- Ground-breaking research by Moorfields Eye Hospital, DeepMind Health
and UCL uses artificial intelligence (AI) to help identify potentially
blinding eye diseases.
- AI system can recommend the correct referral decision for over 50
eye diseases with 94% accuracy – matching world-leading eye experts.
- System could help doctors and other eye health professionals spot
serious conditions earlier and prioritise patients who urgently need
treatment.
- Supporting images, videos and infographics are available here: https://www.dropbox.com/sh/pnqdo6pvlsdyf1w/AAA2ISWOx5NRnJpwWy8Kopj7a?dl=0.
An artificial intelligence (AI) system that can recommend the correct
referral decision for over 50 eye diseases as accurately as
world-leading experts has been developed by researchers at Moorfields
Eye Hospital NHS Foundation Trust, DeepMind Health and University
College London (UCL) Institute of Ophthalmology.
The
breakthrough research, published online by Nature Medicine, describes
how machine learning technology has been successfully trained on
thousands of historic de-personalised eye scans to identify features of
eye disease and recommend how patients should be referred for care. It
is hoped that the technology could one day transform the way
professionals carry out eye tests, allowing them to spot conditions
earlier and prioritise patients with the most serious eye diseases
before irreversible damage sets in.
More than 285 million people
worldwide live with some form of sight loss, including more than two
million people in the UK. Eye diseases remain one of the biggest causes
of sight loss, and many can be prevented with early detection and
treatment.
Dr Pearse Keane, consultant ophthalmologist
at Moorfields Eye Hospital NHS Foundation Trust and NIHR Clinician
Scientist at the UCL Institute of Ophthalmology said:
“The
number of eye scans we’re performing is growing at a pace much faster
than human experts are able to interpret them. There is a risk that this
may cause delays in the diagnosis and treatment of sight-threatening
diseases, which can be devastating for patients.
“The AI
technology we’re developing is designed to prioritise patients who need
to be seen and treated urgently by a doctor or eye care professional. If
we can diagnose and treat eye conditions early, it gives us the best
chance of saving people’s sight. With further research it could lead to
greater consistency and quality of care for patients with eye problems
in the future.”
The study, which was launched in 2016, brought
together leading NHS eye health professionals and scientists from the
National Institute for Health Research (NIHR) and UCL with some of the
UK’s top technologists at DeepMind to investigate whether AI technology
could help improve the care of patients with sight-threatening diseases,
such as age-related macular degeneration and diabetic eye disease.
Using
two types of neural network – mathematical systems for identifying
patterns in images or data – the AI system quickly learnt to identify
ten features of eye disease from highly complex optical coherence
tomography (OCT) scans. The system was then able to recommend a referral
decision based on the most urgent conditions detected.
To
establish whether the AI system was making correct referrals, clinicians
also viewed the same OCT scans and made their own referral decisions.
The study concluded that AI was able to make the right referral
recommendation more than 94% of the time, matching the performance of
expert clinicians.
The AI has been developed with two unique
features which maximise its potential use in eye care. Firstly, the
system can provide information that helps explain to eye care
professionals how it arrives at its recommendations. This information
includes visuals of the features of eye disease it has identified on the
OCT scan and the level of confidence the system has in its
recommendations, in the form of a percentage. This functionality is
crucial in helping clinicians scrutinise the technology’s
recommendations and check its accuracy before deciding the type of care
and treatment a patient receives.
Secondly, the AI system can be
easily applied to different types of eye scanner, not just the specific
model on which it was trained. This could significantly increase the
number of people who benefit from this technology and future-proof it,
so it can still be used even as OCT scanners are upgraded or replaced
over time.
The next step is for the research to go through
clinical trials to explore how this technology might improve patient
care in practice, and regulatory approval before it can be used in
hospitals and other clinical settings.
If clinical trials are
successful in demonstrating that the technology can be used safely and
effectively, Moorfields will be able to use an eventual,
regulatory-approved product for free across all 30 of their UK hospitals
and community clinics, for an initial period of five years.
The
work which has gone into this project will also help accelerate wider
NHS research for many years to come. For example, DeepMind has invested
significant resources to clean, curate and label Moorfields’
de-identified research dataset to create one of the most advanced eye
research databases in the world.
Moorfields owns this database
as a non-commercial public asset, which is already forming the basis of
nine separate medical research studies. In addition, Moorfields can also
use DeepMind’s trained AI model for future non-commercial research
efforts, which could help advance medical research even further.
Mustafa Suleyman, Co-founder and Head of Applied AI at DeepMind Health, said:
“We
set up DeepMind Health because we believe artificial intelligence can
help solve some of society’s biggest health challenges, like avoidable
sight loss, which affects millions of people across the globe. These
incredibly exciting results take us one step closer to that goal and
could, in time, transform the diagnosis, treatment and management of
patients with sight threatening eye conditions, not just at Moorfields,
but around the world.
“We’re immensely proud of this work, which
once again demonstrates what is possible when world-leading clinicians
and technologists collaborate to improve patient care”.
Professor Sir Peng Tee Khaw, director of the NIHR Biomedical
Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL
Institute of Ophthalmology said:
“The results of this
pioneering research with DeepMind are very exciting and demonstrate the
potential sight-saving impact AI could have for patients. I am in no
doubt that AI has a vital role to play in the future of healthcare,
particularly when it comes to training and helping medical professionals
so that patients benefit from vital treatment earlier than might
previously have been possible. This shows the transformative research
than can be carried out in the UK combining world leading industry and
NIHR/NHS hospital/university partnerships.”
Elaine
Manna, 71, from north London and mother of three, went blind in her left
eye from wet age-related macular degeneration (AMD). She is now being
treated at Moorfields Eye Hospital to save the remaining sight in her
right eye. She said:
“I lost the sight in my left eye in the
year 2000 after noticing a sudden blurring of my vision. A few weeks
went by and I was starting to get really worried. A doctor then told me I
had a bleed at the back of my eye that needed to be treated urgently
but it proved too late to save my sight.
“AMD has had a major
impact on my life. I love going to the theatre but I find it difficult
to see people’s faces and I struggle to find my way around dimly lit
rooms. I really hope that technology can help people like me in the
future.”
Matt Hancock, Health and Social Care Secretary, said:
“The
UK leads the world in ground-breaking research and artificial
intelligence has the potential to revolutionise the way we spot eye
disease, and could be genuinely transformative for the NHS in the
future.
“This is hugely exciting and exactly the type of
technology which will benefit the NHS in the long term and improve
patient care – that’s why we fund over a billion pounds a year in health
research as part of our long term plan for the NHS.”
Robert Dufton, chief executive at Moorfields Eye Charity, said:
“The
need for treatment for eye diseases is forecast to grow, in part
because people are living longer, far beyond our ability to meet the
demand using current practice. Artificial intelligence is showing the
potential to transform the speed at which diseases can be diagnosed and
treatments suggested, making the best use of the limited time of
clinicians. AI will also help our understanding of sight loss.
Moorfields Eye Charity is proud to have funded equipment which underpins
Dr Pearse Keane’s work as part of our programme of philanthropic
support in pioneering researchers.”
Tony Young, NHS England’s National Clinical Director for Innovation, said:
“The
NHS has always nurtured medical breakthroughs and now artificial
intelligence, although still in its infancy, has real potential to
radically transform the way medicine is practiced. This exciting
research provides important evidence about how AI can support doctors to
provide more rapid diagnosis and treatment, freeing up clinicians’ time
for direct patient care.”
Cathy Yelf, chief executive of the Macular Society, said:
“Macular
disease is the biggest cause of sight loss in the UK, affecting 600,000
people. It is extremely debilitating and timely treatment for patients
with wet AMD, such as Elaine, is vital. Pressure on eye clinics has
resulted in delays for many patients, which has tragically led to
unnecessary sight loss. We’re excited by this latest development and
hope in time this technology will alleviate the pressure on clinics and
mean patients will get the urgent treatment they need.”
Martin Cordiner, Head of Research at the College of Optometrists said:
“As
optometrists are often the first port of call for people with the
symptoms of eye disease, we are very excited about the potential that AI
has to assist them in helping patients. Further support in prioritising
the referral of the patients with the greatest need is in the interests
of both practitioners and patients, and we look forward to the results
of clinical trials of this technology.”
Michele Acton, Chief Executive at Fight for Sight, said:
“Artificial
intelligence has the potential to help us address so many challenging
health issues. We’re delighted that it is being used to help those
patients most at need to receive timely access to ophthalmologists and
appropriate treatments. This is a great step forward and we believe that
the use of artificial intelligence will have an increasing role in
addressing eye diseases in the future.”
Professor Andrew Lotery, Chair Scientific Committee, The Royal College of Ophthalmologists, said:
“This
paper shows the power of utilizing artificial intelligence in
ophthalmology. Innovative research such as this could help hospital eye
services manage their clinics more effectively in the future.”
