Retina Division, Duke Eye Center, Durham, NC, USA.
Institute for Vision Research, Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
Eye (Lond). 2021 Oct;35(10):2675-2684. doi: 10.1038/s41433-021-01556-4. Epub 2021 May 6.
Sickle cell retinopathy is often initially asymptomatic even in proliferative stages, but can progress to cause vision loss due to vitreous haemorrhages or tractional retinal detachments. Challenges with access and adherence to screening dilated fundus examinations, particularly in medically underserved areas where the burden of sickle cell disease is highest, highlight the need for novel approaches to screening for patients with vision-threatening sickle cell retinopathy. This article reviews the existing literature on and suggests future research directions for coupling artificial intelligence with multimodal retinal imaging to expand access to automated, accurate, imaging-based screening for sickle cell retinopathy. Given the variability in retinal specialist practice patterns with regards to monitoring and treatment of sickle cell retinopathy, we also discuss recent progress toward development of machine learning models that can quantitatively track disease progression over time. These artificial intelligence-based applications have great potential for informing evidence-based and resource-efficient clinical diagnosis and management of sickle cell retinopathy.
镰状细胞性视网膜病变在增殖期通常最初无症状,但可进展导致视力丧失,原因是玻璃体积血或牵引性视网膜脱离。在医疗服务不足的地区,特别是镰状细胞病负担最高的地区,由于难以获得和坚持进行筛查性散瞳眼底检查,这突显了需要采用新方法来筛查有威胁视力的镰状细胞性视网膜病变患者。本文综述了人工智能与多模态视网膜成像相结合的现有文献,并为其未来研究方向提出建议,以扩大自动化、准确、基于成像的镰状细胞性视网膜病变筛查的机会。鉴于视网膜专家在监测和治疗镰状细胞性视网膜病变方面的实践模式存在差异,我们还讨论了最近在开发机器学习模型方面取得的进展,这些模型可以随着时间的推移定量跟踪疾病进展。这些基于人工智能的应用具有为镰状细胞性视网膜病变提供循证和资源高效的临床诊断和管理的巨大潜力。