Study finds AI-driven eye exams increase screening rates for youth with diabetes

Frequent screenings for diabetic eye diseases (DED) facilitate early detection and treatment and can help prevent progression of potentially blinding DED. Generally, diabetes specialists and eye doctors recommend annual screenings, which typically require an additional, separate visit to an eye care provider, such as an optometrist or ophthalmologist, and the use of drops to dilate the pupil so that a clear view of the retina is visible through specialized instruments. 

An alternative to specialist eye exams is so-called autonomous artificial intelligence (AI) diabetic eye exams. During these exams, pictures are taken of the backs of the eyes without the need to dilate them, and AI is used to provide an immediate result. If the AI determines the presence of diabetic eye disease, a referral is made to an eye doctor for further evaluation. If it is absent, “you’re good for the year, and you just saved yourself time,” says Risa Wolf, M.D., a pediatric endocrinologist at Johns Hopkins Children’s Center.

Studies show that currently only 35% to 72% of youth with diabetes undergo recommended screenings, with even higher care gap rates among minority and poor youth. Wolf and colleagues wondered whether autonomous AI eye exams might improve these statistics. To test this, they enrolled 164 participants, ranging in age from 8 to 21 years, in a study and randomly assigned them to one of two groups. A group of 83 patients received the standard screening instructions and care and were referred to either an optometrist or ophthalmologist for an eye exam. A second group of 81 patients underwent a five-to-10-minute autonomous AI system diabetic eye exam during a visit to their endocrinologist (the specialists who typically care for people with diabetes) and received their results at the same visit.

The researchers found that 100% of patients in the group offered the autonomous AI screening completed their eye exam that day, while 22% of patients from the second group followed through within six months to complete an eye exam with an optometrist or ophthalmologist. The researchers also found that 25 out of 81 participants, or 31%, in the autonomous AI group had a result indicating that DED was present. Sixteen of those participants, or 64%, followed through in scheduling a secondary appointment with an eye care provider.

“With AI technology, more people can get screened, which could then help identify more people who need follow-up evaluation,” says Wolf. “If we can offer this more conveniently at the point of care with their diabetes doctor, then we can also potentially improve health equity, and prevent the progression of diabetic eye disease.”

This research was funded by the National Eye Institute of the National Institutes of Health and the Diabetes Research Connection. It was published in Nature Communications

Source: Johns Hopkins Medicine, ScienceDaily, January 13, 2024; see source article