Retinopathy screening a canary in the coal mine of AI-enabled nonspecialist care

Ophthalmologists have seen their future, and it is treating only patients with serious eye problems. The rest will be handled by primary-care providers, eye technicians and even patients themselves connected by telehealth and armed with commercial test kits and AI.

So forecast researchers who surveyed the literature for markers of progress in diabetic retinopathy screening and have reported their findings in Ophthalmology and Therapy.

Janusz Pieczyński, MD, PhD, and colleagues at the University of Warmia and Mazury focused on diabetic retinopathy screening because it’s one of the procedures furthest ahead with AI in all of medicine.

It’s also increasingly in demand as diabetes mellitus continues growing in incidence rates, in places threatening to overwhelm ophthalmologists’ capacity for new cases.

The team analyzed 118 articles, all in English, published between 2015 and 2020.

Their key findings included types of retinal photography devices. Of these, fundus cameras, mobile and portable as well as stationary, are the most common.

Also in wide use are ultra-wide-field (UWF) imaging and optical coherence tomography (OCT).

Meanwhile ophthalmology increasingly recognizes the use of smartphones in the field.

“The common use of smartphones and availability of relatively cheap, easy-to-use adapters for retinal photographs augmented by AI algorithms make it possible for eye fundus photographs to be taken by non-specialists and in non-medical setting,” the authors observe. “This opens the way for in-home testing conducted on a much larger scale in the future.”

Pieczyński and colleagues conclude:

The future of ophthalmic care seems to be remote eye examination done by a technician and aided by AI, with in-home self-testing as a preliminary test. Pre-specialist diagnostics will automatically identify healthy eyes, make a diagnosis and recommend a referral only if necessary. This will make the system less dependent on highly specialized and expensive human resources and will indirectly lead to optimal use of current resources.”

The report is available in full for free.

Dave Pearson

Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.

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