Tien Y. Wong
VIENNA — Diabetic retinopathy is a global disease, and it seems appropriate for a global conference such as Euretina to pay special attention to this emerging epidemic. With this statement, Tien Y. Wong, MD, PhD, introduced the Euretina Lecture at the 2018 meeting.
Diabetes has grown dramatically worldwide to become a global epidemic. By 2030, an expected 400 million people will have diabetes. In countries that were traditionally not affected, such as India and China, and areas in Africa and South America, prevalence has leapt to record numbers. As for diabetic retinopathy, it is expected to reach 150 million cases by 2030, 30 million of which will develop diabetic macular edema.
One major challenge, Tien said, is the “gap in awareness.” More than 75% of patients with DR and 50% of patients with DME are currently unaware of the disease, irrespective of age, gender, ethnic group and severity.
“Are we structured to deal with a problem of such proportion? We have made substantial improvement in ocular treatment, but a greater effort should be made at the level of secondary prevention, taking into account that DR is a consequence of a systemic disease,” Wong said.
Tighter glucose control is key, and blood pressure management also plays a crucial role, he said.
Sustained efforts are needed to set up DR screening programs, although implementation appears to be challenging; in all countries, 10 years on average have passed between proposal and implementation of these programs. However, in countries where national screening programs are in place, such as the United Kingdom, a substantial decrease in the rate of DR and DME has been reported.
Artificial intelligence might play a key role in this respect, Tan said.
“For the diagnosis and screening of DR, artificial intelligence, machine learning and deep learning systems have now achieved the capability to surpass human performance,” he said.
However, the major challenges of deep learning are not technical.
“Many real-world experiments in different settings are needed, and we as physicians must overcome the fear of the ‘black box’ because artificial intelligence is not less transparent than the way in which we have always worked,” he said.
Physicians also need to be reassured that artificial intelligence is not going to replace manpower but will rather create increasing new opportunities, he said. – by Michela Cimberle
Wong TY. Tackling the global burden of diabetic retinopathy: From epidemiology to artificial intelligence. Euretina Lecture 2018. Euretina; Sept. 20, 2018; Vienna.
Disclosure: Tan reports he is a consultant and advisory board member of Abbott, Allergan, Bayer, Genentech, Novartis and Roche, a patent holder for AI software for DR, and co-founder of Eyris.