1
|
Talcott KE, Baxter SL, Chen DK, Korot E, Lee A, Kim JE, Modi Y, Moshfeghi DM, Singh RP. American Society of Retina Specialists Artificial Intelligence Task Force Report. JOURNAL OF VITREORETINAL DISEASES 2024; 8:373-380. [PMID: 39148579 PMCID: PMC11323512 DOI: 10.1177/24741264241247602] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
Since the Artificial Intelligence Committee of the American Society of Retina Specialists developed the initial task force report in 2020, the artificial intelligence (AI) field has seen further adoption of US Food and Drug Administration-approved AI platforms and significant development of AI for various retinal conditions. With expansion of this technology comes further areas of challenges, including the data sources used in AI, the democracy of AI, commercialization, bias, and the need for provider education on the technology of AI. The overall focus of this committee report is to explore these recent issues as they relate to the continued development of AI and its integration into ophthalmology and retinal practice.
Collapse
Affiliation(s)
- Katherine E. Talcott
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
- Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
| | - Sally L. Baxter
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
- Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Dinah K. Chen
- Department of Ophthalmology, NYU Grossman School of Medicine, New York University, NY, USA
- Genentech/Roche, South San Francisco, CA, USA
| | - Edward Korot
- Retina Specialists of Michigan, Grand Rapids, MI, USA
- Horngren Family Vitreoretinal Center, Byers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Aaron Lee
- Roger and Angie Karalis Johnson Retina Center, Department of Ophthalmology, School of Medicine, University of Washington, Seattle, WA, USA
| | - Judy E. Kim
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Yasha Modi
- Department of Ophthalmology, NYU Grossman School of Medicine, New York University, NY, USA
| | - Darius M. Moshfeghi
- Horngren Family Vitreoretinal Center, Byers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Rishi P. Singh
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
- Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
- Cleveland Clinic Martin Health, Stuart, FL, USA
| |
Collapse
|
2
|
Talcott KE, Valentim CCS, Perkins SW, Ren H, Manivannan N, Zhang Q, Bagherinia H, Lee G, Yu S, D'Souza N, Jarugula H, Patel K, Singh RP. Automated Detection of Abnormal Optical Coherence Tomography B-scans Using a Deep Learning Artificial Intelligence Neural Network Platform. Int Ophthalmol Clin 2024; 64:115-127. [PMID: 38146885 DOI: 10.1097/iio.0000000000000519] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
|
3
|
Wai KM, Moshfeghi DM. Photographic Gel Artifact Simulating International Classification of Retinopathy of Prematurity Notch: Stanford University Network for Diagnosis of Retinopathy of Prematurity (SUNDROP) Report no. 16. Ophthalmol Retina 2023; 7:732-736. [PMID: 37548218 DOI: 10.1016/j.oret.2023.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 08/08/2023]
Abstract
PURPOSE To report a series of fundus photographs taken for retinopathy of prematurity (ROP) screening that contain artifacts with imaging characteristics mimicking a notch, a recently refined classification metric in the International Classification of Retinopathy of Prematurity, third edition. DESIGN Retrospective case series. PARTICIPANTS Infants requiring ROP screening in neonatal intensive care units from the Stanford University Network for Diagnosis of Retinopathy of Prematurity (SUNDROP) and TeleROP telemedicine screening programs. METHODS Preterm infants meeting ROP examination criteria were screened with 130° wide-angle imaging systems. The images were taken by a trained nurse in the neonatal intensive care unit and transferred to an ROP specialist using a Health Insurance Portability and Accountability Act-compliant picture archiving and communication system for interpretation. MAIN OUTCOME MEASURES Presence of an artifact that appeared consistent with a notch. RESULTS We identified a total of 17 cases in ROP screening with artifact findings that had imaging characteristics similar to a notch. The artifactual appearance of the pseudo-notch was created by the camera illumination system within the gel-lens interface when the lens was not well apposed to the cornea. In telemedicine screening for ROP, we present fundus images of eyes with a pseudo-notch appearance; review of overlapping images can help differentiate between notch and artifact. CONCLUSIONS Pediatric retinal specialists need to be aware that artifacts play a confounding role in screening for ROP, that can be mitigated through the use of overlapping and redundant images. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
Collapse
Affiliation(s)
- Karen M Wai
- Byers Eye Institute, Horngren Family Vitreoretinal Center, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California
| | - Darius M Moshfeghi
- Byers Eye Institute, Horngren Family Vitreoretinal Center, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California.
| |
Collapse
|
4
|
Moshfeghi DM, Trese MT. Reducing Blindness Resulting from Retinopathy of Prematurity Using Deep Learning. Ophthalmology 2021; 128:1077-1078. [PMID: 34154724 DOI: 10.1016/j.ophtha.2021.04.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/25/2021] [Accepted: 04/27/2021] [Indexed: 10/21/2022] Open
|
5
|
Katargina LA, Chesnokova NB, Beznos OV, Osipova NA, Panova AY. [Pathogenetically oriented approach to prevention of retinopathy of prematurity (experimental study)]. Vestn Oftalmol 2021; 137:26-31. [PMID: 34156775 DOI: 10.17116/oftalma202113703126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Intraperitoneal injections of exogenous melatonin during the development of the retinal vascular system in experimental rats has been shown in a number of experimental studies on the model of EROP to prevent the appearance of histological signs of the development of experimental retinopathy of prematurity (EROP), stabilize the blood-retinal barrier and have a pronounced antioxidant effect, but pathogenetic basis for these phenomena hasn't been studied. PURPOSE To study the influence mechanism of melatonin and its analogues on the development of EROP at the preclinical stage of the pathological process to substantiate new approaches to prevention of ROP. MATERIAL AND METHODS The study included 42 Wistar rat pups (84 eyes) divided into 6 groups: control group, experimental group (rat pups with EROP), experimental groups who underwent injections of melatonin and its analogues K-148, AL-3, K-096. The pups were euthanized on day 7 (4-5 pups from each group at each study period), binocular enucleation was performed, and the content of hypoxia-induced factor1α (HIF-1α) and VEGF-A was determined in retinal samples. RESULTS The intraperitoneal injections of melatonin and its analogs led to a significant decrease in the level of HIF-1α and VEGF-A in the retina of the rat pups of the experimental group until the beginning of pathological vasoproliferation. CONCLUSION Melatonin and its analogues are able to prevent the development of EROP by reducing the level of angiogenic factors in the retina of rat pups at the stage of existing avascular zones, which allows for them to be considered as a new promising approach to preventing the development of ROP.
Collapse
Affiliation(s)
- L A Katargina
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - N B Chesnokova
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - O V Beznos
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - N A Osipova
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - A Yu Panova
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| |
Collapse
|
6
|
Hartnett ME. Retinopathy of Prematurity: Evolving Treatment With Anti-Vascular Endothelial Growth Factor. Am J Ophthalmol 2020; 218:208-213. [PMID: 32450064 DOI: 10.1016/j.ajo.2020.05.025] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 05/15/2020] [Accepted: 05/16/2020] [Indexed: 12/21/2022]
Abstract
PURPOSE To discuss the evolution in retinopathy of prematurity since its first description as retrolental fibroplasia in the United States, including the changes in the understanding of pathophysiology; methods of diagnosis; destructive, anti-vascular endothelial growth factor (anti-VEGF), and supportive treatments; and differences in retinopathy of prematurity manifestations worldwide. The overall goal is to clarify retinopathy of prematurity currently and formulate questions to optimize future care. STUDY DESIGN Literature review and synthesis. METHODS Critical review and consideration of the literature with inclusion of historical articles and those regarding pathophysiologic risk factors, retinopathy of prematurity worldwide, basic and clinical science particularly regarding anti-VEGF mechanisms and agents tested in clinical trials. RESULTS Retinopathy of prematurity has evolved from affecting infants approximately 2 months premature to affecting extremely premature infants. Worldwide, retinopathy of prematurity differs and, in emerging countries, has features similar to that experienced in the United States when retinopathy of prematurity first manifested. Treatments have evolved from destruction of the peripheral avascular retina to inhibit angiogenic stimuli to anti-VEGF agents, which inhibit pathologic angiogenesis but also extend normal intraretinal angiogenesis by ordering the development of intraretinal vessels. Clinical trial evidence is accruing with the goal to develop less destructive treatments to optimize vision and that are protective to the retina and infant. CONCLUSIONS Goals for retinopathy of prematurity are to optimize prenatal and perinatal care, improve diagnostic acumen worldwide and refine treatment strategies, including with anti-VEGF agents, to inhibit intravitreal angiogenesis and facilitate vascularization of the previously avascular retina, which include supporting neural and vascular development of the premature infant and retina.
Collapse
|
7
|
Talcott KE, Kim JE, Modi Y, Moshfeghi DM, Singh RP. The American Society of Retina Specialists Artificial Intelligence Task Force Report. JOURNAL OF VITREORETINAL DISEASES 2020; 4:312-319. [PMID: 37009187 PMCID: PMC9976105 DOI: 10.1177/2474126420914168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Artificial intelligence (AI) is a growing area that relies on the heavy use of diagnostic imaging within the field of retina to offer exciting advancements in diagnostic capability to better understand and manage retinal conditions such as diabetic retinopathy, diabetic macular edema, age-related macular degeneration, and retinopathy of prematurity. However, there are discrepancies between the findings of these AI programs and their referral recommendations compared with evidence-based referral patterns, such as Preferred Practice Patterns by the American Academy of Ophthalmology. The overall focus of this task force report is to first describe the work in AI being completed in the management of retinal conditions. This report also discusses the guidelines of the Preferred Practice Pattern and how they can be used in the emerging field of AI.
Collapse
Affiliation(s)
- Katherine E. Talcott
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
- Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
| | - Judy E. Kim
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Yasha Modi
- Department of Ophthalmology, New York University, New York, NY, USA
| | - Darius M. Moshfeghi
- Horngren Family Vitreoretinal Center, Byers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Rishi P. Singh
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
- Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
| |
Collapse
|
8
|
Smartphone-based fundus photography for screening of plus-disease retinopathy of prematurity. Graefes Arch Clin Exp Ophthalmol 2019; 257:2579-2585. [PMID: 31501929 DOI: 10.1007/s00417-019-04470-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 08/27/2019] [Accepted: 09/05/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Inadequate screening of treatment-warranted retinopathy of prematurity (ROP) can lead to devastating visual outcomes. Especially in resource-poor communities, the use of an affordable, portable, and easy to use smartphone-based non-contact fundus photography device may prove useful for screening for high-risk ROP. This study evaluates the feasibility of screening for high-risk ROP using a novel smartphone-based fundus photography device, RetinaScope. METHODS Retinal images were obtained using RetinaScope on a cohort of prematurely born infants during routine examinations for ROP. Images were reviewed by two masked graders who determined the image quality, the presence or absence of plus disease, and whether there was retinopathy that met predefined criteria for referral. The agreement between image-based assessments was compared to the gold standard indirect ophthalmoscopic assessment. RESULTS Fifty-four eyes of 27 infants were included. A wide-field fundus photograph was obtained using RetinaScope. Image quality was acceptable or excellent in 98% and 95% of cases. There was substantial agreement between the gold standard and photographic assessment of presence or absence of plus disease (Cohen's κ = 0.85). Intergrader agreement on the presence of any retinopathy in photographs was also high (κ = 0.92). CONCLUSIONS RetinaScope can capture digital retinal photographs of prematurely born infants with good image quality for grading of plus disease.
Collapse
|
9
|
Moshfeghi DM, Capone A. Economic Barriers in Retinopathy of Prematurity Management. Ophthalmol Retina 2019; 2:1177-1178. [PMID: 31047186 DOI: 10.1016/j.oret.2018.10.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 09/26/2018] [Accepted: 10/01/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Darius M Moshfeghi
- Horngren Family Vitreoretinal Center, Byers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California.
| | - Antonio Capone
- Associated Retinal Consultants, Royal Oak, Michigan; Oakland University William Beaumont School of Medicine, Auburn Hills, Michigan
| |
Collapse
|