The convergence of artificial intelligence (AI), digital sensing, and ubiquitous computing has created an unprecedented opportunity to transform myopia prevention from a reactive, population-based model into a proactive, precision-driven one. Despite evidence that half the world's population will be myopic by 2050, conventional approaches---school-based vision screening (Phase 1.0) and evidence-based risk factor management (Phase 2.0)---have proven insufficient. We review the emergence of Myopia Prevention and Control 3.0, defined by AI integration across three interconnected domains forming a closed-loop pipeline: (1) AI-driven risk stratification predicting individual-level risk through machine learning on multimodal data; (2) AI-enabled proactive monitoring via wearables, smartphones, and school screening networks; and (3) AI-powered personalized intervention with closed-loop feedback. We critically evaluate evidence across each stage, discuss challenges in data quality, model validation, ethics, and equity, and outline future directions including multimodal foundation models, digital twins, and causal machine learning.
Early and accurate glaucoma detection is critical to prevent irreversible vision loss, yet existing AI methods often rely on unimodal inputs and lack interpretability. We present GlaBoost, a multimodal gradient boosting framework that unifies three complementary signals for glaucoma risk prediction: fundus image embeddings from a pretrained convolutional encoder,free-text neuroretinal rim assessments encoded by a transformer-based language model, and structured ophthalmic biomarkers. These modalities are fused into a single representation and classified by an enhanced XGBoost model.On two real-world annotated datasets, GlaBoost consistently outperforms unimodal and generic multimodal baselines. Feature importance analysis highlights the cup-to-disc ratio, rim thinning, and the ISNT rule as the dominant predictors, yielding clinically consistent and interpretable decisions. GlaBoost offers a transparent and scalable foundation for multimodal decision support in ophthalmology.
This article presents a structured framework of behavioral indicators that may signal progression toward potentially catastrophic threats from artificial intelligence systems. We adopt a pragmatic approach, inspired by established methodologies in cybersecurity and national security. By establishing clear metrics, indicators, and thresholds across multiple dimensions of AI capability and behavior, this framework enables researchers and policymakers to implement evidence-based monitoring protocols.
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, positioning LLM-based clinical trajectory modeling as a methodology that could reduce patient burden and accelerate drug development.
Pietro Belligoli, Nikita Makarov, Sayedali Shetab Boushehri +3