Diagnostic accuracy of a deep learning model for pterygium detection in Barcelos, Brazilian Amazon

This pilot study evaluated the diagnostic accuracy of a deep learning model for detecting pterygium in anterior segment photographs taken using smartphones in the Brazilian Amazon. The model's performance was benchmarked against assessments made by experienced ophthalmologists, considered the clinical gold standard.

In this cross-sectional study, 38 participants (76 eyes) from Barcelos, Brazil, were enrolled. Trained nonmedical health workers captured high-resolution anterior segment images using smartphones. These images were analyzed using a deep learning model based on the MobileNet-V2 convolutional neural network. Diagnostic metrics-including sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve-were calculated and compared with the ophthalmologists' evaluations.

The deep learning model achieved a sensitivity of 91.43%, specificity of 90.24%, positive predictive value of 88.46%, negative predictive value of 92.79%, and an area under the curve of 0.91. Logistic regression revealed no statistically significant association between pterygium and demographic variables such as age or gender.

The deep learning model demonstrated high diagnostic performance in identifying pterygium in a remote Amazonian population. These preliminary findings support the potential use of artificial intelligence-based tools to facilitate early detection and screening in underserved regions, thereby enhancing access to ophthalmic care.