Cited by 626Ophthalmology and Visual Health ResearchRetinal Imaging and AnalysisTelemedicine and Telehealth Implementation

Digital technology, tele-medicine and artificial intelligence in ophthalmology: A global perspective

Open access
Li, Ji-Peng Olivia, Liu, Hanruo, Ting, Darren S.J., Jeon, Sohee, Chan, R.V. Paul, Kim, Judy E., Sim, Dawn A., Thomas, Peter B.M. +9 more·2021·Progress in Retinal and Eye Research

Abstract

The simultaneous maturation of multiple digital and telecommunications technologies in 2020 has created an unprecedented opportunity for ophthalmology to adapt to new models of care using tele-health supported by digital innovations. These digital innovations include artificial intelligence (AI), 5th generation (5G) telecommunication networks and the Internet of Things (IoT), creating an inter-dependent ecosystem offering opportunities to develop new models of eye care addressing the challenges of COVID-19 and beyond. Ophthalmology has thrived in some of these areas partly due to its many image-based investigations. Tele-health and AI provide synchronous solutions to challenges facing ophthalmologists and healthcare providers worldwide. This article reviews how countries across the world have utilised these digital innovations to tackle diabetic retinopathy, retinopathy of prematurity, age-related macular degeneration, glaucoma, refractive error correction, cataract and other anterior segment disorders. The review summarises the digital strategies that countries are developing and discusses technologies that may increasingly enter the clinical workflow and processes of ophthalmologists. Furthermore as countries around the world have initiated a series of escalating containment and mitigation measures during the COVID-19 pandemic, the delivery of eye care services globally has been significantly impacted. As ophthalmic services adapt and form a "new normal", the rapid adoption of some of telehealth and digital innovation during the pandemic is also discussed. Finally, challenges for validation and clinical implementation are considered, as well as recommendations on future directions.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1016/j.preteyeres.2020.100900

Cites

338 of 338 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Inaccurate and underrepresentative training data sets for AI models can cause bias, misleading predictions, adverse events, and large-scale discrimination, causing barriers to adoption.

    “Inaccurate and underrepresentative training data sets for AI models can cause bias, misleading predictions, adverse events, and large-scale discrimination, causing barriers to adoption [32,41,47,48].”

    From Barriers to and facilitators of artificial intelligence adoption in health care: scoping review (2024) · cites this paper as [41]

    In “Equity of access” (page unavailable), the paper says under-represented groups may receive inaccurate diagnoses and warns that algorithmic bias can exacerbate inequities. “Challenges in clinical deployment of AI” (page unavailable) says training datasets and validation require consideration before adoption. The copy does not specifically establish that inaccurate training data cause large-scale discrimination or adverse events. (LLM, conf=0.80)

    Experimental — accuracy not yet measured
  • Data security was identified as a major contributor toward hesitancy, with concerns around cybersecurity relating to both training and testing data as well as fear of trackers and spyware obtaining unsolicited data.

    “Data security was identified as a major contributor toward hesitancy, with concerns around cybersecurity relating to both training and testing data as well as fear of trackers and spyware obtaining unsolicited data [39,41,42,45,48,77].”

    From Barriers to and facilitators of artificial intelligence adoption in health care: scoping review (2024) · cites this paper as [41]

    In “Challenges in clinical deployment of AI” (page not provided), the paper identifies cybersecurity and data protection as issues for both training and testing data. The telemedicine-deployment section also lists security and privacy concerns among barriers to EHR adoption. It does not identify security as a major contributor to hesitancy or mention trackers or spyware obtaining unsolicited data. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 7

  1. Abràmoff Michael D. Lavin Philip T. Birch Michele Shah Nilay James C Folk Pivotal trial of an autonomous AI-based diagnostic system for detection of diabetic retinopathy in primary care offices NPJ Digit. Med. 1 2018 39 31304320 PMC6550188
  2. American Medical Association Augmented intelligence in health care. Policy 2019 https://www.ama-assn.org/system/files/2019-08/ai-2018-board-policy-summary.pdf
  3. Masumoto Hiroki Tabuchi Hitoshi Nakakura Shunsuke Ishitobi Naofumi Miki Masayuki Enno Hiroki Deep-learning classifier with an ultrawide-field scanning laser ophthalmoscope detects glaucoma visual field severity J. Glaucoma 27 2018 647 652 29781835
  4. National Academies of Sciences, Engineering, Medicine, Policy, Affairs Global, Roundtable Government-University-Industry Research The national Academies collection: reports funded by national institutes of health Saunders J. The Transformational Impact of 5G: Proceedings of a Workshop-In Brief 2019 National Academies Press (US) Copyright 2019 By the National Academy of Sciences. All Rights Reserved.: Washington (DC))
  5. Nordrum A. Clark K. IEEE Spectrum staff '5G Bytes: Small Cells Explained 2017 IEEE Spectrum Accessed 20 February 2020 https://spectrum.ieee.org/video/telecom/wireless/5g-bytes-small-cells-explained
  6. Samuel A.L. Some studies in machine learning using the game of checkers (Reprinted from Journal of Research and Development, vol 3, 1959 IBM J. Res. Dev. 44 2000 207 226
  7. World Health Organisation WHO Guideline: Recommendations on Digital Interventions for Health System Strengthening 2019 31162915

Cited by

Sorted by citations

Authors
Li, J.-P. O., Liu, H., Ting, D. S. J., Jeon, S., Chan, R. V. P., Kim, J. E., Sim, D. A., Thomas, P. B. M., Lin, H., Chen, Y., Sakomoto, T., Loewenstein, A., Lam, D. S. C., Pasquale, L. R., Wong, T. Y., Lam, L. A., & Ting, D. S. W.
Affiliations
  • Moorfields Eye Hospital NHS Foundation Trust (GB)
  • Beijing Tongren Hospital (CN)
  • University of Nottingham (GB)
  • University of Illinois Chicago (US)
  • Medical College of Wisconsin (US)
  • State Key Laboratory of Ophthalmology (CN)
  • Peking Union Medical College Hospital (CN)
  • Kagoshima University (JP)
  • Tel Aviv Sourasky Medical Center (IL)
  • Chinese University of Hong Kong, Shenzhen (CN)
  • Icahn School of Medicine at Mount Sinai (US)
  • National University of Singapore (SG)
  • University of Southern California (US)
Corresponding author
  • Ting, Darren S.J.
  • Ting, Daniel S.W.
Venue
Progress in Retinal and Eye Research
Publisher
Elsevier BV
Published
2021-05
Volume
82
Pages
100900
ISSN
1350-9462 (ISSN-L)
OpenAlex
W3083027974
Cited by
626
References
338
Citations by year
2026: 65 · 2025: 118 · 2024: 140 · 2023: 148 · 2022: 92 · 2021: 57 · 2020: 5
FWCI
12.79
Type
journal article
Language
en
Open access
Locations
  • Progress in Retinal and Eye Research (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
Medical Research Council (MR/T001674/1)
Topics
  • Health Sciences › Medicine › Ophthalmology › Ophthalmology and Visual Health Research
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
Keywords
telemedicine, artificial intelligence, digital health, 5G, Internet of Things, ophthalmology, diabetic retinopathy, retinopathy of prematurity, age-related macular degeneration, glaucoma, refractive error correction, cataract, anterior segment disorders, COVID-19 pandemic, eye care delivery, clinical implementation, AI validation
MeSH terms
Digital Technology, COVID-19, SARS-CoV-2, Artificial Intelligence, Delivery of Health Care, Eye Diseases, Humans, Ophthalmology, Global Health, Telemedicine, Inventions

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review