Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA.
Department of Biomedical Data Science, Stanford University, Stanford, CA 94304, USA.
Exp Biol Med (Maywood). 2021 Oct;246(20):2159-2169. doi: 10.1177/15353702211031547. Epub 2021 Aug 18.
Age-related macular degeneration (AMD) is a leading cause of severe vision loss. With our aging population, it may affect 288 million people globally by the year 2040. AMD progresses from an early and intermediate dry form to an advanced one, which manifests as choroidal neovascularization and geographic atrophy. Conversion to AMD-related exudation is known as progression to neovascular AMD, and presence of geographic atrophy is known as progression to advanced dry AMD. AMD progression predictions could enable timely monitoring, earlier detection and treatment, improving vision outcomes. Machine learning approaches, a subset of artificial intelligence applications, applied on imaging data are showing promising results in predicting progression. Extracted biomarkers, specifically from optical coherence tomography scans, are informative in predicting progression events. The purpose of this mini review is to provide an overview about current machine learning applications in artificial intelligence for predicting AMD progression, and describe the various methods, data-input types, and imaging modalities used to identify high-risk patients. With advances in computational capabilities, artificial intelligence applications are likely to transform patient care and management in AMD. External validation studies that improve generalizability to populations and devices, as well as evaluating systems in real-world clinical settings are needed to improve the clinical translations of artificial intelligence AMD applications.
年龄相关性黄斑变性(AMD)是导致严重视力丧失的主要原因。随着人口老龄化,到 2040 年,全球可能有 2.88 亿人受到影响。AMD 从早期和中期干性形式进展为晚期形式,表现为脉络膜新生血管形成和地图状萎缩。向与 AMD 相关的渗出物的转化称为向新生血管性 AMD 的进展,而地图状萎缩的存在称为向晚期干性 AMD 的进展。AMD 进展预测可以实现及时监测、早期发现和治疗,从而改善视力结果。机器学习方法是人工智能应用的一个子集,应用于成像数据在预测进展方面显示出有希望的结果。从光学相干断层扫描中提取的生物标志物在预测进展事件方面具有信息性。本综述的目的是提供关于人工智能中用于预测 AMD 进展的当前机器学习应用的概述,并描述用于识别高风险患者的各种方法、数据输入类型和成像方式。随着计算能力的提高,人工智能应用很可能改变 AMD 的患者护理和管理方式。需要进行外部验证研究,以提高人群和设备的通用性,并评估真实临床环境中的系统,从而提高人工智能 AMD 应用的临床转化。