A photo of your fundus can tell you your health status in advance

Luo Chaoshu, a reporter from Science Times

On November 30, the 2023 edition of the "Blue Book on the Health of Four Million People Undergoing Physical Examinations" (hereinafter referred to as the "Blue Book") based on retinal artificial intelligence assessment was officially released in Beijing. Data from the "Blue Book" show that in recent years, the total detection rate of fundus abnormalities has increased from 76.1% in 2019-2020 to 78.7% in 2022-2023, among which retinal vascular abnormalities have increased from 43.8% to 50.3%.

The health of the whole body can be seen through the eyes

Because a fundus photograph was taken during a physical examination, Ms. Chen, who is in her 30s, was told that she had "papilledema". After further medical treatment, she unexpectedly discovered a brain tumor.

"There are two possible causes of papilledema. One is that there is something wrong with the optic nerve itself, and the other is that something is growing in the brain, and the increased intracranial pressure causes optic nerve edema." Wei Wenbin, deputy director of Beijing Tongren Hospital affiliated to Capital Medical University, said that the retina of the eye is the only tissue in our body that can directly see blood vessels and nerves. The brain, heart, kidneys...almost all human systems can be found in the eyes. "A photo of the fundus shows your health in advance", which means that we can see the health of our whole body through our eyes.

Cases like Ms. Chen are defined as "major positive fundus" in the Blue Book, which refers to serious abnormalities in the retina that require immediate hospital diagnosis or exclusion of lesions that may cause serious visual impairment. If medical treatment is not sought in time, irreversible visual impairment may occur. Among the sample population, there are 950 cases of major positive optic nerve tests like Ms. Chen.

4 types of fundus abnormalities seriously threaten eye health

The Blue Book uses artificial intelligence fundus photography technology to detect disease risks and evaluates abnormalities of various types and levels in 50 diseases in five categories. The results show that 42.9% of the subjects have combined two or more abnormal results, among which retinal vascular abnormalities, refractive fundus changes, macular abnormalities, and optic disc and optic nerve abnormalities are four types of fundus abnormalities that seriously threaten eye health.

The "Blue Book" shows that the fundus health of people undergoing physical examinations is generally poor. With increasing age, the abnormal detection rate gradually increases, especially for people aged 40 and above, with more than 90 out of every 100 people having abnormalities.

Data from the physical examination population over the years show that the overall rate of fundus abnormality detection is still on the rise. Among various fundus abnormalities, the changes in retinal vascular abnormalities over the years are the most obvious, which may be related to the increase in the prevalence of chronic diseases such as hypertension and diabetes.

"As a key component of the eye, the retina plays the role of receiving and transmitting light signals and is a key factor affecting visual function. Due to its special structure, fundus disease has become the leading cause of irreversible blindness and is a focus of the World Health Organization's blindness prevention campaign," said Wei Wenbin.

In the statistical results of fundus abnormality rates, it was found that the mining industry had the highest fundus abnormality detection rate, which was 84.8%; the fundus abnormality detection rate among employees in the electricity, heat, gas and water production and supply industries was second, at 84.1%; the fundus abnormality detection rate among employees in the health and social work industry ranked third, at 82.2%.

In general, the health of the fundus in all industries is generally poor. Except for the above-mentioned special industries that are greatly affected by the working environment, office workers are still the main group with abnormal fundus.

AI-generated content makes “seeing the future at a glance” a reality

At present, AI-generated content represented by ChatGPT is setting off a new wave of AI revolution. When AI-generated content meets fundus medical imaging, what innovations will it bring to medical care?

At the Blue Book launch conference, Zhang Dalei, founder of fundus detection company Eagle Eye, said: "Just like ChatGPT can predict the next word, generative AI can also be used to predict the development and changes of a person's retinal blood vessels and nerves every day, and generate images to help people detect health risks in advance and intervene early."

Hu Hongliang, president of China Science and Technology Literature Publishing House, said: "AI technology can assist doctors in formulating more accurate health management or treatment plans. Using personalized data before, during and after hospitalization to establish disease models and provide accurate support for disease management is in line with the country's requirements for precision medicine or precision health management. On the one hand, it can improve management efficiency, and on the other hand, it can also bring patients a better treatment and health management experience."

Experts at the meeting believe that the use of AI + digital technology can maximize the value of doctors. By building a digital platform, strengthening the application of big data, enabling health check-up reports, and extending to various types of post-check services, it is possible to achieve precise dynamic health management for "thousands of people with thousands of faces" and start an integrated health management system.