Background. Artificial Intelligence (AI) is an advanced technology for the latest 20 years. Machine learning (ML) and deep learning (DL) are the major innovations for AI, which has been applied for multiple fields. Ophthalmology has become to be one of the most significant disciplines for human healthcare. Methodology. This study utilizes methods of text mining and bibliometric analysis to explore applications of AI to ophthalmology. 179 related articles from Web of Science (WOS) and 96 papers from China National Knowledge Infrastructure (CNKI) are explored during the period of 2000 to 2021. A descriptive analysis of major trends, journal releasing, topic mapping and quotation relationships is implemented in this paper. Leading authors, journals, institutions, nations and references in the related research are identified. Results. Findings show that the application of AI technologies in ophthalmologic diagnosis with optical coherence tomography (OCT) fundus images is the core topic for this area’s studies, especially for diabetic retinopathy (DR), aged macular degeneration (AMD) and glaucoma. It is also be predicted as the core direction over the recent years. Besides, The USA, England and China is the most competitive countries in this scientific filed. Journals of Ophthalmology, Investigative Ophthalmology and Visual Science, Eye, Acta Ophthalmologica and Scientific Reports are the top five journal related to the research area. There is a significant difference between WOS and CNKI databases pertaining to the application of Artificial Intelligence (AI) to ophthalmology, especially for the historic development, topic mapping and discipline category. Finally, the potential academic value of interdisciplinary subject of “AI in Ophthalmology” and tradition Chinese medicine (TRM) is discussed. Limitations and suggestions for the future research is indicated at the end of this paper.

Age-related Macular Degeneration (AMD) is the major cause of elders’ vision loss, early screening and treatment are the most efficient way to reduce the rate of blindness. AI-based methods based on ophthalmic images play great potential for AMD diagnosis. However, low levels of accuracy, robustness, and explainability are challenges for AI approaches applied in clinics. Thus, this study proposed a multi-type of data source fusion method and a multi-model fusion approach for AMD detection. Typical unsupervised (Hierarchical Clustering and K-Means), typical supervised (SVM, VGG-16, and ResNet) methods, and proposed methods (multi-source data fusion-based method and multi-model fusion-based approach) are compared based on Optical Coherence Tomography (OCT), Fundus Autofluorescence (FAF), regular color fundus photography (CFP) and Ultra-Wide field Fundus (UWF) images. Data preprocessing and enhancements of each type of data are discussed. A feature extraction based on unsupervised ML models, feature combination and normalization, and multi-layer perception (MLP) algorithm are involved in the proposed multi-source data fusion-based method. Supervised ML and DL models and a voting mechanism are involved in the multi-model fusion-based approach. Findings show that the proposed methods present a high performance of accuracy and robustness. A real-world UWF database is involved from Shenzhen Aier Hospital. Practical and theoretical contributions are delivered. A reference value for medical diagnosis based on multiple digital images is contributed.

Macula fovea detection is a crucial prerequisite towards screening and diagnosing macular diseases. Without early detection and proper treatment, any abnormality involving the macula may lead to blindness. However, with the ophthalmologist shortage and time-consuming artificial evaluation, neither accuracy nor effectiveness of the diagnose process could be guaranteed. In this project, we proposed a deep learning approach on ultra-widefield fundus (UWF) images for macula fovea detection. This study collected 2300 ultra-widefield fundus images from Shenzhen Aier Eye Hospital in China. Methods based on U-shape network (Unet) and Fully Convolutional Networks (FCN) are implemented on 1800 (before amplifying process) training fundus images, 400 (before amplifying process) validation images and 100 test images. Three professional ophthalmologists were invited to mark the fovea. A method from the anatomy perspective is investigated. This approach is derived from the spatial relationship between macula fovea and optic disc center in UWF. A set of parameters of this method is set based on the experience of ophthalmologists and verified to be effective. Results are measured by calculating the Euclidean distance between proposed approaches and the accurate grounded standard, which is detected by Ultra-widefield swept-source optical coherence tomograph (UWF-OCT) approach. Through a comparation of proposed methods, we conclude that, deep learning approach of Unet outperformed other methods on macula fovea detection tasks, by which outcomes obtained are comparable to grounded standard method.