Assessment of an AI-based triage and notification system in detecting clinical signs of retinal diseases

PurposeThis study evaluates the performance of an artificial intelligence based triage and notification system that analyzes fundus photographs for nine signs: cotton wool spots, dot & blot hemorrhages, drusens, flame shaped hemorrhages, glaucomatous disc, hard exudates, retinal neovascularization, preretinal hemorrhage and vascular tortuosity. These signs may be present in multiple retinal diseases. MethodsIn a blinded and adjudicated study, a set of 3484 photographs of unique eyes from 3305 patients, from 15 fundus cameras, were graded by retina specialists, and the results compared with an AI-based system. ResultsThe AI performed at a mean sensitivity of 90.19% and a mean specificity of 88.38% across all signs. The best performance was in detecting glaucomatous disc with a sensitivity of 94.65% and a specificity of 95.36%. The worst performance for sensitivity was for detecting vascular tortuosity at 85.06% and that for specificity was for detecting drusens 85.21%. ConclusionThe AI-based system performs at acceptable sensitivity and specificity levels in comparison to retina specialists in a large sample pooled across 15 fundus cameras for 9 different clinical signs.