50 EyeWorld Asia-Pacific | December 2024 NEWS & OPINION In the near future, there will be an emergence of novel AI technologies to support myopia management in children and adults. These include multimodal AI, explainable AI (XAI), automated machine learning (AutoML), federated learning (FL), synthetic AI technology such as generative adversarial networks (GANs), and natural language processing (NLP) utilising large-language models (LLMs) (i.e. ChatGPT).9 Discussion – Will AI replace Myopia Specialists? The WHO and public health agencies such as the International Agency for Prevention of Blindness have recognised that AI and digital technology will play a major role in tackling myopia as it continues to grow as a global public health public health challenge. The recent interest and surge of AI research using larger datasets, more complex computational methods, will allow for more useful adjunctive tools that can be used for larger-scale myopia management programs. About the Physicians Marcus Ang, MD | Senior Consultant, Singapore National Eye Center, Singapore | marcus.ang@snec.com.sg Relevant Disclosures Ang: None References 1. Burton MJ, Ramke J, Marques AP, et al. The Lancet Global Health Commission on Global Eye Health: vision beyond 2020. Lancet Glob Health. 2021;9(4):e489-e551. 2. Foo LL, Lanca C, Wong CW, et al. Cost of Myopia Correction: A Systematic Review. Front Med (Lausanne). 2021;8:718724. 3. Jonas JB, Ang M, Cho P, et al. IMI Prevention of Myopia and Its Progression. Invest Ophthalmol Vis Sci. 2021;62(5):6. 4. Ang M, Flanagan JL, Wong CW, et al. Review: Myopia control strategies recommendations from the 2018 WHO/IAPB/BHVI Meeting on Myopia. Br J Ophthalmol. 2020;104(11):1482-1487. 5. Eppenberger LS, Grzybowski A, Schmetterer L, Ang M. Myopia Control: Are We Ready for an Evidence Based Approach? Ophthalmol Ther. 2024;13(6):1453-1477. 6. Foo LL, Ang M, Wong CW, et al. Is artificial intelligence a solution to the myopia pandemic? Br J Ophthalmol. 2021;105(6):741-744. 7. Li Y, Foo LL, Wong CW, et al. Pathologic myopia: advances in imaging and the potential role of artificial intelligence. Br J Ophthalmol. 2023;107(5):600-606. 8. Foo LL, Ng WY, Lim GYS, Tan TE, Ang M, Ting DSW. Artificial intelligence in myopia: current and future trends. Curr Opin Ophthalmol. 2021;32(5):413-424. 9. Ng Yin Ling C, Zhu X, Ang M. Artificial intelligence in myopia in children: current trends and future directions. Curr Opin Ophthalmol. 2024;35(6):463-471. 10. Wong CW, Foo LL, Morjaria P, et al. Highlights from the 2019 International Myopia Summit on ‘controversies in myopia’. Br J Ophthalmol. 2021;105(9):1196-1202. Our team at Singapore National Eye Center and Singapore Eye Research Institute are developing Artificial Intelligence algorithms to detect myopia, myopia progression and the future development of complications based on fundus imaging. Source: Marcus Ang, MD However, while these AI technologies hold significant promise in supporting myopia management, the clinicians still have to decide on the appropriate myopia control strategies and which interventions to recommend. Moreover, there are still global challenges including technical or infrastructural barriers to implementation, regulatory and data security issues, as well as health systems integration. Public awareness of myopia and its potential complications are inadequate in many societies around East Asia, which may also hinder acceptance of these novel digital technologies. Nonetheless, novel AI modalities including automated ML, large language models, and federated learning could play an important role in the future by delivering precision medicine, and improving health literacy or public awareness. There is a global recognition that more collaborative efforts across sectors, with the aid of novel digital technologies such as AI, is require to provide deliver evidence-based and world class myopia management to address this growing public health issue.10
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