Caroline Richards, editor, Ophthalmology Times Europe®

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I spoke to Dr Anthony Khawaja of University College London and Moorfields Hospital, London, UK, about the exciting realm of precision medicine in glaucoma.

How do you define ‘precision management’?

In looking after our patients, most of us review the evidence in the literature. For example, when considering glaucoma patients, I might look at the UK glaucoma treatment study (UKGTS),

 a randomised controlled trial that showed that patients treated with a prostaglandin analogue do better on average than those who are not treated.

Evidence-based medicine tells us how best to treat people on average, but everyone is different. Not everybody in the UKGTS who received latanoprost necessarily benefited from it; in fact, 15% of such patients progressed over 2 years, so they were under-treated. Yet three-quarters of the placebo group did not progress, so some may have been over-treated.

Precision management is about going beyond simply what is best for the average group of patients and instead being able to predict, the first time you see a patient, their risk of worsening, and then titrating their treatment accordingly — maybe starting off more intensively in some high-risk patients so that you do not have to observe further vision loss before stepping up treatment. And it is it about choosing no treatment at all for other patients.

This means resources and treatments can be directed only to the people who will benefit, thus sparing the costs and side effects of treatments that will not work. The key here is understanding that one size does not fit all.

Could you expand on what this would look like for glaucoma?

One example of where precision glaucoma management could be useful is trying, the first time you see the patient, to make an assessment about whether they need treatment or not. Take the patient who has high ocular pressure but not glaucoma as of yet. We know from the Ocular Hypertension Treatment Study (OHTS)

 that if you treat such patients, they will do better on average than people who do not receive treatment: fewer of them will convert to glaucoma. But we also know that most of the group that is not treated do not develop glaucoma, so some are being treated unnecessarily.

An OHTS calculator that predicts the risk of conversion to glaucoma already exists,

 which takes into account the age of the patient, baseline pressure, corneal thickness, visual field mean deviation and cup-disc ratio. Unfortunately, this calculator, while helpful, does not really go far enough.

And so what we are looking to do is bring in other new technologies using genetic information or perhaps artificial intelligence (AI) assessments of images to help decide whether a patient will very likely benefit from treatment or, actually, are at such low risk that we can save the costs and the hassle of treatment. This will in turn also free up health service resources so that we can focus on the patients at highest risk.

You can apply this to other aspects of glaucoma care. For somebody with established glaucoma, do you treat or not, and how aggressively do you treat?

Another area which in my opinion can really benefit from the precision management approach in glaucoma is choosing the right treatment. There are so many different types of treatments available, including four major classes of drug, selective laser trabeculoplasty for open angle disease, and a whole spectrum of surgery from the minimally invasive glaucoma surgeries to the traditional incisional surgeries such as trabeculectomy and tube implants.

And if we are honest with ourselves, we do not know who is going to do well with each treatment. As mentioned, some people respond very well to latanoprost, but others do not respond at all and some experience side effects.

In recent years, we have really started to understand what causes glaucoma. In fact, glaucoma is one of the most hereditary of the common diseases in humans; it is about 70% heritable.

This means, in part, that some glaucoma is inherited through generations in an autosomal dominant fashion due to just a single mutation, most commonly in the myocilin gene. But this comprises only about 4% of primary open angle glaucoma (POAG).

The majority of cases are more complex because they are due to a lot of genetic effects, each one small and insufficient in causing glaucoma on its own but when put together cumulatively reach a threshold that causes disease. For years we were unable to identify these small effects, but recently, with large studies, we have been able to identify many more.

For example, 2 years ago, by looking at the pressure in the eyes of around 140,000 people, we identified over 100 points in the genetic code that underlie some people developing high pressure and then glaucoma.

 And what is exciting is that, when you combine the genetic information at all of these points, you can start to predict who is going to get glaucoma, even from the point of birth because our genetic code does not change after that.

Given that it has got such a genetic basis, what we can start to do next is pick out different types of glaucoma, for example, which are currently indistinguishable. So, POAG to us looks pretty uniform. However, genetically speaking there is a subgroup that seems to have a problem particularly located in Schlemm’s canal and collector channels; for another group the problem seems to particularly affect the trabecular meshwork.

If we could work out which of these patients had primarily a trabecular meshwork problem then we would know that treatment targeted to the trabecular meshwork, such as selective laser trabeculoplasty, or the iStent Inject (Glaukos) and trabecular bypass procedures with microstents (Hydrus), is more likely to work.

Conversely, if the issue is predominantly due to a problem with a patient’s collector channels and Schlemm’s canal, then maybe you are better off not targeting the trabecular meshwork. In that way, we can start to use genetic risk scores to be able not only to tell us about the risk of disease progression but also to predict response to treatment.

How exactly would artificial intelligence assist?

Well, in terms of personalising care, there is an awful lot of information that we collect as glaucoma specialists: images that provide detailed information and potential patterns that we recognise. We learned through our training that we can sometimes look at an optic nerve and see when there is a lot of damage and when a person is at high risk, meaning we need to treat them aggressively.

But there are other times where we just get it wrong and do not predict at baseline that somebody is at high risk of getting worse, and they worsen despite our best efforts. Conversely, we might treat other people that are at low risk and we can never know whether they needed that treatment.

The real power of AI in medicine so far is the ability to classify images, which it can do better than any single human grader. AI has the potential to see patterns in an image that no human being, no matter how expert they are, can see: an interesting study that supports this concept is one from the Google Brain group.

They trained an AI algorithm to look at photos of the retina of healthy participants in a couple of studies, including the UK Biobank study, and to predict sex. The algorithm is 97% accurate in identifying whether a fundus photo is from a man or a woman. Is there is one glaucoma specialist or retinal specialist or human in the world who can do that?

The enticing thought is that if AI can see patterns beyond what humans can appreciate currently, it can predict the future. I can definitely see AI working together with genomics in the future, providing much more individualised care.

I have set my research group an ambitious target: by 4 years’ time we will have developed proven algorithms that can predict the risk of glaucoma progression and response to two different treatments. Once we have got this tool, we need to make it easily accessible and understandable to general glaucoma doctors and physicians, and even patients.

We will need to test it prospectively to see whether it does improve decision making. Glaucoma trials can take quite a long time—at least 2 years—and so I think we are looking at an estimated 5 years to get the proof of principle and a pilot tool that will then need to be proven over a few years before something can be rolled out.

In parallel to this, we need genetic data to be available. Currently, most of our patients do not come with genetic data, although increasing numbers of people are obtaining it from direct-to-consumer genetic tests. There are already platforms where healthcare services can interact with genetic databases to pull out the information they need, with the patient’s consent. So, this is one possibility.

This type of testing can cost less than £50 and when done on scale might be nearer to £20 per person, which is excellent value. And if that one £20 test can tell you whether you should be screened for glaucoma, which treatment you should have and whether you need treatment at all, it could provide a similar picture for other diseases.

For example, it could also tell you, say, whether you should take statins if you have got high lipid levels. Should you be screened for breast cancer or should it be delayed? And for prostate cancer? This is just scratching the surface.

The £20 test can inform a whole gamut of health-related decisions. It will really become a question of 

 you test and obtaining genetic information for all people who interact with healthcare services will become routine.

The people in the aforementioned study were all of European descent and we can predict with a certain degree of accuracy someone’s risk of glaucoma if they are European. This prediction works quite well for Asian people too, but not so well for people of African descent.

If we are to develop a new, better way of managing glaucoma, which means that people get the best treatment for them from the get go and that we spare people who do not need treatment, can we really offer it if it only works in people of certain ethnicities? And I think we all know the answer to that is no.

So, one of the challenges is the need to make sure that we are getting enough data and information on people of all ethnicities. And this is why, having started the Moorfields Glaucoma BioResource, I am pleased to be able to recruit patients from all backgrounds due to London’s very diverse population.

The other challenge is to come up with a better way of managing glaucoma so that expertise is widely distributed and not clustered in certain centres of excellence where there are genetics experts. Such care needs to be delivered by any doctor and to an extent that even patients can understand.

It needs to be accessible and rolled out everywhere, equitably, to people of all ethnicities and backgrounds. And that is the key: we need to make this an equitable innovation.

Anthony Khawaja, MA (Cantab), PhD, FRCOphth

Dr Khawaja is associate professor at UCL Institute of Ophthalmology and honorary consultant ophthalmic surgeon at Moorfields Eye Hospital NHS Foundation Trust, London, UK. He reports acting as consultant to Aerie, Allergan, Google Health, Novartis, Reichert and Santen and has received lecturing fees from Grafton Optical and travel support from Thea.

Garway-Heath DF, Crabb DP, Bunce C, et al. Latanoprost for open-angle glaucoma (UKGTS): a randomised, multicentre, placebo-controlled trial. 

Gordon MO, Beiser JA, Brandt JD, et al. The Ocular Hypertension Treatment Study: baseline factors that predict the onset of primary open-angle glaucoma. 

Gordon MO, Torri V, Miglior S, et al. Validated prediction model for the development of primary open-angle glaucoma in individuals with ocular hypertension.

Khawaja AP, Cooke Bailey JN, Wareham NJ, et al. Genome-wide analyses identify 68 new loci associated with intraocular pressure and improve risk prediction for primary open-angle glaucoma. 

Poplin R, Varadarajan A V., Blumer K, et al. Prediction of cardiovascular risk factors from retinal fundus photographs via deep learning. 

Articles

Artificial intelligence and genetic testing are expected to facilitate choosing the best treatment for each unique glaucoma patient within the next decade. This will not only lead to the best outcomes for individuals but will also spare them the costs and side effects of suboptimal treatments.

Precision management to revolutionise glaucoma diagnosis and treatment

Swinging open its doors to ophthalmologists and industry, the RAI Convention Centre in Amsterdam greeted those who chose to attend the 39th Congress of the European Society of Cataract and Refractive Surgeons in person on 8th to 12th October and the, albeit somewhat scaled down, event did not disappoint. I felt privileged to be amongst those able to attend the hotly anticipated schedule of Symposia, Courses, Papers and Programmes in person; the 38th ESCRS had originally been slated for Amsterdam last year too, before being replaced with a fully virtual format when the coronavirus pandemic continued to cling on.

After two long years of conferences being confined to computer screens, it was a somewhat reassuring experience to witness delegates once again take to podiums, exhibition booths and coffee tables, sit together in the halls and discuss the latest advancements in ophthalmology face to face. And exciting too: the buzz of finally being able to conduct business interactions and share research findings in real life seemed to be putting a spring in everyone’s steps.

Despite attendees being provided with complimentary ESCRS-branded face masks when registering and collecting their name badges, fewer people chose to sport them in the congress centre than I had anticipated, even when networking within the confines of a fairly small (and much smaller than in previous years — perhaps to the relief of those with a less-than-perfect sense of direction) Exhibition Hall. Social distancing was also clearly now a thing of the past, and hands were shaken despite the occasional sign asking people to refrain (the elbow bump greeting must have JUST been a fleeting idea during lockdown).

Perhaps the setting had something to do with the relatively relaxed attitudes: I noticed fairly few anti-Covid-19 measures in place in Amsterdam in general whilst there, which is no doubt testament to the fact the Dutch, like many countries, are seeing the positive effects vaccination has had on society. I had a real taste of the changing times at a packed concert at the Het Concertgebouw which I attended on the Friday evening: hundreds of people gathered inside the famous venue to enjoy Berlioz’ Symphonie fantastique and Stravinsky’s Firebird and there wasn’t a covered nose-and-mouth in sight.

That’s not to say the conference organisers at RAI did not take precautions to ensure those entering were deemed a low risk: I had to show my double-vaccination status and ID every time I wanted to enter the building. I also noticed that some exhibition booths had signs requesting that people sanitise their hands before entering.

One thing I had pondered as I collected my badge at on Day 1 was how the ‘hybrid’ nature of it, i.e., part-in-person, part-virtual, would work in practice. This was my first time physically attending such a unique format of conference since the pandemic began, so I was intrigued. According to figures released by the ESCRS, of the 7,122 registrations for the event, a whopping 3,000 of these had opted to participate virtually.

And I was impressed by how seamlessly the two formats were combined during the Symposia; when it was the turn of an off-site ophthalmologist to speak, a video of their talk appeared on the huge screens at the front of the Hall. Some of these had been pre-recorded (this did not ruin my enjoyment of them, as it was still effectively the first time they were being shown).

Other doctors were speaking live from their home country and thus were also able to participate in the Q&A sessions following their talks. I even attended a Session in which the Chair himself was sitting comfortably in his home study back in the UK, introducing the speakers from there, his well-stocked bookcase and criss-cross floral patterned wallpaper providing a visually appealing change of scenery to the usual off-white background you see in congress centres.

Video conferencing formats rarely come without some element of danger, but the technical difficulties were few and only minor; needless to say, they still sparked some sniggering in the crowds: speakers appearing to silently mime their talks (we’ve all heard the line “You’re on mute” enough times to last a lifetime, but there’s no sign those three little words are going away any time soon) or disappearing from view entirely (in one comical moment, an attendee eagerly awaited an answer to his question from the microphone he stood before at the front of the hall only for the presenter to go offline immediately — a mishap that prompted the Chair to suggest, in jest, of course, that the question had not gone down well!)

Overall, the blending of videos with in-person talks added another interesting dimension to the Symposia and by no means lessened the quality or accessibility of the information being disseminated. It’s a format that I suspect may be here to stay even in the post-Covid world, since there will always be reasons that people wishing to attend and/or present at congresses cannot participate in person: it seems better that they can do so in some sort of capacity than not at all, after all.

In the next part of my review of this year’s ESCRS, published next week, I’ll cover a few of the Symposia I had the pleasure of attending over the four days. Stay tuned to find out more!

A melting pot of curious minds congregate in-person and virtually at this year’s ESCRS

The 39th Congress of the European Society for Cataract and Refractive Surgery (ESCRS) plans to open its doors for the first time since the COVID-19 pandemic began at the RAI Congress Centre in Amsterdam, the Netherlands, from 8–11 October 2021. In-person attendance at this much-anticipated yearly event is sure to be an appealing prospect to many. And for those who are unable to attend in person, the Congress will also be held virtually, making the chance to participate in some capacity a reality for all.

So, what is in store for attendees this year over the four action-packed days? At the time of going to press, the ESCRS had not released the full, in-depth programme, however, a range of symposia, programmes, video sessions and workshops will be on offer and are discussed in this brief preview article. There will also be a daily exhibition, giving people the chance to experience the latest technologies in ophthalmology and providing the ideal location for ophthalmologists and researchers to network with their peers.

editorial advisory board members: Dr Albert Augustin, professor of ophthalmology and chairman of the Department of Ophthalmology at the Karlsruhe Municipal Hospital, Germany, and Dr Paolo Fazio, head of the refractive surgery service of the Catanese Centre of Medicine in Catania, Italy, to gain their insights into the topics on the agenda at this year’s event. Read on to find out more!

The Main Symposium to be held in the morning of the opening day of the Congress will be on the interesting-sounding topic “Managing Herpetic Keratitis”. There will also be a Clinical Research Symposium entitled “Stem Cells: Basics and Clinical Perspectives”, taking place after lunch. Two further symposia planned for the afternoon are the “JCRS” (Journal of Cataract and Refractive Surgery) and the “ISRS” (International Society for Refractive Surgery) sessions.

A Video Session due to be held between 5.15pm and 6.45pm will showcase “Challenging Cases”, a topic that proves popular every year at the ESCRS, as ophthalmologists seek to learn how to manage the more difficult patients and/or surgeries. Learning opportunities will also present themselves during the three courses planned for Day 1, whose topics have yet to be disclosed. Friday also marks the day the Exhibition Hall will open (between 9am and 5pm).

The more junior ophthalmologists among attendees will have the chance to network and learn tips and tricks in the “Young Ophthalmologists Programme”, which begins on the Saturday. Dr Augustin comments: “This format is becoming increasingly popular, since young ophthalmologists, and especially young surgeons, now have a new platform to discuss problems or situations in the clinical practice which are unique for beginners and may not be a topic suitable for other formats. This is true for both scientific and surgical questions.”

Meanwhile, the Clinical Research Symposium will be on “Advances in Corneal Cross-Linking”, which is currently a very hot topic. “Corneal crosslinking is an increasingly standardised procedure, with new accelerated protocols that reduce the duration of treatment with similar results to standard ones,” says Dr Augustin.

Emphasising the importance of the “Selecting Advanced IOLs” Main Symposium taking place, Dr Fazio comments: “This is a Symposium that will probably be held for several ESCRS meetings to come since the list of advanced IOLs is becoming more crowded by the day.”

“MIGS: The Evidence-Based Approach” will be the topic of the second of the Main Symposia taking place on the Saturday. Dr Augustin says: “The introduction of MIGS has simplified the approach to glaucoma surgery. A review of recent evidence is important to improve the outcomes in terms of both IOP reduction and complication rate.”

For those wishing to participate in courses, attendees will have the option to either do so in person or virtually, with both types (seven in-person and two virtual) being on offer on Saturday. Free Paper sessions are also expected to place before the day wraps up with a video “Award Session”, between 6.30pm and 8pm.

Sunday is shaping up to be a very busy day at the ESCRS, with two Symposia taking place in the morning—on “Imaging Techniques of the Anterior Segment and Beyond” and “Practical Digital Ophthalmology”—and a couple taking place after lunch.

Referring to the afternoon’s Research Symposia on “Cost Effectiveness and Value-based Healthcare: Have They Entered Ophthalmology?”, Dr Augustin points out: “Limitations on resources make the cost-effectiveness of any procedure very important for all of us. The information in this session should help ophthalmologists to engage with both payers and hospital administration staff.”

Regarding the Main Symposium covering “Enhancements after Refractive Surgery”, he comments: “Enhancement of refractive surgery is also a hot topic because refractive patients have very high expectations, which very often cannot be met with the first procedure. Thus, enhancement procedures can be necessary to produce superior results.”

“Euro Times Satellite Education Symposia” also appear in the schedule at various times throughout the day and there is also a Symposium entitled “IIIC” (Intraocular Lens Implant Club) at the end of the day. The IILC is a group of international specialists which will, no doubt, present the newest developments in IOL design. Dr Augustin believes that development in the field of IOLs is in “constant turmoil, with the introduction of ever more precise lenses for the correction of refraction errors and the management of presbyopia”.

With educative opportunities remaining a major theme at the Congress, nine courses, two of which are offered virtually, are planned to be held at varying times. The Video Session will cover surgical methods, which is always a good opportunity for ophthalmologists to hone their techniques and learn from peers. Sunday also marks the last day the Exhibition is open.

On the final day of the Congress, glaucoma is the subject of the two “Masterclasses” in the morning, which demonstrates the importance that cataract and refractive surgeons need to have a high level of understanding of this disease entity. There will also be a “Hyperopia Workshop”, a total of five in-person courses and a session discussing the work of the non-profit organisation Orbis Flying Eye Hospital; a teaching hospital on board a flight, which delivers eyecare to low- and middle-income countries.

“Don’t miss the ORBIS session,” Dr Augustin advises. “This charity project was established many years ago. You will see and hear the newest activities of this group.”

Dr Augustin also strongly advises attending the “CSCRS Symposium”. “This symposium of the ‘united cataract surgeons of the world’ will provide you with latest news on cataract surgery from a global perspective,” he says.

The final day will be rounded up, as has become something of a tradition at the ESCRS Congress, with the “Best of the Best”, a session that will enable attendees to go away with the main pearls of the event.

The 39th Congress of the European Society for Cataract and Refractive Surgery (ESCRS) will meet at RAI Congress Centre in Amsterdam, the Netherlands, from 8–11 October 2021. The Congress will also be held virtually, making the chance to participate in some capacity a reality for all.

Opportunities lie ahead at the 39th ‘hybrid’ ESCRS

I interviewed retina expert Dr Konstantinos Balaskas about the applications of 

artificial intelligence (AI) in ophthalmology

. The opportunities for patients and healthcare professionals alike are great, but hurdles remain before AI can be fully integrated in real life: economic, ethical and data-privacy issues to name but a few.

How can AI be applied to retinal diseases?

Well, I think AI is quite a broad term. The type of AI that has generated a lot of excitement in recent years is called ‘deep learning’. This is a process by which software programs learn to perform certain tasks by processing large quantities of data.

Deep learning is what has made ophthalmology a pioneer in the field of implementing AI in medicine, because we are increasingly reliant on imaging tests to monitor our patients. Particularly in my subspecialty of interest, medical retina, imaging tests such as optical coherence tomography (OCT) are performed very frequently and have provided the material to train and test and then apply AI decision support systems.

Measuring visual fields with cloud-based AI platform

In retina particularly, some of the most common causes of visual loss in the Western world, such as age-related macular degeneration (AMD) and diabetic retinopathy, are conditions that require early detection, prompt initiation of treatment and regular monitoring in order to preserve vision. And that is where AI decision support systems can help to improve access to care and ensure optimal clinical outcomes for our patients.

An example is the AI decision support system that was developed in a collaboration between Moorfields Eye Hospital, where I am based, and Google DeepMind. It is able to read OCT scans, interpret them, provide a diagnosis and make management recommendations. The other area where AI shows promise is in the development of personalised treatment plans for patients by being able to predict their response to treatment and their visual outcomes over a period of time.

What do you see as the greatest opportunities for real-life implementation that can improve clinical outcomes?

Referring again to those common conditions that threaten vision, such as AMD and diabetic retinopathy, AI decision support tools, once validated and once they have gained regulatory approval as medical devices, can help improve access to care. They can, for example, assist health practitioners in the community in diagnosing diseases early.

In the United Kingdom, where OCT scans are widely available in high street optician practices, an AI tool would be particularly useful to assist them to interpret scans correctly and identify disease at an early stage. Similarly, in diabetic retinopathy, where patients require regular screening and monitoring of their disease, AI tools can significantly increase the efficiency of the screening programmes.

Diabetes and DR: Making progress in the global epidemic

Some such applications already exist, particularly in diabetic retinopathy – they can be of particular use for diabetic retinopathy screening programmes, such as in under-resourced healthcare settings. Other indications for the application of AI monitoring, like AMD, are in advanced stages of development, but have not yet been implemented in real life.

Are there any challenges with integrating AI into retina diagnostics and treatments?

Definitely, there are quite a few. I have a personal academic interest in the field called implementation science, which looks at the gap between developing a medical device such as an AI decision support tool and actually deploying it in real-life clinical practice.

The potential barriers that we need to overcome for the tool to be deployed in a meaningful way to improve outcomes for our patients go beyond testing and validation. These include economic evaluations: how would such an automated decision support model affect the finances of a healthcare system, so that it could provide good value for money or achieve cost savings?

The next consideration is human factors, particularly how these models of care that rely on AI are perceived and accepted by patients and practitioners; what is the level of trust in these technologies? And what level of information and education of patients and the general public is required to build confidence in their use? Then there are considerations around training and the technical infrastructure to support these tools.

AI enhances customised myopic LASIK with ray tracing optimisation

Ethical and data-privacy issues, as well as medico-legal considerations, are also important: who is responsible for decisions made by an AI algorithm rather than a human? How do these tools affect the way healthcare professionals diagnose and manage disease?

There is a phenomenon called automation bias, where practitioners are sometimes more likely to defer to the recommendation of the AI tool, even perhaps against their better judgement. And there is the issue of interpretability—the ‘black box’ phenomenon—in many instances these AI tools are opaque in their functioning.

We do not fully understand how a specific recommendation is reached, whether that is a diagnosis or a management recommendation, and that lack of transparency can exacerbate the medical, legal and ethical issues that were mentioned earlier. In summary, there are several hurdles to overcome before AI tools can be deployed in real life in a way that is safe and will improve clinical outcomes.

How do you envisage life will change for ophthalmologists in the future?

This is an interesting question. I share a positive optimistic vision of AI in medical practice. Our field is becoming increasingly complex and we need to process data from various sources when we are assessing our patients: data from the many imaging modalities, genetic data and the various types of omics, such as proteomics and the emerging field of oculomics, where features on the eye examination can be indicative of problems with systemic health. Even data from home vision monitoring devices will become increasingly available.

Processing and making sense of all this data in order to develop a personalised treatment plan for each individual patient can be a daunting task. AI could become a very useful aid and, as described in the Topol review on AI commissioned by Health Education England, provide the gift of time to patients and practitioners, giving them the chance to discuss and decide together what the optimal treatment plan is, informed by the processing of high-dimensional complex data sources.

1. Campbell JP, Mathenge C, Cherwek H, et al. AI to reduce ocular health disparities: moving from concept to implementation. 

Konstantinos Balaskas, MB BS, MD, FEBO, MRCOphth

Dr Balaskas is a retinal expert at Moorfields Eye Hospital, London, UK, and director of the Moorfields Ophthalmic Reading Centre and AI Analytics Hub. He has a keen academic interest in new ways of delivering care in ophthalmology, including tele-medicine, ‘virtual’ clinics, remote monitoring and AI decision support. He has no financial disclosures.

Ophthalmology, with its heavy reliance on imaging, is an innovator in the field of artificial intelligence in medicine.

Author | Caroline Richards, editor, Ophthalmology Times Europe®

Articles

A melting pot of curious minds congregate in-person and virtually at this year’s ESCRS

Opportunities lie ahead at the 39th ‘hybrid’ ESCRS

Ophthalmology: A pioneer in the field of artificial intelligence

Precision management to revolutionise glaucoma diagnosis and treatment