Can large language models unlock discrete data in ophthalmic diagnostic reports?

Abstract

Objective: To assess the accuracy and efficiency of a large language model (LLM) using two prompt strategies to extract structured data from ophthalmic diagnostic PDF reports. Methods: Twenty deidentified reports across four types (Visual Field, OCT Glaucoma Overview, OCT retinal nerve fiber layer Single Exam, and OCT Thickness Map; n = 5 each) were processed using two GPT-4o-assisted pipelines and compared with a reconciled manual ground truth. Schema-Constrained used Structured Output mode with a predefined JSON Schema; Prompt-Only used a detailed instruction prompt followed by Python conversion to JSON. Outcomes were value accuracy, formatting accuracy, and extraction time. Results: Schema-Constrained value accuracy was 100.00% for Visual Field and RNFL Single Exam, 97.45% for Glaucoma Overview, and 98.00% for Thickness Map; Prompt-Only achieved 100.00% across all four report types. Formatting accuracy was 100.00% for Schema-Constrained across all report types and 100.00% for Prompt-Only except RNFL Single Exam (90.14%). Mean extraction time was 56.51 s per report for manual review versus 5.04 s for Schema-Constrained and 4.70 s for Prompt-Only, an approximately 92% reduction. Conclusions: In this small proof-of-concept dataset, general-purpose LLM-assisted pipelines extracted structured data from ophthalmic diagnostic PDFs with high accuracy and substantially reduced processing time. Prompt-Only achieved the highest value accuracy, while Schema-Constrained produced schema-compliant output with 100% formatting accuracy. These complementary strengths support further evaluation of hybrid, validation-aware workflows for research and clinical data abstraction.