Authors :
Gursimran Singh
Volume/Issue :
Volume 11 - 2026, Issue 1 - January
Google Scholar :
https://tinyurl.com/ycxee24k
Scribd :
https://tinyurl.com/ms5ya9ny
DOI :
https://doi.org/10.38124/ijisrt/26jan012
Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.
Abstract :
Artificial intelligence (AI) and machine learning (ML) have become groundbreaking technologies in the field of
Ophthalmology and especially in the screening of diabetic retinopathy (DR) and glaucoma. This review discusses how AI/ML
systems are currently applied, methodologies used, performance metrics, and clinical implementation issues of AI/ML
systems in the detection of these vision-threatening conditions. Very recent deep learning algorithms have achieved the
diagnostic accuracy of human experts, or more, with a sensitivity and specificity rate over 90% in many of the studies.
However, there are challenges such as dataset bias, regulatory approval, clinical integration and cost-effectiveness that need
to be investigated further. This review is a synthesis of evidence obtained from recent literature and discusses future
directions of AI powered ophthalmic diagnostics.
Keywords :
Artificial Intelligence, Machine Learning, Deep Learning, Diabetic Retinopathy, Glaucoma, Computer Aided Diagnosis, Retinal Imaging.
References :
- Yau JW, Rogers SL, Kawasaki R, et al. Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care. 2012;35(3):556-564.
- Tham YC, Li X, Wong TY, et al. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology. 2014;121(11):2081-2090.
- Resnikoff S, Lansingh VC, Washburn L, et al. Estimated number of ophthalmologists worldwide (International Council of Ophthalmology update): will we meet the needs? Br J Ophthalmol. 2020;104(4):588-592.
- Abràmoff MD, Lavin PT, Birch M, et al. Pivotal trial of an autonomous AI-based diagnostic system for detection of diabetic retinopathy in primary care offices. NPJ Digit Med. 2018;1:39.
- Wilkinson CP, Ferris FL, Klein RE, et al. Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology. 2003;110(9):1677-1682.
- Niemeijer M, van Ginneken B, Cree MJ, et al. Retinopathy online challenge: automatic detection of microaneurysms in digital color fundus photographs. IEEE Trans Med Imaging. 2010;29(1):185-195.
- Gulshan V, Peng L, Coram M, et al. Development and validation of a deep learning algorithm for detection of diabetic retinopathy in retinal fundus photographs. JAMA. 2016;316(22):2402-2410.
- Abràmoff MD, Lou Y, Erginay A, et al. Improved automated detection of diabetic retinopathy on a publicly available dataset through integration of deep learning. Invest Ophthalmol Vis Sci. 2016;57(13):5200-5206.
- Bhaskaranand M, Ramachandra C, Bhat S, et al. The value of automated diabetic retinopathy screening with the EyeArt system: a study of more than 100,000 consecutive encounters from people with diabetes. Diabetes Technol Ther. 2019;21(11):635-643.
- Ting DSW, Cheung CY, Lim G, et al. Development and validation of a deep learning system for diabetic retinopathy and related eye diseases using retinal images from multiethnic populations with diabetes. JAMA. 2017;318(22):2211-2223.
- Weinreb RN, Aung T, Medeiros FA. The pathophysiology and treatment of glaucoma: a review. JAMA. 2014;311(18):1901-1911.
- Bock R, Meier J, Nyúl LG, et al. Glaucoma risk index: automated glaucoma detection from color fundus images. Med Image Anal. 2010;14(3):471-481.
- Li Z, He Y, Keel S, et al. Efficacy of a deep learning system for detecting glaucomatous optic neuropathy based on color fundus photographs. Ophthalmology. 2018;125(8):1199-1206.
- Christopher M, Belghith A, Bowd C, et al. Performance of deep learning architectures and transfer learning for detecting glaucomatous optic neuropathy in fundus photographs. Sci Rep. 2018;8(1):16685.
- Muhammad H, Fuchs TJ, De Cuir N, et al. Hybrid deep learning on single wide-field optical coherence tomography scans accurately classifies glaucoma suspects. J Glaucoma. 2017;26(12):1086-1094.
- Medeiros FA, Jammal AA, Thompson AC. From machine to machine: an OCT-trained deep learning algorithm for objective quantification of glaucomatous damage in fundus photographs. Ophthalmology. 2019;126(4):513-521.
- Kanagasingam Y, Xiao D, Vignarajan J, et al. Evaluation of artificial intelligence-based grading of diabetic retinopathy in primary care. JAMA Netw Open. 2018;1(5):e182665.
- Shibata N, Tanito M, Mitsuhashi K, et al. Development of a deep residual learning algorithm to screen for glaucoma from fundus photography. Sci Rep. 2018;8(1):14665.
- Rajalakshmi R, Subashini R, Anjana RM, et al. Automated diabetic retinopathy detection in smartphone-based fundus photography using artificial intelligence. Eye (Lond). 2018;32(6):1138-1144.
- Ruamviboonsuk P, Krause J, Chotcomwongse P, et al. Deep learning versus human graders for classifying diabetic retinopathy severity in a nationwide screening program. NPJ Digit Med. 2019;2:25.
- Gulshan V, Rajan RP, Widner K, et al. Performance of a deep-learning algorithm vs manual grading for detecting diabetic retinopathy in India. JAMA Ophthalmol. 2019;137(9):987-993.
- Peng Y, Dharssi S, Chen Q, et al. DeepSeeNet: a deep learning model for automated classification of patient-based age-related macular degeneration severity from color fundus photographs. Ophthalmology. 2019;126(4):565-575.
- Schuman JS, Hee MR, Puliafito CA, et al. Quantification of nerve fiber layer thickness in normal and glaucomatous eyes using optical coherence tomography. Arch Ophthalmol. 1995;113(5):586-596.
- Zhou Y, Wang B, Huang L, et al. A benchmark for studying diabetic retinopathy: segmentation, grading, and transferability. IEEE Trans Med Imaging. 2021;40(3):818-828.
- He K, Zhang X, Ren S, et al. Deep residual learning for image recognition. In: Proceedings of the IEEE Conference on Computer Vision and Pattern Recognition. 2016:770-778.
- Huang G, Liu Z, Van Der Maaten L, et al. Densely connected convolutional networks. In: Proceedings of the IEEE Conference on Computer Vision and Pattern Recognition. 2017:4700-4708.
- Tan M, Le QV. EfficientNet: rethinking model scaling for convolutional neural networks. In: International Conference on Machine Learning. 2019:6105-6114.
- Dosovitskiy A, Beyer L, Kolesnikov A, et al. An image is worth 16x16 words: transformers for image recognition at scale. In: International Conference on Learning Representations. 2021.
- Tajbakhsh N, Shin JY, Gurudu SR, et al. Convolutional neural networks for medical image analysis: full training or fine tuning? IEEE Trans Med Imaging. 2016;35(5):1299-1312.
- Chawla NV, Bowyer KW, Hall LO, et al. SMOTE: synthetic minority over-sampling technique. J Artif Intell Res. 2002;16:321-357.
- Ju L, Wang X, Wang L, et al. Improving medical images classification with label noise using dual-uncertainty estimation. IEEE Trans Med Imaging. 2022;41(6):1533-1546.
- Heydon P, Egan C, Bolter L, et al. Prospective evaluation of an artificial intelligence-enabled algorithm for automated diabetic retinopathy screening of 30,000 patients. Br J Ophthalmol. 2021;105(5):723-728.
- Varoquaux G, Cheplygina V. Machine learning for medical imaging: methodological failures and recommendations for the future. NPJ Digit Med. 2022;5(1):48.
- Selvaraju RR, Cogswell M, Das A, et al. Grad-CAM: visual explanations from deep networks via gradient-based localization. In: Proceedings of the IEEE International Conference on Computer Vision. 2017:618-626.
- Ipp E, Liljenquist D, Bode B, et al. Pivotal evaluation of an artificial intelligence system for autonomous detection of referrable and vision-threatening diabetic retinopathy. JAMA Netw Open. 2021;4(11):e2134254.
- Elze T, Pasquale LR, Shen LQ, et al. Patterns of functional vision loss in glaucoma determined with archetypal analysis. J R Soc Interface. 2015;12(103):20141118.
- Xie Y, Nguyen QD, Hamzah H, et al. Artificial intelligence for teleophthalmology-based diabetic retinopathy screening in a national programme: an economic analysis modelling study. Lancet Digit Health. 2020;2(5):e240-e249.
- Beede E, Baylor E, Hersch F, et al. A human-centered evaluation of a deep learning system deployed in clinics for the detection of diabetic retinopathy. In: Proceedings of the 2020 CHI Conference on Human Factors in Computing Systems. 2020:1-12.
- Price WN, Gerke S, Cohen IG. Potential liability for physicians using artificial intelligence. JAMA. 2019;322(18):1765-1766.
- Keane PA, Topol EJ. With an eye to AI and autonomous diagnosis. NPJ Digit Med. 2018;1:40.
- Amann J, Blasimme A, Vayena E, et al. Explainability for artificial intelligence in healthcare: a multidisciplinary perspective. BMC Med Inform Decis Mak. 2020;20(1):310.
- Bellemo V, Lim ZW, Lim G, et al. Artificial intelligence using deep learning to screen for referable and vision-threatening diabetic retinopathy in Africa: a clinical validation study. Lancet Digit Health. 2019;1(1):e35-e44.
- Scheetz J, Rothschild P, McGuinness M, et al. A survey of clinicians on the use of artificial intelligence in ophthalmology, dermatology, radiology and radiation oncology. Sci Rep. 2021;11(1):5193.
- Obermeyer Z, Powers B, Vogeli C, et al. Dissecting racial bias in an algorithm used to manage the health of populations. Science. 2019;366(6464):447-453.
- Morley J, Machado CC, Burr C, et al. The ethics of AI in health care: a mapping review. Soc Sci Med. 2020;260:113172.
- Rieke N, Hancox J, Li W, et al. The future of digital health with federated learning. NPJ Digit Med. 2020;3:119.
- Grassmann F, Mengelkamp J, Brandl C, et al. A deep learning algorithm for prediction of age-related eye disease study severity scale for age-related macular degeneration from color fundus photography. Ophthalmology. 2018;125(9):1410-1420.
- Kaissis GA, Makowski MR, Rückert D, et al. Secure, privacy-preserving and federated machine learning in medical imaging. Nat Mach Intell. 2020;2(6):305-311.
- Tjoa E, Guan C. A survey on explainable artificial intelligence (XAI): toward medical XAI. IEEE Trans Neural Netw Learn Syst. 2021;32(11):4793-4813.
- Russo A, Morescalchi F, Costagliola C, et al. Comparison of smartphone ophthalmoscopy with slit-lamp biomicroscopy for grading diabetic retinopathy. Am J Ophthalmol. 2015;159(2):360-364.
- Chen RJ, Wang JJ, Williamson DF, et al. Algorithmic fairness in artificial intelligence for medicine and healthcare. Nat Biomed Eng. 2023;7(6):719-742.
Artificial intelligence (AI) and machine learning (ML) have become groundbreaking technologies in the field of
Ophthalmology and especially in the screening of diabetic retinopathy (DR) and glaucoma. This review discusses how AI/ML
systems are currently applied, methodologies used, performance metrics, and clinical implementation issues of AI/ML
systems in the detection of these vision-threatening conditions. Very recent deep learning algorithms have achieved the
diagnostic accuracy of human experts, or more, with a sensitivity and specificity rate over 90% in many of the studies.
However, there are challenges such as dataset bias, regulatory approval, clinical integration and cost-effectiveness that need
to be investigated further. This review is a synthesis of evidence obtained from recent literature and discusses future
directions of AI powered ophthalmic diagnostics.
Keywords :
Artificial Intelligence, Machine Learning, Deep Learning, Diabetic Retinopathy, Glaucoma, Computer Aided Diagnosis, Retinal Imaging.