Diabetic Retinopathy: Can Artificial Intelligence Provide a Better Way to Detect Disease?

Linda Brookes, MSc

Disclosures

June 07, 2018

Will It Affect Screening Rates?

Of the estimated 23.1 million people diagnosed with diabetes in the United States,[10] only 50%-65% are likely to have an annual dilated eye examination,[11] as recommended by both the American Diabetes Association[12] and the American Academy of Ophthalmology.[13] Among the reasons identified for nonadherence to the annual eye examination is that patients with diabetes prioritize their symptomatic health problems over those that are asymptomatic, such as DR.

Courtesy of Retina Gallery

Patients with diabetes have more than two dozen clinical visits on average per year across different specialties, Wykoff notes. "If they can have some of their eye care incorporated into visits that they are already having with their primary care providers or with their diabetologist or endocrinologist, it will be more efficient for them, and we are more likely to capture them before they have disease that causes significant vision loss," he says.

Shubrook is also enthusiastic. "For people who do not have access to an ophthalmologist or people who are resistant to going to an ophthalmologist, for whatever reason, this tool could really be helpful," he declares.

If [patients] can have some of their eye care...with their primary care providers...we are more likely to capture them before they have...vision loss.

But from his own experience, patients who have had an eye examination as part of a primary care visit are often reluctant to go to an ophthalmologist. "I have tried to explain that an eye examination with a primary care provider is not the same thing as one performed by an eye doctor, and that just because I don't see a problem does not mean that they are okay, but this is confusing to patients," Shubrook said. "So I stopped looking at patients' eyes because I found that they were more likely to go to the eye doctor when I did not do it."

Inevitable Change

Other companies, such as Google's DeepMind,[14] are also working to bring AI devices to the market for the detection of eye diseases.

"Such devices as the IDx-DR are going to change the system of how we do things in the long term," Wykoff predicts.

Shubrook also sees a place for such devices in primary care "as long as we ensure that we are not reducing the number of people who have to have the gold standard of care, which is the dilated eye examination."

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