Artificial intelligence in corneal diseases: A narrative review.

Journal: Contact lens & anterior eye : the journal of the British Contact Lens Association
PMID:

Abstract

Corneal diseases represent a growing public health burden, especially in resource-limited settings lacking access to specialized eye care. Artificial intelligence (AI) offers promising solutions for automating the diagnosis and management of corneal conditions. This narrative review examines the application of AI in corneal diseases, focusing on keratoconus, infectious keratitis, pterygium, dry eye disease, Fuchs endothelial corneal dystrophy, and corneal transplantation. AI models integrating diverse imaging modalities (e.g., corneal topography, slit-lamp, and anterior segment OCT images) and clinical data have demonstrated high diagnostic accuracy, often outperforming human experts. Emerging trends include the incorporation of biomechanical data to enhance keratoconus detection, leveraging in vivo confocal microscopy for diagnosing infectious keratitis, and employing multimodal approaches for comprehensive disease analysis. Additionally, AI has shown potential in predicting disease progression, treatment outcomes, and postoperative complications in corneal transplantation. While challenges remain such as population heterogeneity, limited external validation, and the "black box" nature of some models, ongoing advancement in explainable AI, data augmentation, and improved regulatory frameworks can serve to address these limitations.

Authors

  • Tuan Nguyen
  • Joshua Ong
  • Mouayad Masalkhi
    University College Dublin School of Medicine, Belfield, Dublin 4, Ireland.
  • Ethan Waisberg
    University College Dublin School of Medicine, Belfield, Dublin, Ireland. Electronic address: ethan.waisberg@ucdconnect.ie.
  • Nasif Zaman
    Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, Nevada, United States.
  • Prithul Sarker
    Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA.
  • Sarah Aman
    Wilmer Eye Institute, Johns Hopkins Medicine, Baltimore, MD, United States.
  • Haotian Lin
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou.
  • Mingjie Luo
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
  • Renato Ambrosio
    Brazilian Study Group of Artificial Intelligence and Corneal Analysis - BrAIN, Rio de Janeiro & Maceió, Brazil.
  • Aydano P Machado
    Department of Ophthalmology of Federal University of São Paulo, São Paulo, Brazil.
  • Darren S J Ting
    Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom.
  • Jodhbir S Mehta
    Singapore National Eye Centre, Singapore, Singapore.
  • Alireza Tavakkoli
    Department of Computer Science and Engineering, University of Nevada School of Medicine, Reno, NV 89557, USA.
  • Andrew G Lee
    Center for Space Medicine, Baylor College of Medicine, Houston, Texas, United States; Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas, United States; The Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas, United States; Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, New York, United States; Department of Ophthalmology, University of Texas Medical Branch, Galveston, Texas, United States; University of Texas MD Anderson Cancer Center, Houston, Texas, United States; Texas A&M College of Medicine, Texas, United States; Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States.