The following article is a part of conference coverage from the American Academy of Ophthalmology 2020, being held virtually from November 13 to 15, 2020. The team at Ophthalmology Advisor will be reporting on the latest news and research conducted by leading experts in ophthalmology. Check back for more from the AAO 2020.
For its first all-virtual meeting, the American Academy of Ophthalmology (AAO) pulled off a star-studded event that featured appearances from author Malcolm Gladwell and performer Penn Jillette. But while celebrities brought some glitz to the conference, the main attractions for the Young Ophthalmologists Committee (YO) were the technologies that have allowed clinicians to sharpen their acumen, reach across the globe, and continue serving patients through a pandemic.
Presenters at the group’s Focus on Technology presentation discussed telemedicine, big data, the application of artificial intelligence, and even telesurgery.
Featured among the guest speakers, Julia Haller, MD, ophthalmologist-in-chief at the Wills Eye Hospital in Philadelphia, discussed how high-tech can even help to “equalize gender disparities” in medicine. She discussed how this tech-forward approach to medicine can offer a path to success with more flexible time demands than, for example, a traditional path as a high-volume surgeon.
“We can now even have a busy clinical career more flexibly as advances in telemedicine allow us to see patients remotely, and to build our clinical volume with more efficiency, broader reach and collaborative opportunities,” Dr. Haller explained. She also says remote and virtual mentoring opportunities also give women the opportunity to access a “key ingredient women have been last in line for. We can now Zoom into our virtual seat at the table.” She does warn, however, that research has shown some disparities continue and burnout may be exacerbated by these technologies.
Another presenter, Thomas Lee, MD, director of the vision center at the Children’s Hospital of Los Angeles, shared how technologies helped him guide retinopathy of prematurity surgeries in Armenia and elsewhere from his home in the United States, even when the time difference meant he was working at 1:00am to provide assistance. “We came up with a solution that not only allowed us to train their doctors with me supervising their doctors, but to crowdsource this with other doctors all over the world.”
Michael D. Abramoff, MD, a professor of Ophthalmology and Visual Sciences at the University of Iowa, spoke on a piece he coauthored for the American Journal of Ophthalmology earlier this year regarding the ethics of using autonomous, as opposed to assistive, artificial intelligence in ophthalmology. The team came up with requirements for the technology that included: showing that it improves patient outcomes, designing the technology so that it is intuitive how it works in comparison to human clinicians, validating it rigorously against clinical outcomes in the intended clinical workflow, and assuming liability.
The presentation also reviewed the Intelligent Research in Sight (IRIS) Registry, the first national eye disease registry, 6 years after its launch. Dr. Michael Chiang, MD, of the Casey Eye Institute at Oregon Health & Science University in Portland explained that, with data uploaded from the electronic health records of 430 million eye exams, it is now “the largest data set of its kind anywhere in the world.”
This “big data” has “enormous power,” Dr. Chiang described. It can characterize patient populations as well as analyze practice patterns, rare events, relationships, and trends. He explained that — although there are still challenges facing the registry, such as its vulnerability — it offers an opportunity for knowledge-discovery, and that knowledge can then be fed back into real-world care.