Eyeworld

I AUGUST 2020 | EYEWORLD | 45 reach patients who may not be located in areas with easy access to care. "I think screening initiatives combined with AI technologies may help to diagnose eye disease that might other- wise get missed," he said. It could also require fewer resources to operate, as opposed to some of the more time- and labor-intensive tests, Dr. Stoller said. Dr. Joseph said that if AI reaches the point where it's able to predict disease pro- gression and more tailored therapy, physicians could hopefully use resources more efficiently, instead of relying on a cookie-cutter approach. "If we're looking at earlier disease detection and more accurate detection, hopefully we're treating patients before they develop a serious disease burden," he said. Risks and challenges Dr. Ho said that one possible risk is that you can get misled by large datasets. Just because there's an association doesn't mean there's causation, he said. AI may give you hypotheses but not definite causation or optimal treatment. Expert, experienced human intelligence will still Specifically relating to diabetic retinopathy, Dr. Ho said it's important to improve commu- nication among all members of the care team. In large-scale disease screening, the interaction would hopefully become more refined, provid- ing risk assessments to the general care team from specialists. Cost effectiveness Dr. Ho said AI could create value by identifying patients who are more responsive to medica- tion, those who may not respond to certain treatments, those at risk for vision loss, and patients more likely to be lost to follow-up. Currently AI algorithms are employed in home monitoring solutions for the early detection of neovascular AMD and in the near future with home diagnostic imaging that may refine treatment of macular diseases with increased value to the patient and the healthcare system in general. The cost-efficient interpretation of daily home OCT images for the identification and quantification of intra- and subretinal fluid will require AI assistance. Dr. Stoller added that AI may be a cost-ef- fective way to improve patients' access to care because remote visits/teleophthalmology help continued on page 46 AI-based identification and quantification of intra- and subretinal fluid on home OCT images of a patient with neovascular AMD (Notal Vision) Source: Notal Vision

• Cover