An unmet need exists for effective, low-cost screening tools for retinoblastoma, especially in regions with limited resources. To meet this need, researchers at the University of Michigan in Ann Arbor have developed the EyeScreen smartphone application.1
“This app is another step toward using artificial intelligence [AI] and machine learning in the field of ophthalmology,” said Hakan Demirci, MD.
LEUKOCORIA. Researchers hope that the app will facilitate early, accurate detection of leukocoria and other anomalies.
Need for early detection. Early detection and treatment of retinoblastoma are essential for improving a child’s chances of survival. As Dr. Demirci noted, global mortality rates in retinoblastoma are disproportionate, with “higher death rates in lower-income parts of the world compared to higher-income regions.” For instance, patients from high-income countries are diagnosed at a median age of 14.1 months, and less than 1% have metastasis. In contrast, those from low- income countries are diagnosed at a median age of 30.5 months, with 18.9% having metastasis.
Smartphone apps have been created previously to screen for leukocoria, the leading presenting sign of retinoblastoma, but they have limitations.1 The EyeScreen app has been designed for Android devices, the most commonly used smartphones in the world, for real-time screening using multiple directions of gaze, Dr. Demirci said.
Study details. For this study, more than 4,000 images from 1,457 children were obtained using the EyeScreen app on Android smartphones at pediatric and ophthalmology clinics in Addis Ababa, Ethiopia. Eighty percent of the images were used to train a machine learning model to detect leukocoria; the remaining 20% were used to test the accuracy of the model. Analysis of the results showed 87% sensitivity and 73% specificity.
Using AI to guide screening. Dr. Demirci said that he thinks the app will be useful for multiple types of care providers, including physician extenders and pediatricians, throughout the world. Failure to detect leukocoria and other pupillary anomalies “can cause delays in diagnosis and treatment of retinoblastoma,” even in higher-income countries, he said.
Coming soon. Dr. Demirci said the EyeScreen app is “very close” to being ready for use in clinical practice. He said that his team is trying to improve the model’s sensitivity and specificity, in collaboration with Professor Elliott Soloway from University of Michigan’s College of Electrical Engineering and Computer Science. They plan to “increase the availability of the app for other researchers and physicians around the world.”
The team is also working on adding new features to the app and developing it to potentially detect other eye problems. “Considering how cell phones are widely used everywhere, I think this will be a good step for further developments,” he said.
—Patricia Weiser, PharmD
1 Bernard A et al. Ophthalmology Science. 2022;2(3):100158.
Relevant financial disclosures: Dr. Demirci—None.
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Full Financial Disclosures
Dr. Demirci Aura Bioscience: C; Castle Bioscience: C.
Dr. Moghimi NEI/NIH: S.
Dr. Roth NIH: S.
Dr. Tam None.
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