David A. Merle
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View article: Understanding the robustness of vision-language models to medical image artefacts
Understanding the robustness of vision-language models to medical image artefacts Open
Vision-language models (VLMs) show promise for answering clinically relevant questions, but their robustness to medical image artefacts remains unclear. We evaluated VLMs’ robustness through their performance on images with and without wea…
View article: Deep Research Agents: Major Breakthrough or Incremental Progress for Medical AI ? (Preprint)
Deep Research Agents: Major Breakthrough or Incremental Progress for Medical AI ? (Preprint) Open
UNSTRUCTURED Deep Research Agents are autonomous LLM-based systems capable of iterative web search, retrieval, and synthesis. They are increasingly positioned as the next major leap in medical AI. In this Viewpoint, we argue that while th…
View article: Extracellular matrix stiffness modulates angiogenic properties of the retinal pigment epithelium
Extracellular matrix stiffness modulates angiogenic properties of the retinal pigment epithelium Open
Physiological and pathological processes, such as aging and basal deposit aggregation in degenerative retinal diseases like age-related macular degeneration (AMD), alter the mechanical properties of Bruch’s membrane (BrM). These mechanical…
View article: Mild <i>RPE65</i> -Associated Inherited Retinal Dystrophies: A Multimodal Clinical and Genetic Evaluation
Mild <i>RPE65</i> -Associated Inherited Retinal Dystrophies: A Multimodal Clinical and Genetic Evaluation Open
Localized multimodal diagnostics help detect early changes in mild RPE65-associated IRDs, supporting precise monitoring and gene therapy counseling.
View article: Incidence, risk factors, and outcomes of numerical hypotony and choroidal effusion following <scp>PRESERFLO MicroShunt</scp> implantation
Incidence, risk factors, and outcomes of numerical hypotony and choroidal effusion following <span>PRESERFLO MicroShunt</span> implantation Open
Purpose To evaluate the incidence, outcomes, and risk factors of numerical hypotony (NH) and choroidal effusion (CE) following standalone PRESERFLO MicroShunt (PMS) implantation. Methods Primary open‐angle glaucoma (POAG) and pseudoexfolia…
View article: Towards a FHIR Specification for Research in Ophthalmology: Designing the EyeMatics Core Data Set for Multi-Centric Data Integration
Towards a FHIR Specification for Research in Ophthalmology: Designing the EyeMatics Core Data Set for Multi-Centric Data Integration Open
Introduction: EyeMatics (Eye disease “treated” with interoperable medical informatics) is a clinical use case in Germany’s Medical Informatics Initiative (MII). The objective of EyeMatics is to improve the understanding of the treatment ef…
View article: In-Context Learning for Data-Efficient Diabetic Retinopathy Detection via Multimodal Foundation Models
In-Context Learning for Data-Efficient Diabetic Retinopathy Detection via Multimodal Foundation Models Open
View article: Flavoprotein Fluorescence Imaging in Stargardt Disease: Linking Metabolic Stress to Structural Damage
Flavoprotein Fluorescence Imaging in Stargardt Disease: Linking Metabolic Stress to Structural Damage Open
This study demonstrates that FPF imaging is a promising tool for detecting early metabolic changes in Stargardt disease, potentially serving as a non-invasive biomarker for monitoring disease progression and treatment response. However, cu…
View article: Short-Term Outcomes of Pediatric Patients With Mild Autosomal Recessive <i>RPE65</i>-Associated Retinal Dystrophy Treated With Voretigene Neparvovec
Short-Term Outcomes of Pediatric Patients With Mild Autosomal Recessive <i>RPE65</i>-Associated Retinal Dystrophy Treated With Voretigene Neparvovec Open
This study aids clinical decision-making in unclear cases by demonstrating that early treatment with voretigene neparvovec in mild RPE65-IRD provides functional benefits while minimizing the risk of fast-growing chorioretinal atrophy.
View article: Exploring the Dilemma of AI Use in Medical Research and Knowledge Synthesis: A Perspective on Deep Research Tools
Exploring the Dilemma of AI Use in Medical Research and Knowledge Synthesis: A Perspective on Deep Research Tools Open
Advances in artificial intelligence (AI) promise to reshape the landscape of scientific inquiry. Amidst all these, OpenAI’s latest tool, Deep Research, stands out for its potential to revolutionize how researchers engage with the literatur…
View article: Eye Care in the Intensive Care Unit
Eye Care in the Intensive Care Unit Open
Critically ill patients in the intensive care unit (ICU) are especially at high risk of ocular surface damage due to sedation, mechanical ventilation, and impairment of protective eye mechanisms (e.g., reduced blink reflex and tear product…
View article: Understanding the robustness of vision-language models to medical image artefacts
Understanding the robustness of vision-language models to medical image artefacts Open
Vision-language models (VLMs) can answer clinically relevant questions with their reasoning capabilities and user-friendly interfaces. However, their robustness to commonly existing medical image artefacts has not been explored, leaving ma…
View article: Clinical manifestations of dual-gene variants involving ABCA4 in retinal dystrophies
Clinical manifestations of dual-gene variants involving ABCA4 in retinal dystrophies Open
Background This study investigates the clinical manifestations of inherited retinal diseases (IRD) associated with dual-gene variant constellations involving biallelic ABCA4 variants. Methods We assess four cases for their unique phenotypi…
View article: Revealing the Impact of Pre-training Data on Medical Foundation Models
Revealing the Impact of Pre-training Data on Medical Foundation Models Open
Medical foundation models (FM), pre-trained on large-scale unlabelled data, have demonstrated robust performance and high efficiency when fine-tuned to various clinically relevant applications. However, the impact of pre-training data on m…
View article: Preserflo MicroShunt Implantation for Glaucoma Secondary to Viral and Juvenile Idiopathic Arthritis-Related Anterior Uveitis
Preserflo MicroShunt Implantation for Glaucoma Secondary to Viral and Juvenile Idiopathic Arthritis-Related Anterior Uveitis Open
The PMS is safe and effective for glaucoma secondary to viral anterior uveitis. Conversely, it is moderately effective in eyes with JIA-related UG, with a high probability of bleb fibrosis development.
View article: EyeMatics – Multizentrische Datenauswertung von Real-World-Daten mit interoperabler medizinischer Informatik
EyeMatics – Multizentrische Datenauswertung von Real-World-Daten mit interoperabler medizinischer Informatik Open
View article: Three-Year Results of XEN-45 Implantation for Glaucoma Secondary to Fuchs Uveitis Syndrome, Intermediate Uveitis, and Juvenile Idiopathic Arthritis-Related Anterior Uveitis
Three-Year Results of XEN-45 Implantation for Glaucoma Secondary to Fuchs Uveitis Syndrome, Intermediate Uveitis, and Juvenile Idiopathic Arthritis-Related Anterior Uveitis Open
XEN-45 demonstrates a favourable safety and efficacy profile for glaucoma secondary to FUS and IU. However, its efficacy is significantly poor for JIA-related uveitic glaucoma.
View article: EyeMatics: An Ophthalmology Use Case Within the German Medical Informatics Initiative
EyeMatics: An Ophthalmology Use Case Within the German Medical Informatics Initiative Open
The EyeMatics project, embedded as a clinical use case in Germany’s Medical Informatics Initiative, is a large digital health initiative in ophthalmology. The objective is to improve the understanding of the treatment effects of intravitre…
View article: Clinical relevance of brain MRI changes in primary central nervous system lymphoma after high-dose-chemotherapy and autologous stem cell transplantation
Clinical relevance of brain MRI changes in primary central nervous system lymphoma after high-dose-chemotherapy and autologous stem cell transplantation Open
Primary central nervous system lymphoma (PCNSL) is a potentially curable disease, but affected patients often struggle in everyday life due to disease- and therapy-associated sequelae. High-dose chemotherapy followed by autologous stem cel…
View article: A CASE OF ACUTE ZONAL OCCULT OUTER RETINOPATHY UNDER IMMUNOMODULATORY TREATMENT
A CASE OF ACUTE ZONAL OCCULT OUTER RETINOPATHY UNDER IMMUNOMODULATORY TREATMENT Open
Purpose: To describe the clinical course and treatment response of a case of acute zonal occult outer retinopathy. Methods: This is an observational case report. The examinations included ophthalmic examination, longitudinal multimodal ima…
View article: Two-Year Results of XEN Gel Stent Implantation for Pseudoexfoliative Glaucoma in Phakic versus Pseudophakic Eyes
Two-Year Results of XEN Gel Stent Implantation for Pseudoexfoliative Glaucoma in Phakic versus Pseudophakic Eyes Open
Objectives: To investigate whether phakia affects the outcome of XEN-45 gel stent implantation in the treatment of pseudoexfoliative glaucoma (PXG). Methods: A retrospective, comparative cohort study of 30 phakic and 55 pseudophakic PXG pa…
View article: Long-term efficacy and safety of XEN-45 gel stent implantation in patients with normal-tension glaucoma
Long-term efficacy and safety of XEN-45 gel stent implantation in patients with normal-tension glaucoma Open
Background Minimally invasive bleb surgery using the XEN-45 gel stent has not been established for the treatment of normal-tension glaucoma (NTG). The main objective of this study was to evaluate the long-term treatment efficacy and safety…
View article: Defining reference values of arterioles in healthy individuals for studies with adaptive optics imaging
Defining reference values of arterioles in healthy individuals for studies with adaptive optics imaging Open
Purpose To investigate age-dependent wall to lumen ratio (WLR) reference values for healthy individuals in adaptive optics imaging (AO). WLR serves as an objective, dimensionless parameter for the evaluation of structural changes in vessel…
View article: User Friendliness and Perioperative Guidance Benefits of a Cataract Surgery Education App: Randomized Controlled Trial
User Friendliness and Perioperative Guidance Benefits of a Cataract Surgery Education App: Randomized Controlled Trial Open
Background Cataract surgeries are among the most performed surgeries worldwide. A thorough patient education is essential to inform patients about the perioperative process and postoperative target results concerning the intraocular lens a…
View article: Restoring vision after cat bite: a case report on successful diagnostic and therapeutic regimen for Capnocytophaga endophthalmitis
Restoring vision after cat bite: a case report on successful diagnostic and therapeutic regimen for Capnocytophaga endophthalmitis Open
View article: User Friendliness and Perioperative Guidance Benefits of a Cataract Surgery Education App: Randomized Controlled Trial (Preprint)
User Friendliness and Perioperative Guidance Benefits of a Cataract Surgery Education App: Randomized Controlled Trial (Preprint) Open
BACKGROUND Cataract surgeries are among the most performed surgeries worldwide. A thorough patient education is essential to inform patients about the perioperative process and postoperative target results concerning the intraocular lens …
View article: A morphometric analysis of the retinal arterioles with adaptive optics imaging in <scp><i>RPE65</i></scp>‐associated retinal dystrophy after treatment with voretigene neparvovec
A morphometric analysis of the retinal arterioles with adaptive optics imaging in <span><i>RPE65</i></span>‐associated retinal dystrophy after treatment with voretigene neparvovec Open
Purpose To investigate the changes in retinal arterial architecture after treatment with voretigene neparvovec in patients with retinal dystrophy caused by bi‐allelic mutations in the RPE65 gene. Methods Sixteen eyes treated with voretigen…
View article: Patient Reported and Clinical Outcomes after High-Dose Chemotherapy and Autologous Stem Cell Transplantation in Primary Central Nervous System Lymphoma
Patient Reported and Clinical Outcomes after High-Dose Chemotherapy and Autologous Stem Cell Transplantation in Primary Central Nervous System Lymphoma Open
Primary central nervous system lymphomas (PCNSL) are rare and associated with an adverse prognosis. High-dose chemotherapy followed by autologous stem cell transplantation (HDC/ASCT) improves progression free (PFS) and overall survival (OS…
View article: 10q26 – The enigma in age-related macular degeneration
10q26 – The enigma in age-related macular degeneration Open
Despite comprehensive research efforts over the last decades, the pathomechanisms of age-related macular degeneration (AMD) remain far from being understood. Large-scale genome wide association studies (GWAS) were able to provide a defined…
View article: SARS-CoV-2 spike protein functionally interacts with primary human conjunctival epithelial cells to induce a pro-inflammatory response
SARS-CoV-2 spike protein functionally interacts with primary human conjunctival epithelial cells to induce a pro-inflammatory response Open