I(eye)-SCREEN: A real-world AI-based infrastructure for screening and prediction of progression in age-related macular degeneration (AMD) providing accessible shared care

I（eye）-Screen的目的是开发一种基于人工智能（AI）的诊断决策支持系统，用于在视力丧失发生之前的早期阶段筛查和监测年龄相关性黄斑变性（AMD）。晚期AMD是法律的失明>50年的主要原因，有1.1亿人处于风险中。该多学科联盟汇集了临床视网膜专家网络，在人工智能开发前沿工作的计算机科学家，基于社区的验光师/验光师基础设施和在数字平台性能方面经验丰富的SME，以开发创新和值得信赖的人工智能工具，通过基于云的基础设施进行广泛的实时AMD筛查和监测。为了实现在早期AMD中找到“大海捞针”的雄心勃勃的目标，使用光学相干断层扫描（OCT），一种高分辨率、轻松的成像模式，在广泛的体积扫描中提供视网膜的详细表征。将开发用于医学成像的突破性人工智能方法，以实现从稀疏纵向OCT数据中进行数据高效和稳健的学习，从而系统地分析密集的数据量并识别疾病活动的（亚）临床标志物。整个欧洲的临床研究中心将收集纵向队列，用于使用眼科诊所提供的高端OCT设备校准和微调算法。然后，创新的人工智能技术将被创建，以将检测和监控工具转移到隔壁眼镜商/验光师办公室使用的低成本设备上。该项目的时机完全符合最近监管机构批准的第一种治疗方法，以阻止主要萎缩型AMD的进展。由此产生的基于人工智能的“共享护理”策略提供了不受限制的视力维护护理，具有最大的健康公平性，并为反映视网膜生物标志物的全身性，心血管和神经退行性疾病的筛查提供了一个榜样。

The aim of I(eye)-Screen is to develop an artificial intelligence (AI)-based diagnostic decision support system for screening and monitoring of age-related macular degeneration (AMD) at an early stage before vision loss occurs. Late AMD is the leading cause of legal blindness >50 years with 110 mio individuals at risk. The multidisciplinary consortium brings together a network of clinical retina experts, computer scientists working at the cutting edge of AI development, an infrastructure of community-based opticians/optometrists and an SME experienced in digital platform performance to develop innovative and trustworthy AI tools for broad, real-time AMD screening and monitoring via a cloud-based infrastructure with unlimited access. To achieve the ambitious goal of finding “the needle in the haystack” in early AMD, Optical Coherence Tomography (OCT), a high-resolution, effortless imaging modality is used providing a detailed characterization of the retina in extensive volumetric scans. Breakthrough AI approaches for medical imaging will be developed to enable data-efficient and robust learning from sparse longitudinal OCT data to systematically analyse dense data volumes and identify (sub)clinical markers of disease activity. Clinical sites throughout Europe will collect a longitudinal cohort serving for calibrating and fine-tuning algorithms using the high-end OCT device available at eye clinics. Innovative AI technology will then be created to transferthe detection and monitoring tools to low-cost devices used in next door opticians’/optometrists’ offices. The timing of the project perfectly fits the recent regulatory approval of the first therapy to halt progression of the major atrophic type of AMD. The resulting AIbased “shared care” strategy offers unrestricted accessibility to vision-maintaining care with greatest health equity and provides a role model for screening for systemic, cardiovascular and neurodegenerative disease reflecting retinal biomarkers.