Publications by authors named "Zhi-Da Soh"

Background: Previously, based on retinal photographs, we developed a deep-learning algorithm to predict biological age (termed, RetiAGE) that was associated with future risks of morbidity and mortality. This study specifically aimed to evaluate the performance of RetiAGE in predicting future risks of chronic obstructive pulmonary disease (COPD).

Methods: RetiAGE scores were generated from retinal images in the UK Biobank and stratified into tertiles.

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Background: To evaluate the 6-year physiological rates-of-change in ganglion cell inner plexiform layer (GCIPL) and retinal nerve fibre layer (RNFL) thickness measured with optical coherence tomography.

Methods: We included 2202 out of 2661 subjects from the population-based Singapore Chinese Eye Study who returned for follow-up 6 years after baseline examination (follow-up rate 87.7%).

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Article Synopsis
  • The study aimed to establish normal measurements for anterior segment optical coherence tomography (ASOCT) to improve its clinical use in detecting primary angle closure disease (PACD).
  • It included 2157 eyes from the Singapore Chinese Eye Study, excluding those with previous eye surgeries, where a deep-learning algorithm assessed various anterior chamber measurements.
  • Findings showed that anterior chamber depth and width decreased with age and were smaller in females, while lens vault increased; specific percentile cut-offs were identified as effective indicators for detecting PACD.
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Purpose: Animal models suggest omega-3 polyunsaturated fatty acids (PUFAs) may protect against myopia by modulating choroidal blood perfusion, but clinical evidence is scarce and mixed. We aimed to determine the causality between omega-3 PUFAs and myopia using Mendelian randomization (MR) analysis.

Design: Two-sample MR analysis.

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Background: Artificial intelligence (AI) that utilizes deep learning (DL) has potential for systemic disease prediction using retinal imaging. The retina's unique features enable non-invasive visualization of the central nervous system and microvascular circulation, aiding early detection and personalized treatment plans for personalized care. This review explores the value of retinal assessment, AI-based retinal biomarkers, and the importance of longitudinal prediction models in personalized care.

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Purpose: To examine the 6-year incidence of visual impairment (VI) and identify risk factors associated with VI in a multiethnic Asian population.

Design: Prospective, population-based, cohort study.

Participants: Adults aged ≥ 40 years were recruited from the Singapore Epidemiology of Eye Diseases cohort study at baseline.

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Introduction: Our study aimed to examine the relationship between cardiovascular diseases (CVD) with peripapillary retinal fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) thickness profiles in a large multi-ethnic Asian population study.

Methods: 6,024 Asian subjects were analyzed in this study. All participants underwent standardized examinations, including spectral domain OCT imaging (Cirrus HD-OCT; Carl Zeiss Meditec).

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Primary angle closure glaucoma is a visually debilitating disease that is under-detected worldwide. Many of the challenges in managing primary angle closure disease (PACD) are related to the lack of convenient and precise tools for clinic-based disease assessment and monitoring. Artificial intelligence (AI)- assisted tools to detect and assess PACD have proliferated in recent years with encouraging results.

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Purpose: To evaluate the relationships between chronic kidney disease (CKD) with retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL) thickness profiles of eyes in Asian and White populations.

Design: Cross-sectional analysis.

Participants: A total of 5066 Asian participants (1367 Malays, 1772 Indians, and 1927 Chinese) from the Singapore Epidemiology of Eye Diseases Study (SEED) were included, consisting of 9594 eyes for peripapillary RNFL analysis and 8661 eyes for GCIPL analysis.

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Article Synopsis
  • - The study aimed to create and validate a deep learning algorithm to automate the annotation of the scleral spur and segmentation of anterior chamber structures in OCT scans, enhancing measurement accuracy for eye parameters.
  • - It utilized data from multiple studies on angle-closure disease and employed advanced imaging techniques and specialized neural networks to improve the precision of automated measurements compared to manual methods.
  • - Results showed high reliability, with the algorithm achieving a low error rate for scleral spur annotation and excellent similarity in structure segmentation, indicating that automated measurements were closely aligned with those made by human experts.
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Objective: To determine the incidence and risk factors for primary open-angle glaucoma (POAG) and ocular hypertension (OHT) in a multiethnic Asian population.

Design: Population-based cohort study.

Participants: The Singapore Epidemiology of Eye Diseases study included 10 033 participants in the baseline examination between 2004 and 2011.

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The advents of information technologies have led to the creation of ever-larger datasets. Also known as , these large datasets are characterized by its volume, variety, velocity, veracity, and value. More importantly, big data has the potential to expand traditional research capabilities, inform clinical practice based on real-world data, and improve the health system and service delivery.

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Article Synopsis
  • The study evaluated anxiety and depression levels in 195 participants, including 93 with Posner-Schlossman syndrome (PSS) and 102 healthy controls.
  • PSS patients exhibited higher rates of anxiety (23.7%) compared to controls (9.8%), while depression rates were similar between the two groups.
  • Mental well-being was identified as a significant risk factor for anxiety and depression in PSS patients, highlighting the importance of addressing mental health in clinical management.
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Anterior chamber depth (ACD) is a major risk factor of angle closure disease, and has been used in angle closure screening in various populations. However, ACD is measured from ocular biometer or anterior segment optical coherence tomography (AS-OCT), which are costly and may not be readily available in primary care and community settings. Thus, this proof-of-concept study aims to predict ACD from low-cost anterior segment photographs (ASPs) using deep-learning (DL).

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Purpose: To develop a deep learning (DL) algorithm for predicting anterior chamber depth (ACD) from smartphone-acquired anterior segment photographs.

Methods: For algorithm development, we included 4,157 eyes from 2,084 Chinese primary school students (aged 11-15 years) from Mojiang Myopia Progression Study (MMPS). All participants had with ACD measurement measured with Lenstar (LS 900) and anterior segment photographs acquired from a smartphone (iPhone Xs), which was mounted on slit lamp and under diffuses lighting.

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Aims: To identify blood metabolite markers associated with intraocular pressure (IOP) in a population-based cross-sectional study.

Methods: This study was conducted in a multiethnic Asian population (Chinese, n=2805; Indians, n=3045; Malays, n=3041 aged 40-80 years) in Singapore. All subjects underwent standardised systemic and ocular examinations, and biosamples were collected.

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Background: ageing is an important risk factor for a variety of human pathologies. Biological age (BA) may better capture ageing-related physiological changes compared with chronological age (CA).

Objective: we developed a deep learning (DL) algorithm to predict BA based on retinal photographs and evaluated the performance of our new ageing marker in the risk stratification of mortality and major morbidity in general populations.

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Article Synopsis
  • The study aimed to identify the risk factors and incidence of primary angle-closure disease (PACD) over six years within a diverse group of Asian adults aged 40 and older.
  • Conducted as part of the Singapore Epidemiology of Eye Diseases study, the research included examinations like slit-lamp biomicroscopy and intraocular pressure measurements on participants followed from 2004-2017, focusing on those at risk for PACG and PACD.
  • Findings revealed a six-year PACD incidence rate of 3.50%, with increased age, higher intraocular pressure, and shallower anterior chamber depth being significant risk factors for developing PACD, while late posterior subcapsular cataract showed a protective
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Purpose: Detection of early glaucoma remains limited with the conventional analysis of the retinal nerve fiber layer (RNFL). This study assessed whether compensating the RNFL thickness for multiple demographic and anatomic factors improves the detection of glaucoma.

Design: Cross-sectional study.

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Background: Deep learning algorithms have been built for the detection of systemic and eye diseases based on fundus photographs. The retina possesses features that can be affected by gender differences, and the extent to which these features are captured via photography differs depending on the retinal image field.

Objective: We aimed to compare deep learning algorithms' performance in predicting gender based on different fields of fundus photographs (optic disc-centered, macula-centered, and peripheral fields).

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Article Synopsis
  • The study assesses the effectiveness of deep learning (DL) algorithms in detecting pterygium—an eye condition—using color photographs taken with slit-lamp and handheld cameras.
  • Researchers analyzed a total of 2503 images from a major eye disease study, applied the algorithms, and validated their performance on internal and two external test image sets.
  • Results showed high accuracy in detecting pterygium, with sensitivity and specificity rates suggesting these DL algorithms could serve as a practical screening tool for identifying serious cases of pterygium in clinical settings.
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