Artificial intelligence applications and cataract management: A systematic review

Artificial intelligence (AI)-based applications exhibit the potential to improve the quality and efficiency of patient care in different fields, including cataract management. A systematic review of the different applications of AI-based software on all aspects of a cataract patient's management, from diagnosis to follow-up, was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. All selected articles were analyzed to assess the level of evidence according to the Oxford Centre for Evidence-Based Medicine 2011 guidelines, and the quality of evidence according to the Grading of Recommendations Assessment, Development and Evaluation system. Of the articles analyzed, 49 met the inclusion criteria. No data synthesis was possible for the heterogeneity of available data and the design of the available studies. The AI-driven diagnosis seemed to be comparable and, in selected cases, to even exceed the accuracy of experienced clinicians in classifying disease, supporting the operating room scheduling, and intraoperative and postoperative management of complications. Considering the heterogeneity of data analyzed, however, further randomized controlled trials to assess the efficacy and safety of AI application in the management of cataract should be highly warranted

A Review of the Latest Machine Learning Advances in Cataract Diagnosis

Cataract disorder is one of the most common vision disorders in the world. As the average age of the world population increases, many people suffer from it in middle and old age. Timely diagnosis can prevent the reduction of vision and eventually loss of sight. Considering the prevalence of Artificial Intelligence algorithms, especially in the medical industry, they could be used for Cataract diagnosis, IOL determination, and PCO diagnosis. According to the studies, the proposed models for Cataract diagnosis are very accurate. These developed algorithms have been able to make access to ophthalmology services easier and reduce treatment costs significantly

Efficient Pyramid Channel Attention Network for Pathological Myopia Detection

Pathological myopia (PM) is the leading ocular disease for impaired vision and blindness worldwide. The key to detecting PM as early as possible is to detect informative features in global and local lesion regions, such as fundus tessellation, atrophy and maculopathy. However, applying classical convolutional neural networks (CNNs) to efficiently highlight global and local lesion context information in feature maps is quite challenging. To tackle this issue, we aim to fully leverage the potential of global and local lesion information with attention module design. Based on this, we propose an efficient pyramid channel attention (EPCA) module, which dynamically explores the relative importance of global and local lesion context information in feature maps. Then we combine the EPCA module with the backbone network to construct EPCA-Net for automatic PM detection based on fundus images. In addition, we construct a PM dataset termed PM-fundus by collecting fundus images of PM from publicly available datasets (e.g., the PALM dataset and ODIR dataset). The comprehensive experiments are conducted on three datasets, demonstrating that our EPCA-Net outperforms state-of-the-art methods in detecting PM. Furthermore, motivated by the recent pretraining-and-finetuning paradigm, we attempt to adapt pre-trained natural image models for PM detection by freezing them and treating the EPCA module and other attention modules as the adapters. The results show that our method with the pretraining-and-finetuning paradigm achieves competitive performance through comparisons to part of methods with traditional fine-tuning methods with fewer tunable parameters.Comment: 12 page

Accelerating precision ophthalmology: recent advances

Introduction: The future of ophthalmology is precision medicine. With a growing incidence of lifestyle-associated ophthalmic disease such as diabetic retinopathy, the use of technology has the potential to overcome the burden on clinical specialists. Advances in precision medicine will help improve diagnosis and better triage those with higher clinical need to the appropriate experts, as well as providing a more tailored approach to treatment that could help transform patient management. Areas covered: A detailed literature review was conducted using OVID Medline and PubMed databases to explore advances in precision medicine within the areas of retinal disease, glaucoma, cornea, cataracts and uveitis. Over the last three years [2019–2022] are explored, particularly discussing technological and genomic advances in screening, diagnosis, and management within these fields. Expert opinion: Artificial intelligence and its subspecialty deep learning provide the most substantial ways in which diagnosis and management of ocular diseases can be further developed within the advancing field of precision medicine. Future challenges include optimal training sets for algorithms and further developing pharmacogenetics in more specialized areas

Artificial Intelligence for the Estimation of Visual Acuity Using Multi-Source Anterior Segment Optical Coherence Tomographic Images in Senile Cataract

Purpose: To investigate an artificial intelligence (AI) model performance using multi-source anterior segment optical coherence tomographic (OCT) images in estimating the preoperative best-corrected visual acuity (BCVA) in patients with senile cataract. Design: Retrospective, cross-instrument validation study. Subjects: A total of 2,332 anterior segment images obtained using swept-source OCT, optical biometry for intraocular lens calculation, and a femtosecond laser platform in patients with senile cataract and postoperative BCVA ≥ 0.0 logMAR were included in the training/validation dataset. A total of 1,002 images obtained using optical biometry and another femtosecond laser platform in patients who underwent cataract surgery in 2021 were used for the test dataset. Methods: AI modeling was based on an ensemble model of Inception-v4 and ResNet. The BCVA training/validation dataset was used for model training. The model performance was evaluated using the test dataset. Analysis of absolute error (AE) was performed by comparing the difference between true preoperative BCVA and estimated preoperative BCVA, as ≥0.1 logMAR (AE≥0.1) or <0.1 logMAR (AE <0.1). AE≥0.1 was classified into underestimation and overestimation groups based on the logMAR scale. Outcome measurements: Mean absolute error (MAE), root mean square error (RMSE), mean percentage error (MPE), and correlation coefficient between true preoperative BCVA and estimated preoperative BCVA. Results: The test dataset MAE, RMSE, and MPE were 0.050 ± 0.130 logMAR, 0.140 ± 0.134 logMAR, and 1.3 ± 13.9%, respectively. The correlation coefficient was 0.969 (p 0.1 was 21.4% in the AE≥0.1 group, of which 88.9% were in the underestimation group. The incidence of vision-impairing disease in the underestimation group was 95.7%. Preoperative corneal astigmatism and lens thickness were higher, and nucleus cataract was more severe (p < 0.001, 0.007, and 0.024, respectively) in AE≥0.1 than that in AE <0.1. The longer the axial length and the more severe the cortical/posterior subcapsular opacity, the better the estimated BCVA than the true BCVA. Conclusions: The AI model achieved high-level visual acuity estimation in patients with senile cataract. This quantification method encompassed both visual acuity and cataract severity of OCT image, which are the main indications for cataract surgery, showing the potential to objectively evaluate cataract severity.ope