arXiv:2505.20810eess.IVcs.CV2025-05被引 11

AI结合眼底成像可早期发现糖尿病、心血管病等致命疾病

The Role of AI in Early Detection of Life-Threatening Diseases: A Retinal Imaging Perspective

  • 用高分辨率眼底扫描+深度学习分析微血管和神经退行性变化
  • 对糖尿病视网膜病变检测敏感度超90%,心血管风险预测准确率AUC达0.89
  • 适合临床筛查、慢病管理及基层医疗推广

眼底成像已成为检测系统性疾病(如糖尿病、高血压、阿尔茨海默病和心血管疾病)生物标志物的无创有效手段,但现有研究分散于不同平台与专业领域。光学相干断层扫描(OCT/OCTA)和自适应光学(AO)技术进步使分辨率可达5 μm,显著提升对比度与空间整合能力,可早期发现微血管异常与神经退行性改变。与此同时,人工智能与机器学习算法大幅提升了大规模眼底数据的分析效率,例如深度学习模型对糖尿病视网膜病变的检测敏感度超过90%,基于眼底照片预测心血管风险的AUC达0.89。移动健康技术与远程眼科平台的发展进一步降低了成本,扩大了筛查覆盖范围并支持长期监测。尽管如此,其在临床中的应用仍受限于成像协议不统一、AI模型外部验证不足以及临床流程整合困难。本文系统综述了最新的OCT/OCTA与AO进展、AI/ML方法及mHealth/远程眼科实践,量化评估其在各类疾病中的诊断性能,并提出多中心标准化协议、前瞻性验证试验及将眼底筛查无缝融入初级与专科诊疗路径的路线图,为重大系统性疾病实现精准预防、早期干预和持续治疗铺平道路。

原文摘要 · Abstract (English)

Retinal imaging has emerged as a powerful, non-invasive modality for detecting and quantifying biomarkers of systemic diseases-ranging from diabetes and hypertension to Alzheimer's disease and cardiovascular disorders but current insights remain dispersed across platforms and specialties. Recent technological advances in optical coherence tomography (OCT/OCTA) and adaptive optics (AO) now deliver ultra-high-resolution scans (down to 5 μm ) with superior contrast and spatial integration, allowing early identification of microvascular abnormalities and neurodegenerative changes. At the same time, AI-driven and machine learning (ML) algorithms have revolutionized the analysis of large-scale retinal datasets, increasing sensitivity and specificity; for example, deep learning models achieve > 90 \% sensitivity for diabetic retinopathy and AUC = 0.89 for the prediction of cardiovascular risk from fundus photographs. The proliferation of mobile health technologies and telemedicine platforms further extends access, reduces costs, and facilitates community-based screening and longitudinal monitoring. Despite these breakthroughs, translation into routine practice is hindered by heterogeneous imaging protocols, limited external validation of AI models, and integration challenges within clinical workflows. In this review, we systematically synthesize the latest OCT/OCT and AO developments, AI/ML approaches, and mHealth/Tele-ophthalmology initiatives and quantify their diagnostic performance across disease domains. Finally, we propose a roadmap for multicenter protocol standardization, prospective validation trials, and seamless incorporation of retinal screening into primary and specialty care pathways-paving the way for precision prevention, early intervention, and ongoing treatment of life-threatening systemic diseases.

眼底成像AI医疗早期检测心血管风险

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