Current status and solutions for AI ethics in ophthalmology: a bibliometric analysis

Ophthalmology, an early adopter of medical artificial intelligence (AI), has made significant advancements, but ethical discussions limited. This bibliometric analysis reviewed 498 publications from Web of Science and Scopus (2000-2023) to explore the evolution, status, thematic trends, data modalities and their ethical focus, and solutions in ophthalmic AI ethics. Ophthalmology ranks second in medical AI ethics, with major contributors from the United States (US), China, the United Kingdom (UK), Singapore and India. Ethical concerns focus on privacy, fairness, and transparency. Ethical priorities differ by modality with fundus imaging (59.4%) and Optical Coherence Tomography (OCT) (30.9%) as the most common. Most studies (78.3%) address ethics in diagnostic algorithm development, while only 11.5% directly target ethical concerns, though this focus is increasing. This study highlights the need for AI technologies and guidelines to address ethical challenges in ophthalmology, offering a future direction for research and innovation in medical AI governance.