Current and future roles of artificial intelligence in retinopathy of prematurity

Retinopathy of prematurity (ROP) is a severe condition affecting premature infants, leading to abnormal retinal blood vessel growth, retinal detachment, and potential blindness. While semi-automated systems have been used in the past to diagnose ROP-related plus disease by quantifying retinal vessel features, traditional machine learning (ML) models face challenges like accuracy and overfitting. Recent advancements in deep learning (DL), especially convolutional neural networks (CNNs), have significantly improved ROP detection and classification. The i-ROP deep learning (i-ROP-DL) system also shows promise in detecting plus disease, offering reliable ROP diagnosis potential. This research comprehensively examines the contemporary progress and challenges associated with using retinal imaging and artificial intelligence (AI) to detect ROP, offering valuable insights that can guide further investigation in this domain. Based on 89 original studies in this field (out of 1487 studies that were comprehensively reviewed), we concluded that traditional methods for ROP diagnosis suffer from subjectivity and manual analysis, leading to inconsistent clinical decisions. AI holds great promise for improving ROP management. This review explores AI's potential in ROP detection, classification, diagnosis, and prognosis.Comment: 28 pages, 8 figures, 2 tables, 235 references, 1 supplementary tabl

Automated Fovea Detection Based on Unsupervised Retinal Vessel Segmentation Method

The Computer Assisted Diagnosis systems could save workloads and give objective diagnostic to ophthalmologists. At first level of automated screening of systems feature extraction is the fundamental step. One of these retinal features is the fovea. The fovea is a small fossa on the fundus, which is represented by a deep-red or red-brown color in color retinal images. By observing retinal images, it appears that the main vessels diverge from the optic nerve head and follow a specific course that can be geometrically modeled as a parabola, with a common vertex inside the optic nerve head and the fovea located along the apex of this parabola curve. Therefore, based on this assumption, the main retinal blood vessels are segmented and fitted to a parabolic model. With respect to the core vascular structure, we can thus detect fovea in the fundus images. For the vessel segmentation, our algorithm addresses the image locally where homogeneity of features is more likely to occur. The algorithm is composed of 4 steps: multi-overlapping windows, local Radon transform, vessel validation, and parabolic fitting. In order to extract blood vessels, sub-vessels should be extracted in local windows. The high contrast between blood vessels and image background in the images cause the vessels to be associated with peaks in the Radon space. The largest vessels, using a high threshold of the Radon transform, determines the main course or overall configuration of the blood vessels which when fitted to a parabola, leads to the future localization of the fovea. In effect, with an accurate fit, the fovea normally lies along the slope joining the vertex and the focus. The darkest region along this line is the indicative of the fovea. To evaluate our method, we used 220 fundus images from a rural database (MUMS-DB) and one public one (DRIVE). The results show that, among 20 images of the first public database (DRIVE) we detected fovea in 85% of them. Also for the MUMS-DB database among 200 images we detect fovea correctly in 83% on them

Novel Fundus Image Preprocessing for Retcam Images to Improve Deep Learning Classification of Retinopathy of Prematurity

Retinopathy of Prematurity (ROP) is a potentially blinding eye disorder because of damage to the eye's retina which can affect babies born prematurely. Screening of ROP is essential for early detection and treatment. This is a laborious and manual process which requires trained physician performing dilated ophthalmological examination which can be subjective resulting in lower diagnosis success for clinically significant disease. Automated diagnostic methods can assist ophthalmologists increase diagnosis accuracy using deep learning. Several research groups have highlighted various approaches. This paper proposes the use of new novel fundus preprocessing methods using pretrained transfer learning frameworks to create hybrid models to give higher diagnosis accuracy. The evaluations show that these novel methods in comparison to traditional imaging processing contribute to higher accuracy in classifying Plus disease, Stages of ROP and Zones. We achieve accuracy of 97.65% for Plus disease, 89.44% for Stage, 90.24% for Zones with limited training dataset.Comment: 10 pages, 4 figures, 7 tables. arXiv admin note: text overlap with arXiv:1904.08796 by other author

Deep learning in ophthalmology: The technical and clinical considerations

The advent of computer graphic processing units, improvement in mathematical models and availability of big data has allowed artificial intelligence (AI) using machine learning (ML) and deep learning (DL) techniques to achieve robust performance for broad applications in social-media, the internet of things, the automotive industry and healthcare. DL systems in particular provide improved capability in image, speech and motion recognition as well as in natural language processing. In medicine, significant progress of AI and DL systems has been demonstrated in image-centric specialties such as radiology, dermatology, pathology and ophthalmology. New studies, including pre-registered prospective clinical trials, have shown DL systems are accurate and effective in detecting diabetic retinopathy (DR), glaucoma, age-related macular degeneration (AMD), retinopathy of prematurity, refractive error and in identifying cardiovascular risk factors and diseases, from digital fundus photographs. There is also increasing attention on the use of AI and DL systems in identifying disease features, progression and treatment response for retinal diseases such as neovascular AMD and diabetic macular edema using optical coherence tomography (OCT). Additionally, the application of ML to visual fields may be useful in detecting glaucoma progression. There are limited studies that incorporate clinical data including electronic health records, in AL and DL algorithms, and no prospective studies to demonstrate that AI and DL algorithms can predict the development of clinical eye disease. This article describes global eye disease burden, unmet needs and common conditions of public health importance for which AI and DL systems may be applicable. Technical and clinical aspects to build a DL system to address those needs, and the potential challenges for clinical adoption are discussed. AI, ML and DL will likely play a crucial role in clinical ophthalmology practice, with implications for screening, diagnosis and follow up of the major causes of vision impairment in the setting of ageing populations globally

Accuracy of Deep Learning Algorithms for the Diagnosis of Retinopathy of Prematurity by Fundus Images: A Systematic Review and Meta-Analysis

Background. Retinopathy of prematurity (ROP) occurs in preterm infants and may contribute to blindness. Deep learning (DL) models have been used for ophthalmologic diagnoses. We performed a systematic review and meta-analysis of published evidence to summarize and evaluate the diagnostic accuracy of DL algorithms for ROP by fundus images. Methods. We searched PubMed, EMBASE, Web of Science, and Institute of Electrical and Electronics Engineers Xplore Digital Library on June 13, 2021, for studies using a DL algorithm to distinguish individuals with ROP of different grades, which provided accuracy measurements. ,e pooled sensitivity and specificity values and the area under the curve (AUC) of summary receiver operating characteristics curves (SROC) summarized overall test performance. ,e performances in validation and test datasets were assessed together and separately. Subgroup analyses were conducted between the definition and grades of ROP. ,reshold and nonthreshold effects were tested to assess biases and evaluate accuracy factors associated with DL models. Results. Nine studies with fifteen classifiers were included in our meta-analysis. A total of 521,586 objects were applied to DL models. For combined validation and test datasets in each study, the pooled sensitivity and specificity were 0.953 (95% confidence intervals (CI): 0.946–0.959) and 0.975 (0.973–0.977), respectively, and the AUC was 0.984 (0.978–0.989). For the validation dataset and test dataset, the AUC was 0.977 (0.968–0.986) and 0.987 (0.982–0.992), respectively. In the subgroup analysis of ROP vs. normal and differentiation of two ROP grades, the AUC was 0.990 (0.944–0.994) and 0.982 (0.964–0.999), respectively. Conclusions. Our study shows that DL models can play an essential role in detecting and grading ROP with high sensitivity, specificity, and repeatability. ,e application of a DL-based automated system may improve ROP screening and diagnosis in the future

The Impact of Artificial Intelligence and Deep Learning in Eye Diseases: A Review

Artificial intelligence (AI) is a subset of computer science dealing with the development and training of algorithms that try to replicate human intelligence. We report a clinical overview of the basic principles of AI that are fundamental to appreciating its application to ophthalmology practice. Here, we review the most common eye diseases, focusing on some of the potential challenges and limitations emerging with the development and application of this new technology into ophthalmology

A Review of the Management of Eye Diseases Using Artificial Intelligence, Machine Learning, and Deep Learning in Conjunction with Recent Research on Eye Health Problems: Eye Microbiome

In the field of computer science, Artificial Intelligence can be considered one of the branches that study the development of algorithms that mimic certain aspects of human intelligence. Over the past few years, there has been a rapid advancement in the technology of computer-aided diagnosis (CAD). This in turn has led to an increase in the use of deep learning methods in a variety of applications. For us to be able to understand how AI can be used in order to recognize eye diseases, it is crucial that we have a deep understanding of how AI works in its core concepts. This paper aims to describe the most recent and applicable uses of artificial intelligence in the various fields of ophthalmology disease

The upcoming role of Artificial Intelligence (AI) for retinal and glaucomatous diseases

: In recent years, the role of artificial intelligence (AI) and deep learning (DL) models is attracting increasing global interest in the field of ophthalmology. DL models are considered the current state-of-art among the AI technologies. In fact, DL systems have the capability to recognize, quantify and describe pathological clinical features. Their role is currently being investigated for the early diagnosis and management of several retinal diseases and glaucoma. The application of DL models to fundus photographs, visual fields and optical coherence tomography (OCT) imaging has provided promising results in the early detection of diabetic retinopathy (DR), wet age-related macular degeneration (w-AMD), retinopathy of prematurity (ROP) and glaucoma. In this review we analyze the current evidence of AI applied to these ocular diseases, as well as discuss the possible future developments and potential clinical implications, without neglecting the present limitations and challenges in order to adopt AI and DL models as powerful tools in the everyday routine clinical practice

Deployment of Artificial Intelligence in Real-World Practice: Opportunity and Challenge.

Artificial intelligence has rapidly evolved from the experimental phase to the implementation phase in many image-driven clinical disciplines, including ophthalmology. A combination of the increasing availability of large datasets and computing power with revolutionary progress in deep learning has created unprecedented opportunities for major breakthrough improvements in the performance and accuracy of automated diagnoses that primarily focus on image recognition and feature detection. Such an automated disease classification would significantly improve the accessibility, efficiency, and cost-effectiveness of eye care systems where it is less dependent on human input, potentially enabling diagnosis to be cheaper, quicker, and more consistent. Although this technology will have a profound impact on clinical flow and practice patterns sooner or later, translating such a technology into clinical practice is challenging and requires similar levels of accountability and effectiveness as any new medication or medical device due to the potential problems of bias, and ethical, medical, and legal issues that might arise. The objective of this review is to summarize the opportunities and challenges of this transition and to facilitate the integration of artificial intelligence (AI) into routine clinical practice based on our best understanding and experience in this area