, and Scopus using the following terms: "large language models," "generative artificial intelligence," "ophthalmology," "ChatGPT," and "eye," based on relevance to this review. From a clinical viewpoint specific to ophthalmologists, we explore from the different stakeholders' perspectives-including patients, physicians, and policymakers-the potential LLM applications in education, research, and clinical domains specific to ophthalmology. We also highlight the foreseeable challenges of LLM implementation into clinical practice, including the concerns of accuracy, interpretability, perpetuating bias, and data security. As LLMs continue to mature, it is essential for stakeholders to jointly establish standards for best practices to safeguard patient safety.

Financial disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Keywords: Artificial intelligence; ChatGPT; Chatbots; Large language models.

Abstract

Grants and funding