Assessing the possibility of using portable and stationary non-mydriatic fundus cameras for diabetic retinopathy screening assisted by an artificial intelligence-based software platform in primary care
DOI:
https://doi.org/10.31288/oftalmolzh202462226Keywords:
diabetes mellitus, diabetic retinopathy, artificial intelligence, screening, retina, undus cameraAbstract
Purpose: To assess the possibility of using portable and stationary non-mydriatic (NM) fundus cameras for diabetic retinopathy (DR) screening assisted by the artificial intelligence (AI)-based Retina-AI CheckEye© software platform in primary care.
Material and Methods: In this prospective, open-label study, 609 subjects (1218 eyes) with either diagnosed diabetes mellitus (DM) or risk factors for DM were divided into two groups depending on whether the fundus camera was stationary or portable. NM single-field fundus photography was performed with a stationary fundus camera in group 1 and a portable camera in group 2. The AI-based Retina-AI CheckEye© software platform was used for the analysis of digital color fundus photographs of subject eyes for signs of DR. The numbers of poor-quality fundus images and the presence or absence of DR were noted, and the stage of DR was assessed.
Results: In group 1 and group 2, there were 37 eyes and 339 eyes, respectively, whose images could not be processed by the neural network. DR was found in 15 subjects (5.17%) in group 1 and 8 subjects (2.51%) in group 2. Previously undiagnosed DM complicated by DR was discovered in 13 (4.5%) of the subjects included in group 1 versus 7 (2%) of the subjects included in group 2.
Conclusion: Digital color fundus images taken with stationary and portable NM fundus cameras through non-dilated pupils and analyzed by the AI-based Retina-AI CheckEye© software platform provided DR detection and grading by stages among subjects with diagnosed DM as well those with undiagnosed DM. The percentage of poor-quality photographs can be reduced and the effectiveness of DR screening with the use of the AI-based Retina-AI CheckEye© software platform can be improved through the involvement of an experienced operator and better adherence to protocol for uploading fundus images to the cloud storage.
References
Sun H, Saeedi P, Karuranga S, et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022;183:109119. https://doi.org/10.1016/j.diabres.2021.109119
Magliano DJ, Boyko EJ; IDF Diabetes Atlas 10th edition scientific committee. IDF DIABETES ATLAS. 10th ed. Brussels: International Diabetes Federation; 2021
Hossain MJ, Al-Mamun M, Islam MR. Diabetes mellitus, the fastest growing global public health concern: Early detection should be focused. Health Sci Rep. 2024 Mar 22;7(3):e2004. https://doi.org/10.1002/hsr2.2004
Wong TY, Tan TE. The Diabetic Retinopathy "Pandemic" and Evolving Global Strategies: The 2023 Friedenwald Lecture. Invest Ophthalmol Vis Sci. 2023;64(15):47. https://doi.org/10.1167/iovs.64.15.47
Teo ZL, Tham YC, Yu M, et al.. Global prevalence of diabetic retinopathy and projection of burden through 2045: systematic review and meta-analysis. Ophthalmology. 2021; 128(11): 1580-1591 https://doi.org/10.1016/j.ophtha.2021.04.027
Nevska AO, Pohosian OA, Goncharuk KO, Sofyna DF, Chernenko OO, Tronko KM, Kozhan NI, Korol AR. Detecting diabetic retinopathy using an artificial intelligence-based software platform: a pilot study. J Ophthalmol. (Ukraine). 2024;(1):27-31. https://doi.org/10.31288/oftalmolzh202412731
Vychuzhanin V., Rudnichenko N., Guzun O., Zadorozhnyy O., Korol A. Gritsuk I. Artificial intelligence integration in the diagnosis, prognosis and diabetic neovascular glaucoma treatment. CEUR Workshop Proceedings. 2024;3790;238-249. https://ceur-ws.org/Vol-3790/paper21.pdf
Аnatychuk L, Kobylianskyi R, Zadorozhnyy O, et al. Ocular surface heat flux density as a biomarker related to diabetic retinopathy (pilot study). Adv Ophthalmol Pract Res. 2024;4(3):107-111. https://doi.org/10.1016/j.aopr.2024.03.004
Midena E, Zennaro L, Lapo C, Torresin T, Midena G, Frizziero L. Comparison of 50° handheld fundus camera versus ultra-widefield table-top fundus camera for diabetic retinopathy detection and grading. Eye (Lond). 2023;37(14):2994-2999. https://doi.org/10.1038/s41433-023-02458-3
Kubin AM, Huhtinen P, Ohtonen P, Keskitalo A, Wirkkala J, Hautala N. Comparison of 21 artificial intelligence algorithms in automated diabetic retinopathy screening using handheld fundus camera. Ann Med. 2024;56(1):2352018. https://doi.org/10.1080/07853890.2024.2352018
Ruamviboonsuk P, Wongcumchang N, Surawongsin P, Panyawatananukul E, Tiensuwan M. Screening for diabetic retinopathy in rural area using single-field, digital fundus images. J Med Assoc Thai. 2005;88:176-80.
Suansilpong A, Rawdaree P. Accuracy of single-field nonmydriatic digital fundus image in screening for diabetic retinopathy. J Med Assoc Thai. 2008;91:1397-403.
Wilkinson CP, Ferris FL 3rd, Klein RE, Lee PP, Agardh CD, Davis M, Dills D, Kampik A, Pararajasegaram R, Verdaguer JT; Global Diabetic Retinopathy Project Group. Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology. 2003 Sep;110(9):1677-82. https://doi.org/10.1016/S0161-6420(03)00475-5
Fenner BJ, Wong RL, Lam WC, Tan GS, Cheung G. Advances in retinal imaging and applications in diabetic retinopathy screening: a review. Ophthalmol Ther. 2018;7(2):333-346. https://doi.org/10.1007/s40123-018-0153-7
Alabdulwahhab KM. Diabetic Retinopathy Screening Using Non-Mydriatic Fundus Camera in Primary Health Care Settings - A Multicenter Study from Saudi Arabia. Int J Gen Med. 2023;16:2255-2262. https://doi.org/10.2147/IJGM.S410197
Cuscó C, Esteve-Bricullé P, Almazán-Moga A, et al. Microvascular Metrics on Diabetic Retinopathy Severity: Analysis of Diabetic Eye Images from Real-World Data. Biomedicines. 2024;12:2753. https://doi.org/10.3390/biomedicines12122753
Bazyka DA, Sushko VO, Fedirko PA, et al. Retina vessels changes in Chornobyl nuclear power plant employees who experienced long-term abnormal radiation exposure at the workplace as a result of the occupation of Chornobyl nuclear power plant in 2022. Probl Radiat Med Radiobiol. 2022;27:423-430. https://doi.org/10.33145/2304-8336-2022-27-423-430
Fedirko PA, Babenko TF, Kolosynska OO, et al. Morphometric parameters of retinal macular zone in reconvalescents of acute radiation sickness (in remote period). Probl Radiat Med Radiobiol. 2018;2018(23):481-489. https://doi.org/10.33145/2304-8336-2018-23-481-489
Hansen AB, Hartvig NV, Jensen MS, Borch-Johnsen K, Lund-Andersen H, Larsen M. Diabetic retinopathy screening using digital non-mydriatic fundus photography and automated image analysis. Acta Ophthalmol Scand. 2004;82(6):666-672. https://doi.org/10.1111/j.1600-0420.2004.00350.x
Scanlon PH. The English National Screening Programme for diabetic retinopathy 2003-2016. Acta Diabetol. 2017;54(6):515-525. https://doi.org/10.1007/s00592-017-0974-1
Srihatrai P, Hlowchitsieng T. The diagnostic accuracy of single- and five-field fundus photography in diabetic retinopathy screening by primary care physicians. Indian J Ophthalmol. 2018;66(1):94-97. https://doi.org/10.4103/ijo.IJO_657_17
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Nevska A. O., Pohosian O. A., Goncharuk K. O., Chernenko O. O., Hymanyk I. V., Korol A. R.
This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a Creative Commons Attribution 4.0 International (CC BY 4.0) that allows users to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author as long as they cite the source.
COPYRIGHT NOTICE
Authors who publish in this journal agree to the following terms:
- Authors hold copyright immediately after publication of their works and retain publishing rights without any restrictions.
- The copyright commencement date complies the publication date of the issue, where the article is included in.
DEPOSIT POLICY
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) during the editorial process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work with an acknowledgement of its initial publication in this journal.
- Post-print (post-refereeing manuscript version) and publisher's PDF-version self-archiving is allowed.
- Archiving the pre-print (pre-refereeing manuscript version) not allowed.
.png)
