Instant automatic diagnosis of diabetic retinopathy

TL;DR

This study evaluates OphtAI, an AI system using neural networks for rapid, accurate, and comprehensive automatic detection and severity assessment of diabetic retinopathy from fundus images, outperforming existing FDA-approved AI tools.

Contribution

The paper introduces OphtAI, a novel ensemble neural network system capable of instant, accurate DR diagnosis and severity assessment, validated on large datasets and demonstrating superior performance.

Findings

Achieved AUC of 0.989 for referable DR detection in public dataset.

Outperformed the only FDA-approved AI system in the same conditions.

Provided diagnosis in less than 2 seconds, enabling rapid screening.

Abstract

The purpose of this study is to evaluate the performance of the OphtAI system for the automatic detection of referable diabetic retinopathy (DR) and the automatic assessment of DR severity using color fundus photography. OphtAI relies on ensembles of convolutional neural networks trained to recognize eye laterality, detect referable DR and assess DR severity. The system can either process single images or full examination records. To document the automatic diagnoses, accurate heatmaps are generated. The system was developed and validated using a dataset of 763,848 images from 164,660 screening procedures from the OPHDIAT screening program. For comparison purposes, it was also evaluated in the public Messidor-2 dataset. Referable DR can be detected with an area under the ROC curve of AUC = 0.989 in the Messidor-2 dataset, using the University of Iowa's reference standard (95% CI: 0.984-0.994). This is better than the only AI system authorized by the FDA, evaluated in the exact same conditions (AUC = 0.980). OphtAI can also detect vision-threatening DR with an AUC of 0.997 (95% CI: 0.996-0.998) and proliferative DR with an AUC of 0.997 (95% CI: 0.995-0.999). The system runs in 0.3 seconds using a graphics processing unit and less than 2 seconds without. OphtAI is safer, faster and more comprehensive than the only AI system authorized by the FDA so far. Instant DR diagnosis is now possible, which is expected to streamline DR screening and to give easy access to DR screening to more diabetic patients.