Development and Validation of a Deep Learning Algorithm for Detection of Diabetic Retinopathy in Retinal Fundus Photographs

Abstract

Among individuals with diabetes, the prevalence of diabetic retinopathy is approximately 28.5% in the United States¹ and 18% in India.² Most guidelines recommend annual screening for those with no retinopathy or mild diabetic retinopathy, repeat examination in 6 months for moderate diabetic retinopathy, and an ophthalmologist referral for treatment evaluation within a few weeks to months for severe or worse diabetic retinopathy or the presence of referable diabetic macular edema, known as clinically significant macular edema.³ Referable diabetic retinopathy has been defined as moderate or worse diabetic retinopathy or referable diabetic macular edema,⁴ given that recommended management changes from yearly screening to closer follow-up at moderate disease severity.³ Retinal photography with manual interpretation is a widely accepted screening tool for diabetic retinopathy, with performance that can exceed that of in-person dilated eye examinations.³