Publikasjoner
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Karabeg, Mia; Petrovski, Goran; Holen, Katrine; Sauesund, Ellen Steffenssen; Fosmark, Dag Sigurd & Russell, Greg
[Vis alle 14 forfattere av denne artikkelen]
(2025).
Comparison of Validity and Reliability of Manual Consensus Grading vs. Automated AI Grading for Diabetic Retinopathy Screening in Oslo, Norway: A Cross-Sectional Pilot Study.
Journal of Clinical Medicine.
14(13).
doi:
10.3390/JCM14134810.
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Background: Diabetic retinopathy (DR) is a leading cause of visual impairment worldwide. Manual grading of fundus images is the gold standard in DR screening, although it is time-consuming. Artificial intelligence (AI)-based algorithms offer a faster alternative, though concerns remain about their diagnostic reliability.
Methods: A cross-sectional pilot study among patients (≥18 years) with diabetes was established for DR and diabetic macular edema (DME) screening at the Oslo University Hospital (OUH), Department of Ophthalmology, and the Norwegian Association of the Blind and Partially Sighted (NABP). The aim of the study was to evaluate the validity (accuracy, sensitivity, specificity) and reliability (inter-rater agreement) of automated AI-based compared to manual consensus (MC) grading of DR and DME, performed by a multidisciplinary team of healthcare professionals. Grading of DR and DME was performed manually and by EyeArt (Eyenuk) software version v2.1.0, based on the International Clinical Disease Severity Scale (ICDR) for DR. Agreement was measured by Quadratic Weighted Kappa (QWK) and Cohen’s Kappa (κ). Sensitivity, specificity, and diagnostic test accuracy (Area Under the Curve (AUC)) were also calculated.
Results: A total of 128 individuals (247 eyes) (51 women, 77 men) were included, with a median age of 52.5 years. Prevalence of any vs. referable DR (RDR) was 20.2% vs. 11.7%, while sensitivity was 94.0% vs. 89.7%, specificity was 72.6% was 83.0%, and AUC was 83.5% vs. 86.3%, respectively. DME was detected only in one eye by both methods.
Conclusions: AI-based grading offered high sensitivity and acceptable specificity for detecting DR, showing moderate agreement with manual assessments. Such grading may serve as an effective screening tool to support clinical evaluation, while ongoing training of human graders remains essential to ensure high-quality reference standards for accurate diagnostic accuracy and the development of AI algorithms.
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Karabeg, Mia; Petrovski, Goran; Hertzberg, Silvia Nanjala Walekhwa; Erke, Maja Gran; Fosmark, Dag Sigurd & Russell, Greg
[Vis alle 13 forfattere av denne artikkelen]
(2024).
A pilot cost-analysis study comparing AI-based EyeArt® and ophthalmologist assessment of diabetic retinopathy in minority women in Oslo, Norway.
International Journal of Retina and Vitreous (IJRV).
10(1).
doi:
10.1186/s40942-024-00547-3.
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Background Diabetic retinopathy (DR) is the leading cause of adult blindness in the working age population worldwide, which can be prevented by early detection. Regular eye examinations are recommended and crucial for detecting sight-threatening DR. Use of artificial intelligence (AI) to lessen the burden on the healthcare system is needed. Purpose To perform a pilot cost-analysis study for detecting DR in a cohort of minority women with DM in Oslo, Norway, that have the highest prevalence of diabetes mellitus (DM) in the country, using both manual (ophthalmologist) and autonomous (AI) grading. This is the first study in Norway, as far as we know, that uses AI in DR- grading of retinal images. Methods On Minority Women’s Day, November 1, 2017, in Oslo, Norway, 33 patients (66 eyes) over 18 years of age diagnosed with DM (T1D and T2D) were screened. The Eidon - True Color Confocal Scanner (CenterVue, United States) was used for retinal imaging and graded for DR after screening had been completed, by an ophthalmologist and automatically, using EyeArt Automated DR Detection System, version 2.1.0 (EyeArt, EyeNuk, CA, USA). The gradings were based on the International Clinical Diabetic Retinopathy (ICDR) severity scale [1] detecting the presence or absence of referable DR. Cost-minimization analyses were performed for both grading methods. Results 33 women (64 eyes) were eligible for the analysis. A very good inter-rater agreement was found: 0.98 (P < 0.01), between the human and AI-based EyeArt grading system for detecting DR. The prevalence of DR was 18.6% (95% CI: 11.4–25.8%), and the sensitivity and specificity were 100% (95% CI: 100–100% and 95% CI: 100–100%), respectively. The cost difference for AI screening compared to human screening was $143 lower per patient (cost-saving) in favour of AI. Conclusion Our results indicate that The EyeArt AI system is both a reliable, cost-saving, and useful tool for DR grading in clinical practice.
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Medin, Ingvild Helle; Dalby, Marius; Kure, Ingeborg Slørdahl Hjort; Karabeg, Mia; Drolsum, Liv Kari & Kristianslund, Olav
(2022).
Intraocular Inflammation in Eyes Operated for Late In-the-bag intraOcular lens dislocatioN (LION): A Randomized Clinical Trial.
American Journal of Ophthalmology.
ISSN 0002-9394.
238,
s. 66–74.
doi:
10.1016/j.ajo.2021.12.019.
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PURPOSE To compare the intraocular inflammation after 2 surgical approaches for late in-the-bag intraocular lens (IOL) dislocation. DESIGN Prospective, randomized, parallel-group clinical trial. METHODS We randomly assigned 100 patients (100 eyes) referred to Oslo University Hospital (tertiary referral center) with late in-the-bag IOL dislocation into IOL repositioning by scleral suturing (n=49) or IOL exchange with retropupillary fixation of an iris-claw lens (n=51). Patients were examined before surgery and 2 weeks, 6 weeks, and 6 months after surgery. The main outcome measure was anterior chamber laser flare, measured with a laser flare meter as photon counts per millisecond (pc/ms). RESULTS Two weeks following surgery, median flare values were 28.9 pc/ms (range, 7.9-140) in the repositioning group and 31.6 pc/ms (range, 9.8-92.3) in the exchange group (P = .83). Flare levels were still elevated after 6 weeks with no difference between the groups (P = .93), whereas it decreased to baseline levels after 6 months. Six weeks following surgery, the central retinal thickness was similar (P = .97); cystoid macular edema (CME) was found in 4 and 5 patients, respectively (P = .85); and the mean best corrected visual acuity was 0.17 (95% CI 0.09, 0.25) and 0.21 (95% CI 0.09, 0.32) logarithm of the minimum angle of resolution, respectively (P = .61). CONCLUSIONS This study revealed similar levels of intraocular inflammation following IOL repositioning and IOL exchange. There was no significant difference regarding risk of CME and visual outcome. The prolonged elevation in postoperative flare indicates a possible requirement for an extended anti-inflammatory treatment period after these operations.
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Nes, Dragana; Berg-Hansen, Pål; Benavent, Sigrid Aune de Rodez; Høgestøl, Einar August; Beyer, Mona K. & Rinker, Daniel Allen
[Vis alle 12 forfattere av denne artikkelen]
(2022).
Exploring Retinal Blood Vessel Diameters as Biomarkers in Multiple Sclerosis.
Journal of Clinical Medicine.
11(11).
doi:
10.3390/jcm11113109.
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We aimed to determine whether retinal vessel diameters and retinal oxygen saturation in newly diagnosed patients with multiple sclerosis (pwMS) are different from those of a healthy population. Retinal blood vessel diameters were measured using imaging with a spectrophotometric non-invasive retinal oximeter. Twenty-three newly diagnosed untreated relapsing-remitting MS (RRMS) patients (mean age: 32.2 ± 7.5 years, age range = 18–50 years, 56.5% female) were measured and compared to 23 age- and sex-matched healthy controls (HCs) (mean age: 34.8 ± 8.1 years). Patients with Optic Neuritis were excluded. Retinal venular diameter (143.8 µm versus 157.8 µm: mean; p = 0.0013) and retinal arteriolar diameter (112.6 µm versus 120.6 µm: mean; p = 0.0089) were smaller in pwMS when compared with HCs, respectively. There was no significant difference in the oxygen saturation in retinal venules and arterioles in pwMS (mean: 60.0% and 93.7%; p = 0.5980) compared to HCs (mean: 59.3% and 91.5%; p = 0.8934), respectively. There was a significant difference in the median low contrast visual acuity (2.5% contrast) between the pwMS and the HC groups (p = 0.0143) Retinal arteriolar and venular diameter may have potential as objective biomarkers for MS.
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Publisert
29. okt. 2021 13:31
- Sist endret
28. apr. 2023 14:29