Future of Vision and Diabetic Eyecare

V. Akshaya, M.Optom

Assistant Professor, Nethra Institute of Optometry, Arani, India PhD – Optometry (Pursuing), Chitkara University, Chandigarh, India

Introduction:

India is called the “Diabetes Capital of the World,” as mentioned by Indian Council of Medical Research (ICMR). The country now has 101 million diabetics, besides which there are a further 136 million pre-diabetic individuals in need of prevention. Globally more than 100 million individuals are living with Diabetic Retinopathy (DR). It is one of the leading causes of Blindness and Vision Impairment among the working age adult population. ⁽¹⁾ Blurred or diminished vision is the main symptom reported in ocular complications like Diabetic Retinopathy and Diabetic Macular Oedema.

Diabetic Retinopathy is a microvascular complication of diabetes that can progress without symptoms to vision loss. Major diagnostic advances in the field of Diabetes were evolved in the 21st century (ETDRS Classification System, PRP Laser, Optical Coherence Tomography, and anti-VEGF Injections). By 2030 it is predicted that there will be a higher number of  advanced technologies, which will reshape clinical and research aspects.

Teleophthalmology in Diabetic Eyecare:

In diabetic eye care, Teleophthalmology primarily uses retinal imaging which provides point to point Diabetic screening at primary eye care or other non-eye care areas. The advantages of this mode of screening are numerous. This is usually done in reduced cost, improved screening rates, identifies risk of blindness, reduced need of Ophthalmologic visits, improved access in areas where they have few eye care practitioners as well as educating patients with diabetes.

M.K Ling et al., reported that 91% of participants involved in Teleophthalmology screening between 2016-2020 and were diagnosed with type 2 Diabetes Mellitus (DM), wherein, 69% of participants involved 2 years follow up and 22% of participants involved follow up for 5 years. The proportion of patients receiving eyecare after DM diagnosis was 22% in the first year and there was a 10% increase in the second year. Author suggested that Teleophthalmology involves regular eye screening which helps in earlier detection of Diabetic Retinopathy. ⁽²⁾

Artificial Intelligence in Diabetic Eyecare:

Application of Deep Learning has a significant impact in the medical field.  Uppamma, P., & Bhattacharya, S. (2023) reported that it has helped  many Ophthalmologists in detecting diseases including the diabetic retinopathy and in identifying the severity of the conditions. ⁽³⁾ Deep learning in conjunction with teleophthalmology helps in first line of screening and disease detection without the need of an experienced practitioner especially in the rural areas.

Apart from ophthalmology, Deep learning Technology has significant application in various medical areas such as prostate image analysis, foetal localisation, thyroid diagnosis, brain tumour detection, deep learning, lung nodule classification, cardiac functioning, diabetes identification etc.

Conclusion:

Recent advances in diagnosis and management of Diabetic Retinopathy and upcoming new models helps to provide a better future for patients with Diabetes and helps in reducing the incidence of Diabetic Retinopathy by 2030.

Reference:

1. Tan, T. E., & Wong, T. Y. (2023). Diabetic retinopathy: Looking forward to 2030. Frontiers in Endocrinology, 13.
2. Lieng, M. K., Emami-Naeini, P., Lee, S. C., Alber, S., & Yiu, G. (2024). Teleophthalmology provides earlier eye care access for patients with newly-diagnosed diabetes. Heliyon, 10(4), 2405-8440.
3. Uppamma, P., & Bhattacharya, S. (2023). Deep learning and medical image processing techniques for diabetic retinopathy: a survey of applications, challenges, and future trends. Journal of Healthcare Engineering, 2023, 1-18.