Machine Learning Approaches in High Myopia: Systematic Review and Meta-Analysis

BackgroundIn recent years, with the rapid development of machine learning (ML), it has gained widespread attention from researchers in clinical practice. ML models appear to demonstrate promising accuracy in the diagnosis of complex diseases, as well as in predicting disease...

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Main Authors: Huiyi Zuo, Baoyu Huang, Jian He, Liying Fang, Minli Huang
Format: Article
Language:English
Published: JMIR Publications 2025-01-01
Series:Journal of Medical Internet Research
Online Access:https://www.jmir.org/2025/1/e57644
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author Huiyi Zuo
Baoyu Huang
Jian He
Liying Fang
Minli Huang
author_facet Huiyi Zuo
Baoyu Huang
Jian He
Liying Fang
Minli Huang
author_sort Huiyi Zuo
collection DOAJ
description BackgroundIn recent years, with the rapid development of machine learning (ML), it has gained widespread attention from researchers in clinical practice. ML models appear to demonstrate promising accuracy in the diagnosis of complex diseases, as well as in predicting disease progression and prognosis. Some studies have applied it to ophthalmology, primarily for the diagnosis of pathologic myopia and high myopia-associated glaucoma, as well as for predicting the progression of high myopia. ML-based detection still requires evidence-based validation to prove its accuracy and feasibility. ObjectiveThis study aims to discern the performance of ML methods in detecting high myopia and pathologic myopia in clinical practice, thereby providing evidence-based support for the future development and refinement of intelligent diagnostic or predictive tools. MethodsPubMed, Cochrane, Embase, and Web of Science were thoroughly retrieved up to September 3, 2023. The prediction model risk of bias assessment tool was leveraged to appraise the risk of bias in the eligible studies. The meta-analysis was implemented using a bivariate mixed-effects model. In the validation set, subgroup analyses were conducted based on the ML target events (diagnosis and prediction of high myopia and diagnosis of pathological myopia and high myopia-associated glaucoma) and modeling methods. ResultsThis study ultimately included 45 studies, of which 32 were used for quantitative meta-analysis. The meta-analysis results unveiled that for the diagnosis of pathologic myopia, the summary receiver operating characteristic (SROC), sensitivity, and specificity of ML were 0.97 (95% CI 0.95-0.98), 0.91 (95% CI 0.89-0.92), and 0.95 (95% CI 0.94-0.97), respectively. Specifically, deep learning (DL) showed an SROC of 0.97 (95% CI 0.95-0.98), sensitivity of 0.92 (95% CI 0.90-0.93), and specificity of 0.96 (95% CI 0.95-0.97), while conventional ML (non-DL) showed an SROC of 0.86 (95% CI 0.75-0.92), sensitivity of 0.77 (95% CI 0.69-0.84), and specificity of 0.85 (95% CI 0.75-0.92). For the diagnosis and prediction of high myopia, the SROC, sensitivity, and specificity of ML were 0.98 (95% CI 0.96-0.99), 0.94 (95% CI 0.90-0.96), and 0.94 (95% CI 0.88-0.97), respectively. For the diagnosis of high myopia-associated glaucoma, the SROC, sensitivity, and specificity of ML were 0.96 (95% CI 0.94-0.97), 0.92 (95% CI 0.85-0.96), and 0.88 (95% CI 0.67-0.96), respectively. ConclusionsML demonstrated highly promising accuracy in diagnosing high myopia and pathologic myopia. Moreover, based on the limited evidence available, we also found that ML appeared to have favorable accuracy in predicting the risk of developing high myopia in the future. DL can be used as a potential method for intelligent image processing and intelligent recognition, and intelligent examination tools can be developed in subsequent research to provide help for areas where medical resources are scarce. Trial RegistrationPROSPERO CRD42023470820; https://tinyurl.com/2xexp738
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spelling doaj-art-3f0f1287a9ff43a3bed2abef65e1145a2025-01-03T21:45:30ZengJMIR PublicationsJournal of Medical Internet Research1438-88712025-01-0127e5764410.2196/57644Machine Learning Approaches in High Myopia: Systematic Review and Meta-AnalysisHuiyi Zuohttps://orcid.org/0000-0002-0447-2879Baoyu Huanghttps://orcid.org/0000-0003-3225-0138Jian Hehttps://orcid.org/0009-0003-3469-4573Liying Fanghttps://orcid.org/0000-0002-7244-7245Minli Huanghttps://orcid.org/0009-0003-9028-6857 BackgroundIn recent years, with the rapid development of machine learning (ML), it has gained widespread attention from researchers in clinical practice. ML models appear to demonstrate promising accuracy in the diagnosis of complex diseases, as well as in predicting disease progression and prognosis. Some studies have applied it to ophthalmology, primarily for the diagnosis of pathologic myopia and high myopia-associated glaucoma, as well as for predicting the progression of high myopia. ML-based detection still requires evidence-based validation to prove its accuracy and feasibility. ObjectiveThis study aims to discern the performance of ML methods in detecting high myopia and pathologic myopia in clinical practice, thereby providing evidence-based support for the future development and refinement of intelligent diagnostic or predictive tools. MethodsPubMed, Cochrane, Embase, and Web of Science were thoroughly retrieved up to September 3, 2023. The prediction model risk of bias assessment tool was leveraged to appraise the risk of bias in the eligible studies. The meta-analysis was implemented using a bivariate mixed-effects model. In the validation set, subgroup analyses were conducted based on the ML target events (diagnosis and prediction of high myopia and diagnosis of pathological myopia and high myopia-associated glaucoma) and modeling methods. ResultsThis study ultimately included 45 studies, of which 32 were used for quantitative meta-analysis. The meta-analysis results unveiled that for the diagnosis of pathologic myopia, the summary receiver operating characteristic (SROC), sensitivity, and specificity of ML were 0.97 (95% CI 0.95-0.98), 0.91 (95% CI 0.89-0.92), and 0.95 (95% CI 0.94-0.97), respectively. Specifically, deep learning (DL) showed an SROC of 0.97 (95% CI 0.95-0.98), sensitivity of 0.92 (95% CI 0.90-0.93), and specificity of 0.96 (95% CI 0.95-0.97), while conventional ML (non-DL) showed an SROC of 0.86 (95% CI 0.75-0.92), sensitivity of 0.77 (95% CI 0.69-0.84), and specificity of 0.85 (95% CI 0.75-0.92). For the diagnosis and prediction of high myopia, the SROC, sensitivity, and specificity of ML were 0.98 (95% CI 0.96-0.99), 0.94 (95% CI 0.90-0.96), and 0.94 (95% CI 0.88-0.97), respectively. For the diagnosis of high myopia-associated glaucoma, the SROC, sensitivity, and specificity of ML were 0.96 (95% CI 0.94-0.97), 0.92 (95% CI 0.85-0.96), and 0.88 (95% CI 0.67-0.96), respectively. ConclusionsML demonstrated highly promising accuracy in diagnosing high myopia and pathologic myopia. Moreover, based on the limited evidence available, we also found that ML appeared to have favorable accuracy in predicting the risk of developing high myopia in the future. DL can be used as a potential method for intelligent image processing and intelligent recognition, and intelligent examination tools can be developed in subsequent research to provide help for areas where medical resources are scarce. Trial RegistrationPROSPERO CRD42023470820; https://tinyurl.com/2xexp738https://www.jmir.org/2025/1/e57644
spellingShingle Huiyi Zuo
Baoyu Huang
Jian He
Liying Fang
Minli Huang
Machine Learning Approaches in High Myopia: Systematic Review and Meta-Analysis
Journal of Medical Internet Research
title Machine Learning Approaches in High Myopia: Systematic Review and Meta-Analysis
title_full Machine Learning Approaches in High Myopia: Systematic Review and Meta-Analysis
title_fullStr Machine Learning Approaches in High Myopia: Systematic Review and Meta-Analysis
title_full_unstemmed Machine Learning Approaches in High Myopia: Systematic Review and Meta-Analysis
title_short Machine Learning Approaches in High Myopia: Systematic Review and Meta-Analysis
title_sort machine learning approaches in high myopia systematic review and meta analysis
url https://www.jmir.org/2025/1/e57644
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AT jianhe machinelearningapproachesinhighmyopiasystematicreviewandmetaanalysis
AT liyingfang machinelearningapproachesinhighmyopiasystematicreviewandmetaanalysis
AT minlihuang machinelearningapproachesinhighmyopiasystematicreviewandmetaanalysis