The Evolution of Diabetic Retinopathy Screening Programmes: A Chronology of Retinal Photography from 35 mm Slides to Artificial Intelligence

Josef Huemer,1,2 Siegfried K Wagner,1 Dawn A Sim1 1NIHR Biomedical Research Center at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK; 2Vienna Institute for Research in Ocular Surgery, A Karl Landsteiner Institute, Hanusch Hospital, Vienna, AustriaCorrespo...

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Main Authors: Huemer J, Wagner SK, Sim DA
Format: Article
Language:English
Published: Dove Medical Press 2020-07-01
Series:Clinical Ophthalmology
Subjects:
Online Access:https://www.dovepress.com/the-evolution-of-diabetic-retinopathy-screening-programmes-a-chronolog-peer-reviewed-article-OPTH
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author Huemer J
Wagner SK
Sim DA
author_facet Huemer J
Wagner SK
Sim DA
author_sort Huemer J
collection DOAJ
description Josef Huemer,1,2 Siegfried K Wagner,1 Dawn A Sim1 1NIHR Biomedical Research Center at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK; 2Vienna Institute for Research in Ocular Surgery, A Karl Landsteiner Institute, Hanusch Hospital, Vienna, AustriaCorrespondence: Dawn A SimMoorfields Eye Hospital, NHS Foundation Trust, 62 City Road, London EC1V 2PD, United KingdomTel +44 (0)20 7253 3411Email dawnsim@nhs.netAbstract: As a third of people with diabetes mellitus (DM) will suffer the microvascular complications of diabetic retinopathy (DR) and therapeutic options can effectively prevent visual impairment, systematic screening has substantially reduced disease burden in developed countries. In an effort to tackle the rising incidence of DM, screening programmes have modernized in synchrony with technical and infrastructural advancements. Patient evaluation has shifted from face-to-face ophthalmologist-based review delivered through community grassroots to asynchronous store-and-forward modern telemedicine platforms commissioned on a nationwide scale. First pioneered with primitive 35-mm slide film retinal photography, the last decade has seen an emergence of high resolution and widefield imaging devices, which may reveal extents of DR indiscernible to the clinician but with implications of potential earlier identification. Similar progress has been seen in image analysis approaches – automated image analysis of retinal photographs of DR has evolved from qualitative feature detection to rules-based algorithms to autonomous artificial intelligence-powered classification. Such models have, relatively rapidly, been validated and are now receiving approval from health regulation authorities with deployment into the clinical sphere. In this review, we chart the evolution of global DR screening programmes since their inception highlighting major milestones in healthcare infrastructure, telemedicine approaches and imaging devices that have shaped the robust and effective frameworks recognised today. We also provide an outlook for the future of DR screening in the context of recent technological advancements with respect to their limitations in current times.Keywords: telemedicine, artificial intelligence, imaging, diabetes, retina, photography
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spelling doaj.art-6bd6f3d33a4f4172b16af0ebcd7c66552022-12-21T22:59:56ZengDove Medical PressClinical Ophthalmology1177-54832020-07-01Volume 142021203555486The Evolution of Diabetic Retinopathy Screening Programmes: A Chronology of Retinal Photography from 35 mm Slides to Artificial IntelligenceHuemer JWagner SKSim DAJosef Huemer,1,2 Siegfried K Wagner,1 Dawn A Sim1 1NIHR Biomedical Research Center at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK; 2Vienna Institute for Research in Ocular Surgery, A Karl Landsteiner Institute, Hanusch Hospital, Vienna, AustriaCorrespondence: Dawn A SimMoorfields Eye Hospital, NHS Foundation Trust, 62 City Road, London EC1V 2PD, United KingdomTel +44 (0)20 7253 3411Email dawnsim@nhs.netAbstract: As a third of people with diabetes mellitus (DM) will suffer the microvascular complications of diabetic retinopathy (DR) and therapeutic options can effectively prevent visual impairment, systematic screening has substantially reduced disease burden in developed countries. In an effort to tackle the rising incidence of DM, screening programmes have modernized in synchrony with technical and infrastructural advancements. Patient evaluation has shifted from face-to-face ophthalmologist-based review delivered through community grassroots to asynchronous store-and-forward modern telemedicine platforms commissioned on a nationwide scale. First pioneered with primitive 35-mm slide film retinal photography, the last decade has seen an emergence of high resolution and widefield imaging devices, which may reveal extents of DR indiscernible to the clinician but with implications of potential earlier identification. Similar progress has been seen in image analysis approaches – automated image analysis of retinal photographs of DR has evolved from qualitative feature detection to rules-based algorithms to autonomous artificial intelligence-powered classification. Such models have, relatively rapidly, been validated and are now receiving approval from health regulation authorities with deployment into the clinical sphere. In this review, we chart the evolution of global DR screening programmes since their inception highlighting major milestones in healthcare infrastructure, telemedicine approaches and imaging devices that have shaped the robust and effective frameworks recognised today. We also provide an outlook for the future of DR screening in the context of recent technological advancements with respect to their limitations in current times.Keywords: telemedicine, artificial intelligence, imaging, diabetes, retina, photographyhttps://www.dovepress.com/the-evolution-of-diabetic-retinopathy-screening-programmes-a-chronolog-peer-reviewed-article-OPTHtelemedicine artificial intelligence imaging diabetes retina photography
spellingShingle Huemer J
Wagner SK
Sim DA
The Evolution of Diabetic Retinopathy Screening Programmes: A Chronology of Retinal Photography from 35 mm Slides to Artificial Intelligence
Clinical Ophthalmology
telemedicine artificial intelligence imaging diabetes retina photography
title The Evolution of Diabetic Retinopathy Screening Programmes: A Chronology of Retinal Photography from 35 mm Slides to Artificial Intelligence
title_full The Evolution of Diabetic Retinopathy Screening Programmes: A Chronology of Retinal Photography from 35 mm Slides to Artificial Intelligence
title_fullStr The Evolution of Diabetic Retinopathy Screening Programmes: A Chronology of Retinal Photography from 35 mm Slides to Artificial Intelligence
title_full_unstemmed The Evolution of Diabetic Retinopathy Screening Programmes: A Chronology of Retinal Photography from 35 mm Slides to Artificial Intelligence
title_short The Evolution of Diabetic Retinopathy Screening Programmes: A Chronology of Retinal Photography from 35 mm Slides to Artificial Intelligence
title_sort evolution of diabetic retinopathy screening programmes a chronology of retinal photography from 35 mm slides to artificial intelligence
topic telemedicine artificial intelligence imaging diabetes retina photography
url https://www.dovepress.com/the-evolution-of-diabetic-retinopathy-screening-programmes-a-chronolog-peer-reviewed-article-OPTH
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