Analysis of the performance of the CorneAI for iOS in the classification of corneal diseases and cataracts based on journal photographs

CorneAI for iOS is an artificial intelligence (AI) application to classify the condition of the cornea and cataract into nine categories: normal, infectious keratitis, non-infection keratitis, scar, tumor, deposit, acute primary angle closure, lens opacity, and bullous keratopathy. We evaluated its performance to classify multiple conditions of the cornea and cataract of various races in images published in the Cornea journal. The positive predictive value (PPV) of the top classification with the highest predictive score was 0.75, and the PPV for the top three classifications exceeded 0.80. For individual diseases, the highest PPVs were 0.91, 0.73, 0.42, 0.72, 0.77, and 0.55 for infectious keratitis, normal, non-infection keratitis, scar, tumor, and deposit, respectively. CorneAI for iOS achieved an area under the receiver operating characteristic curve of 0.78 (95% confidence interval [CI] 0.5–1.0) for normal, 0.76 (95% CI 0.67–0.85) for infectious keratitis, 0.81 (95% CI 0.64–0.97) for non-infection keratitis, 0.55 (95% CI 0.41–0.69) for scar, 0.62 (95% CI 0.27–0.97) for tumor, and 0.71 (95% CI 0.53–0.89) for deposit. CorneAI performed well in classifying various conditions of the cornea and cataract when used to diagnose journal images, including those with variable imaging conditions, ethnicities, and rare cases.