India's largest eye care provider, Aravind Eye Hospital, has been quietly working for over four years with Google on a project to use artificial intelligence (AI) in ophthalmology. Aravind Eye Hospital, which has branches across India, is headquartered in Madurai, Tamil Nadu. Lily Peng, product manager at Google, who released a paper on the research a year ago, said at the 2017 WIRED Business Conference that Google had just finished a clinical study in India, and that work was underway to get the technology into routine use with patients. India, considered the diabetes capital of the world, has over 70 million diabetes patients who are at risk of blindness due to the disease. India's largest eye care provider, Aravind Eye Hospital, has been quietly working for over three to four years with Google on a project to use artificial intelligence in ophthalmology At the TensorFlow Dev Summit earlier this year, Peng had said that that Google's machine learning algorithm was very close to an ophthalmologist in terms of performance.
In an evaluation of retinal photographs from adults with diabetes, an algorithm based on deep machine learning had high sensitivity and specificity for detecting referable diabetic retinopathy, according to a study published online by JAMA. Among individuals with diabetes, the prevalence of diabetic retinopathy is approximately 29 percent in the United States. Most guidelines recommend annual screening for those with no retinopathy or mild diabetic retinopathy and repeat examination in 6 months for moderate diabetic retinopathy. Retinal photography with manual interpretation is a widely accepted screening tool for diabetic retinopathy. Automated grading of diabetic retinopathy has potential benefits such as increasing efficiency and coverage of screening programs; reducing barriers to access; and improving patient outcomes by providing early detection and treatment.
The AI-powered, cloud-based system will be available for use by primary care providers. Over 30 million Americans have diabetes, and diabetic retinopathy--which occurs when blood sugar levels result in damage to retinal blood vessels--is considered mostly preventable. Still, it causes vision loss in tens of thousands of people each year and is the leading cause of blindness among working-age Americans. "Many patients with diabetes are not adequately screened for diabetic retinopathy since about 50 percent of them do not see their eye doctor on a yearly basis," Malvina Eydelman, MD, said in the FDA's official announcement. She serves as director of the Division of Ophthalmic, and Ear, Nose and Throat Devices at the agency's Center for Devices and Radiological Health.
Diabetic retinopathy, an eye disorder caused by diabetes, is the primary cause of blindness in America and over 99% of cases in India. India and China currently account for over 90 million diabetic patients and are on the verge of an explosion of diabetic populations. This may result in an unprecedented number of persons becoming blind unless diabetic retinopathy can be detected early. Aravind Eye Hospitals is the largest eye care facility in the world, handling over 2 million patients per year. The hospital is on a massive drive throughout southern India to detect diabetic retinopathy at an early stage.