Evaluation of an OCT-AI–Based Telemedicine Platform for Retinal Disease Screening and Referral in a Primary Care Setting

PURPOSE: To evaluate the performance of a telemedicine platform integrated with optical coherence tomography (OCT) and artificial intelligence (AI) techniques for retinal disease screening and referral. METHODS: We constructed an OCT-AI–based telemedicine platform and deployed it at four primary care stations located in Jing'an district, Shanghai, to detect retinal disease cases among aged groups and refer them to Shanghai Tenth People's Hospital (TENTH Hospital). Two ophthalmologists jointly graded the data set collected from this pilot application, and then the performance of this platform was analyzed from multiple aspects. RESULTS: This study included 1257 participants between July 2020 and September 2020, of whom 394 had retinal pathologies and 146 were even considered urgent cases by the ophthalmologists. The OCT-AI models achieved a sensitivity of 96.6% (95% confidence interval [CI], 91.8%–98.7%) and specificity of 98.8% (95% CI, 98.0%–99.3%) for detecting urgent cases and a sensitivity of 98.5% (95% CI, 96.5%–99.4%) and specificity of 96.2% (95% CI, 94.6%–97.3%) for detecting both urgent and routine cases. Coupled with AI, our platform reduced the workload of human consultation by 96.2% for massive normal cases. The detected disease cases received online medical suggestions at an average time of 21.4 hours via this platform. CONCLUSIONS: This platform can automatically identify patients with retinal disease with high sensitivity and specificity, support timely human consultation, and bring necessary referrals. TRANSLATIONAL RELEVANCE: The OCT-AI–based telemedicine platform shows great practical value for retinal disease screening and referral in a real-world primary care setting.