Duoru Lin

• Ph.D.
• Sun Yat-sen University

Retinal oximetry, which refers to the measurement of the oxygen saturation of haemoglobin in retinal blood, has emerged as a promising tool for understanding ocular and systemic diseases over the past few decades. Advances in traditional dual-wavelength measurement techniques, as well as their integration with more advanced technologies, have drive...

Preeclampsia (PE), a severe hypertensive disorder during pregnancy, significantly contributes to maternal and neonatal mortality. Existing prediction biomarkers are often invasive and expensive, hindering their widespread application. This study introduces PROMPT (Preeclampsia Risk factor + Ophthalmic data + Mean arterial pressure Prediction Test),...

Importance Although augmenting large language models (LLMs) with knowledge bases may improve medical domain–specific performance, practical methods are needed for local implementation of LLMs that address privacy concerns and enhance accessibility for health care professionals. Objective To develop an accurate, cost-effective local implementation...

Aim To investigate the association of floor area ratio (FAR), an indicator of built environments, and myopia onset. Methods This prospective cohort study recruited 136 753 children aged 6–10 years from 108 schools in Shenzhen, China at baseline (2016–2017). Refractive power was measured with non-cycloplegic autorefraction over a 2-year follow-up p...

Fundus fluorescein angiography (FFA) examinations are widely used in the evaluation of fundus disease conditions to facilitate further treatment suggestions. Here, we present a protocol for performing deep learning-based FFA image analytics with classification and segmentation tasks. We describe steps for data preparation, model implementation, sta...

Background/aims The aim of this study was to develop and evaluate digital ray, based on preoperative and postoperative image pairs using style transfer generative adversarial networks (GANs), to enhance cataractous fundus images for improved retinopathy detection. Methods For eligible cataract patients, preoperative and postoperative colour fundus...

Background This study aimed to explore the postoperative myopic shift and its relationship to visual acuity rehabilitation in patients with bilateral congenital cataracts (CCs). Methods Bilateral CC patients who underwent cataract extraction and primary intraocular lens implantations before 6 years old were included and divided into five groups ac...

Utilization of digital technologies for cataract screening in primary care is a potential solution for addressing the dilemma between the growing aging population and unequally distributed resources. Here, we propose a digital technology-driven hierarchical screening (DH screening) pattern implemented in China to promote the equity and accessibilit...

AIM: To establish a classification for congenital cataracts that can facilitate individualized treatment and help identify individuals with a high likelihood of different visual outcomes. METHODS: Consecutive patients diagnosed with congenital cataracts and undergoing surgery between January 2005 and November 2021 were recruited. Data on visual out...

Purpose To characterize the morphology of persistent pupillary membranes (PPMs) in pediatric patients and explore the corresponding surgical approaches. Setting Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. Design A prospective observational study. Methods Consecutive pediatric patients with PPMs who underwent surgery fr...

Background Emerging three-dimensional digital visualization technology (DVT) provides more advantages than traditional microscopy in microsurgery; however, its impact on microsurgeons’ visual and nervous systems and delicate microsurgery is still unclear, which hinders the wider implementation of DVT in digital visualization for microsurgery. Meth...

Age is closely related to human health and disease risks. However, chronologically defined age often disagrees with biological age, primarily due to genetic and environmental variables. Identifying effective indicators for biological age in clinical practice and self-monitoring is important but currently lacking. The human lens accumulates age-rela...

Importance Retinal diseases are the leading cause of irreversible blindness worldwide, and timely detection contributes to prevention of permanent vision loss, especially for patients in rural areas with limited medical resources. Deep learning systems (DLSs) based on fundus images with a 45° field of view have been extensively applied in populatio...

Image quality variation is a prominent cause of performance degradation for intelligent disease diagnostic models in clinical applications. Image quality issues are particularly prominent in infantile fundus photography due to poor patient cooperation, which poses a high risk of misdiagnosis. Here, we developed a deep learning-based image quality a...

Data quality issues have been acknowledged as one of the greatest obstacles in medical artificial intelligence research. Here, we present DeepFundus, which employs deep learning techniques to perform multidimensional classification of fundus image quality and provide real-time guidance for on-site image acquisition. We describe steps for data prepa...

Ischemic retinal diseases (IRDs) are a series of common blinding diseases that depend on accurate fundus fluorescein angiography (FFA) image interpretation for diagnosis and treatment. An artificial intelligence system (Ai-Doctor) was developed to interpret FFA images. Ai-Doctor performed well in image phase identification (area under the curve [AU...

Deep learning (DL) is the new high-profile technology in medical artificial intelligence (AI) for building screening and diagnosing algorithms for various diseases. The eye provides a window for observing neurovascular pathophysiological changes. Previous studies have proposed that ocular manifestations indicate systemic conditions, revealing a new...

Aims To report the incidence and associated risk factors for developing suspected and definitive glaucoma after bilateral congenital cataract (CC) removal with a 5-year follow-up. Methods Secondary analysis of a prospective longitudinal cohort study. Bilateral CC patients who had undergone cataract surgery between January 2011 and December 2014 at...

Medical artificial intelligence (AI) has been moving from the research phase to clinical implementation. However, most AI-based models are mainly built using high-quality images preprocessed in the laboratory, which is not representative of real-world settings. This dataset bias proves a major driver of AI system dysfunction. Inspired by the design...

Early detection of visual impairment is crucial but is frequently missed in young children, who are capable of only limited cooperation with standard vision tests. Although certain features of visually impaired children, such as facial appearance and ocular movements, can assist ophthalmic practice, applying these features to real-world screening r...

Background: We aimed to evaluate the morphological characteristics of the subfoveal choroid and explore the possible association of these characteristics with best-corrected visual acuity (BCVA) in postoperative patients with unilateral congenital cataracts (CCs). Methods: This was a cross-sectional study. Subfoveal choroidal structures were mea...

Aim: To investigate the ocular development of patients who had unilateral congenital cataract (CC) combined with persistent fetal vasculature (PFV). Methods: This cross-sectional, observational study included patients who had unilateral CC and PFV and those with isolated unilateral CC. Axial length (AL), keratometry, anterior chamber depth (ACD)...

Purpose: To investigate the incidence and characteristics of retinopathy of prematurity (ROP) premature infants with late gestational age (GA) and large birth weight (BW) and show a 7-year trend of ROP incidence in South China. Methods: This retrospective, cross-sectional study included premature infants who received ROP screening in a 7-year pe...

Medical artificial intelligence (AI) and big data technology have rapidly advanced in recent years, and they are now routinely used for image-based diagnosis. China has a massive amount of medical data. However, a uniform criteria for medical data quality have yet to be established. Therefore, this review aimed to develop a standardized and detaile...

Purpose: To broaden the mutation and phenotype spectrum of the GJA8 and CHMP4B genes and to reveal genotype-phenotype correlations in a cohort of Chinese patients with congenital cataracts (CCs). Methods: Six Chinese Han families with CCs inherited in an autosomal dominant (AD) pattern were recruited for this study. All patients underwent full ocul...

Reliable validated methods are necessary to verify the performance of diagnosis and therapy-assisted models in clinical practice. However, some validated results have research bias and may not reflect the results of real-world application. In addition, the conduct of clinical trials has executive risks for the indeterminate effectiveness of models...

Retinal exudates and/or drusen (RED) can be signs of many fundus diseases that can lead to irreversible vision loss. Early detection and treatment of these diseases are critical for improving vision prognosis. However, manual RED screening on a large scale is time-consuming and labour-intensive. Here, we aim to develop and assess a deep learning sy...

Background Medical artificial intelligence (AI) has entered the clinical implementation phase, although real-world performance of deep-learning systems (DLSs) for screening fundus disease remains unsatisfactory. Our study aimed to train a clinically applicable DLS for fundus diseases using data derived from the real world, and externally test the m...

Purpose: To study the morphology of the posterior lens cortex and posterior capsules (PCs) in pediatric patients with posterior lens opacities using intraoperative optical coherence tomography (iOCT). Setting: Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. Design: A prospective observational study. Methods: Pediatric...

Visual neuroadaptation is believed to play an important role in determining the final visual outcomes following intraocular lens (IOL) implantation. To investigate visual neuroadaptation in patients with age-related cataracts (ARCs) after phacoemulsification with multifocal and monofocal IOL implantation, we conducted a prospective, controlled clin...

Infantile cataract is the main cause of infant blindness worldwide. Although previous studies developed artificial intelligence (AI) diagnostic systems for detecting infantile cataracts in a single center, its generalizability is not ideal because of the complicated noises and heterogeneity of multicenter slit-lamp images, which impedes the applica...

Background Ocular changes are traditionally associated with only a few hepatobiliary diseases. These changes are non-specific and have a low detection rate, limiting their potential use as clinically independent diagnostic features. Therefore, we aimed to engineer deep learning models to establish associations between ocular features and major hepa...

Background: Human immunodeficiency virus (HIV) infection has become a chronic disease and attracted public attention globally. Population migration was considered hindering the control and management of HIV infection, but limited studies have explored how population mobility could influence the development of HIV-related complications and overall...

Background Cryptophthalmos is characterized by congenital ocular dysplasia with eyelid malformation. The pathogenicity of mutations in genes encoding components of the FRAS1/FREM protein complex is well established, but the underlying pathomechanisms of this disease are still unclear. In the previous study, we generated mice carrying Frem2R725X/R21...

Background The high prevalence of ocular manifestations (OMs) in patients with human immunodeficiency virus (HIV) infection and chronic diseases such as diabetes has become a global health issue. However, there is still a lack of an appropriate ophthalmic diagnostic procedure for the early detection of OMs in this population, leading to the risk of...

A challenge of chronic diseases that remains to be solved is how to liberate patients and medical resources from the burdens of long-term monitoring and periodic visits. Precise management based on artificial intelligence (AI) holds great promise; however, a clinical application that fully integrates prediction and telehealth computing has not been...

Background: Although influencing the severity of postoperative intraocular inflammation of congenital cataract, the developmental characteristics of cytokine profile in the aqueous humor during childhood had not been described. And its relationship with the inflammatory response after intraocular surgery remained unsolved. Methods: Preoperative...

Cerebrovascular disease (CeVD) is one of the leading global causes of death and severe disability. To date, retinal microangiopathy has become a reflection of cerebral microangiopathy, mirroring the vascular pathological modifications in vivo. To evaluate the retinal structure and microvasculature in patients with CeVD, we conducted a cross-section...

Artificial intelligence (AI) based on deep learning has shown excellent diagnostic performance in detecting various diseases with good-quality clinical images. Recently, AI diagnostic systems developed from ultra-widefield fundus (UWF) images have become popular standard-of-care tools in screening for ocular fundus diseases. However, in real-world...

Background/aims: To develop a deep learning system for automated glaucomatous optic neuropathy (GON) detection using ultra-widefield fundus (UWF) images. Methods: We trained, validated and externally evaluated a deep learning system for GON detection based on 22 972 UWF images from 10 590 subjects that were collected at 4 different institutions...

Background About 30% of cell lines have been cellular cross-contaminated and misidentification, which can result in invalidated experimental results and unusable therapeutic products. Cell morphology under the microscope was observed routinely, and further DNA sequencing analysis was performed periodically to verify cell line identity, but the sequ...

Background: Myopia is the leading cause of visual impairment and affects millions of children worldwide. Timely and annual manual optometric screenings of the entire at-risk population improve outcomes, but screening is challenging due to the lack of availability and training of assessors and the economic burden imposed by the screenings. Recently...

Background: To investigate the attitude and formal suggestions on talent cultivation in the field of medical artificial intelligence (AI). Methods: An electronic questionnaire was sent to both medical-related field or non-medical field population using the WenJuanXing web-application via social media. The questionnaire was designed to collect: (...

Brain-computer interfaces (BCIs) have shown great prospects as real-time bidirectional links between living brains and actuators. Artificial intelligence (AI), which can advance the analysis and decoding of neural activity, has turbocharged the field of BCIs. Over the past decade, a wide range of BCI applications with AI assistance have emerged. Th...

Aims To compare macular structure and vasculature between neuromyelitis optica spectrum disorder (NMOSD) and primary open angle glaucoma (POAG) using optical coherence tomography angiography. Methods NMOSD patients (n=124) with/without a history of optic neuritis (ON) (NMO+ON: 113 eyes; NMO-ON: 95 eyes), glaucomatous patients (n=102) with early/ad...

Background Color vision is the ability to detect, distinguish, and analyze the wavelength distributions of light independent of the total intensity. It mediates the interaction between an organism and its environment from multiple important aspects. However, the physicochemical basis of color coding has not been explored completely, and how color p...

Purpose: To develop and evaluate a deep learning (DL) system for retinal hemorrhage (RH) screening using ultra-widefield fundus (UWF) images. Methods: A total of 16,827 UWF images from 11,339 individuals were used to develop the DL system. Three experienced retina specialists were recruited to grade UWF images independently. Three independent data...

Retinal detachment can lead to severe visual loss if not treated timely. The early diagnosis of retinal detachment can improve the rate of successful reattachment and the visual results, especially before macular involvement. Manual retinal detachment screening is time-consuming and labour-intensive, which is difficult for large-scale clinical appl...

Abstract Background Approximately 1 in 33 newborns is affected by congenital anomalies worldwide. We aimed to develop a practical model for identifying infants with a high risk of congenital cataracts (CCs), which is the leading cause of avoidable childhood blindness. Methods This case-control study was performed in the Zhongshan Ophthalmic Center...

The general public’s attitudes, demands, and expectations regarding medical AI could provide guidance for the future development of medical AI to satisfy the increasing needs of doctors and patients. The objective of this study is to investigate public perceptions, receptivity, and demands regarding the implementation of medical AI. An online quest...

Background: Lattice degeneration and/or retinal breaks, defined as notable peripheral retinal lesions (NPRLs), are prone to evolving into rhegmatogenous retinal detachment which can cause severe visual loss. However, screening NPRLs is time-consuming and labor-intensive. Therefore, we aimed to develop and evaluate a deep learning (DL) system for au...

Background Ocular manifestation, which occurs in 82·6% patients with HIV/AIDS, affects quality of life and has become a serious global public health problem. However, little attention has been paid to this issue because of its uncertain relationship with survival outcome. We aimed to demonstrate the potential relationship between ocular manifestati...

Background Common diseases are not satisfactorily managed under the current health-care system because of inadequate medical resources and limited accessibility. We aimed to establish and validate a universal artificial intelligence (AI) platform for collaborative management of cataracts involving multilevel clinical scenarios, and explored an AI-b...

Purpose To establish and validate a universal artificial intelligence (AI) platform for collaborative management of cataracts involving multilevel clinical scenarios and explored an AI-based medical referral pattern to improve collaborative efficiency and resource coverage. Methods The training and validation datasets were derived from the Chinese...

BACKGROUND In vitro human cell line models have been widely used for biomedical research to predict clinical response, identify novel mechanisms and drug response. However, one-fifth to one-third of cell lines have been cross-contaminated, which can seriously result in invalidated experimental results, unusable therapeutic products and waste of res...

Background CC-Cruiser is an artificial intelligence (AI) platform developed for diagnosing childhood cataracts and providing risk stratification and treatment recommendations. The high accuracy of CC-Cruiser was previously validated using specific datasets. The objective of this study was to compare the diagnostic efficacy and treatment decision-ma...

Cryptophthalmos is a rare congenital disorder characterized by ocular dysplasia with eyelid malformation. Complete cryptophthalmos is characterized by the presence of continuous skin from the forehead over the eyes and onto the cheek, along with complete fusion of the eyelids. In the present study, we characterized the clinical manifestations of th...

Background The ideal surgical timings for cataract extraction (CE) and intraocular lens (IOL) implantation are vital for vision reconstruction in patients with childhood cataract (CC), yet they still remain controversial. We aimed to analyze the real-world practical pattern of surgical timings of CE and IOL implantations among a large number of Chi...

Tacrolimus has been widely applied to prevent organ rejection after transplantation. However, the conventional pharmaceutical formulation of tacrolimus limits its applications in ocular therapy due to its hydrophobicity and low corneal penetrability. We optimized tacrolimus-loaded methoxy poly (ethylene glycol-block-poly (d, l)-lactic-co-glycolic a...

Purpose: We assess the prevalence of spectacle wear and the factors associated with compliance among aphakic infants with congenital cataracts who underwent lens extraction in South China. Methods: Infants aged 3 months to 3 years were enrolled from among participants in the Childhood Cataract Program of the Chinese Ministry of Health (CCPMOH)....

Purpose We investigate visual function impairment and ocular structure in patients with unilateral posterior lens opacity, a type of congenital cataract (CC) in our novel CC category system. Methods We studied patients aged 3 to 15 years who were diagnosed with unilateral posterior CC. Best corrected visual acuity (BCVA) and visual evoked potentia...

Aim To investigate the characteristics of young adult cataract (YAC) patients over a 10-year period. Methods This observational study included YAC patients aged 18–49 years who were treated surgically for the first time at the Zhongshan Ophthalmic Center in China. YAC patients were analysed and compared with patients with childhood cataract (CC) i...

Purpose: To measure the aqueous humor concentrations of inflammatory factors in patients with congenital cataract and to investigate the relationship between the levels and postoperative inflammatory responses. Methods: Aqueous humor samples were prospectively collected from 65 eyes of children with congenital cataracts from January to June 2015...