A close-up of a child being examined for diabetic retinopathy at an Orbis International partner hospital. Photo courtesy of Geoff Oliver Bugbee

As Diabetes Awareness month comes to a close, the promise of Artificial Intelligence (AI) and the role it can play in helping doctors to detect and diagnose diabetic retinopathy—a common complication of diabetes that can lead to blindness—is front and center. A recent study by eyecare nonprofit Orbis International has found that AI can accurately detect diabetic retinopathy in children and young adults, an important breakthrough that can mean the difference between healthy sight and irreversible vision loss for youngsters with diabetes.

The peer-reviewed study, published in Clinical Medicine Insights: Endocrinology and Diabetes, shows that Cybersight AI, a component of Orbis's telemedicine and e-learning platform, can be an effective tool to support medical staff, who are often overburdened with patient caseloads, to care for children with diabetes, especially in low-resource settings with limited numbers of trained health care professionals.

"To date, AI has been studied to detect diabetic retinopathy in adults," said Nicolas Jaccard, principal architect, telehealth and program technology for Orbis International. "These studies have shown that AI is highly effective and accurate, but almost none have been tested on children. Adults and children with diabetes both require regular eye screenings to detect diabetic retinopathy and keep the condition from progressing, which can lead to irreversible vision loss or blindness.

“However, trained eyecare professionals cannot meet the growing demand for diabetic retinopathy screening as the prevalence of diabetes continues to rise. A tool like Cybersight AI can help to meet this burden, especially for children and young adults who have been shown are less likely to seek out routine eye screenings," Jaccard said.

The study screened more than 1,300 children and young adults between the ages of 3 and 26 diagnosed with diabetes, and was carried out at the Dhaka BIRDEM-2 hospital in Bangladesh. Each patient had images of their retinas (the back of the eye), taken on a fundus camera at the hospital, evaluated by Cybersight AI and by a fully qualified optometrist certified to grade for diabetic retinopathy. Results showed that Cybersight AI accurately detected any signs of diabetic retinopathy among children and young adults, despite the algorithms having been trained on adults.

Here is a step-by-step description about how to use Orbis’ Cybersight AI to perform an automated interpretation of fundus images. Cybersight AI is a free, open-access tool that can detect and visualize diabetic retinopathy, glaucoma and macular disease, and can be used by eye health professionals with a Cybersight Consult account.

"Diabetes is on the rise for young people in Bangladesh," said Dr. Munir Ahmed, country director for Orbis Bangladesh. "Type II diabetes nearly tripled in people under 20 years of age in just seven years, from 2011 to 2018. Adolescents with type II diabetes have a higher risk of developing diabetic retinopathy, as compared to adults. This is very concerning in Bangladesh where children and young adults do not have access to the regular diabetic retinopathy screening required to manage the disease and prevent future vision loss or blindness."

Diabetic retinopathy is the leading cause of vision loss among working-age people around the world. Access to diabetic retinopathy screening is critical to preventing visual impairment as most patients do not realize they have the eye disease until their vision is already affected irreversibly. Bangladesh and other low-resource settings lack the infrastructure and trained personnel to implement the screenings effectively. In Bangladesh, there are only 6.2 ophthalmologists per 1 million people. This is not nearly enough to meet the need.

This study comes on the heels of others published by Orbis International highlighting the benefits of AI in eyecare in low- and middle-income countries. Orbis recently published back-to-back studies from Rwanda, including the first to show that use of AI for diabetic retinopathy could significantly boost referral uptake and included results that are broadly applicable across other settings for AI-supported diabetic retinopathy screenings.

Orbis is just one of many optical companies that is using AI to diagnose and detect ocular diseases.

Orbis is a leading global non-governmental organization that has been a pioneer in the prevention and treatment of avoidable blindness and vision loss for over four decades. Orbis transforms lives by delivering the skills, resources and knowledge needed to deliver accessible quality eyecare.

Working in collaboration with local partners, including hospitals, universities, government agencies and ministries of health, Orbis provides hands-on ophthalmology training, strengthens health care infrastructure and advocates for the prioritization of eye health on public health agendas. Orbis operates the world's only Flying Eye Hospital, a fully accredited ophthalmic teaching hospital on board an MD-10 aircraft, as well as its award-winning telemedicine platform, Cybersight.

VM Summit to Explore Risks and Rewards of AI Implementation

NEW YORK—This year will mark the 18th annual Vision Monday Leadership Summit, when influential thought leaders, business experts and vision care professionals will explore the critical decisions that today’s leaders need to wrestle with. This year’s Summit, taking place on March 13, 2024 in New York City, is titled, "What's Your AI Acuity? Sharpening a Vision for the Future” and the program will strive to develop a clear-eyed view of the risks and rewards of AI implementation. Specifically, the Summit will explore the increasingly important role that artificial intelligence is playing in the diagnosis and treatment of ocular disease.

“We’re bringing to the Summit two renowned ophthalmologists, James Tsai, MD and Pearse Keane, MD. They will give Summit attendees an exclusive look at how their teams in the U.S. and U.K., respectively, are using AI to analyze and detect diabetic retinopathy and other sight-threatening conditions,” said Andrew Karp, group editor, lenses and technology, Jobson Medical Information.

Dr. Tsai heads the Center for Ophthalmic Artificial Intelligence and Human Health at the Icahn School of Medicine at Mount Sinai, the first of its kind in New York and one of the first in the U.S. The Center is dedicated to advancing artificial intelligence in the field of ophthalmology.

This first-of-its-kind initiative strives to transform patient care with more timely diagnosis of eye disease and innovative risk assessment of systemic health conditions. The Center aims to advance clinical innovation in AI-based diagnostic care in ophthalmology and population-based medical care, while advancing the understanding of cardiovascular and neurological conditions that impact patient well-being. Mount Sinai is incorporating AI into trainee and physician education, research, and the clinical setting for rapid diagnosis of eye diseases and conditions including macular degeneration, diabetic retinopathy, glaucoma, hypertensive retinopathy, systemic conditions and retinal tumors. Early detection and intervention can prevent vision loss and may also prevent heart attack and stroke since several eye conditions are linked to cardiovascular and neurological issues.

“Our department is excited to be at the forefront of ophthalmic innovation in AI and Human Health and play a critical role in validating and implementing the most promising technologies,” said Dr. Tsai, Delafield-Rogers professor and chair of ophthalmology at Icahn Mount Sinai and the Mount Sinai Health System, president of New York Eye and Ear Infirmary of Mount Sinai (NYEE), and inaugural director of the Center. “We anticipate that the Center will help revolutionize and transform population-based health, thereby enhancing quality and equitable care.

“Besides the more timely diagnosis and referral of community-based ocular conditions, we will better predict cardiovascular health in the future since recent research has shown that cardiovascular risk factors can be determined from AI-guided analysis of retinal fundus photographs. No other specialty in medicine allows such an unimpeded view and assessment of the cardiovascular and neurological systems.”

Dr. Pearse Keane leads a pioneering research program at Moorfields Eye Hospital in London that is investigating whether AI can help meet a growing clinical need to better analyze eye scans. Now in its seventh year, the program grew out of a partnership with AI developer DeepMind and now involves Google Health.

“I believe that this technology has the potential to help save the sight of millions of people and I’m proud that Moorfields, the NHS (National Health System) and the UK as a whole, can play a central role,” remarked Dr. Keane.

"The growing use of Artificial Intelligence in both health care and retail portends a seismic shift in how companies are operating," noted Marge Axelrad, SVP editorial director of Vision Monday and VMAIL. "With its vast capabilities, AI is opening up new dimensions and providing previously unimagined insights for customers, patients and employees," she said.

"AI is already creating a new series of questions for decision makers," added Jobson’s Karp. "Among these are: Will AI demand a rethink of products, services and processes? Will leaders and managers come to depend on AI to make decisions about people, productivity and automation? Is AI the great equalizer for independents and entrepreneurs? Will patients trust advice from an algorithm? Will consumers accept recommendations from 'the machine?' What role will critical thinking and human intelligence play as AI spreads?"

The 2024 VM Leadership Summit program will open with a networking breakfast from 8:00 to 9:00 a.m. and the program and lunch will run from 9:00 a.m. to 2:30 p.m. Registration includes the full program, networking breakfast and lunch. Details for registration are posted at www.visionmonday.com/summit. Early bird tickets and registration have a deadline of 11:59 p.m. ET on Dec. 31.

At presstime, Platinum Sponsors of the 2024 VM Leadership Summit include EssilorLuxottica and VSP Vision. The Gold Sponsor is Ocuco. Look for further information about speakers and the venue which will be posted soon in upcoming VMAIL announcements.