This diagnostic study develops and prospectively validates a deep learning algorithm that uses ocular fundus images to recognize numerous retinal diseases in a clinical setting at 65 screening centers in 19 Chinese provinces.

Dear EditorUveal melanoma (UM) is the most frequent primary malignant intraocular tumor in adults with an estimated incidence of 4-5 per million per year in western countries [1]. About 50% of UM patients eventually develop metastasis. In a previous study, the prognosis of Chinese UM was mainly correlated with visual clinical features and gene sequencing results. Models designed to predict UM prognosis have been previously described [2], but these studies were based on Caucasians, not Chinese. Further, our previous study [3] determined that the clinical characteristics were different between Chinese and Caucasian UM patients. Therefore, in this study, we analyzed the clinical characteristics and survival status of 1553 patients diagnosed with UM over a period of 15 years in China, and also included factors that were not included in our previous study, such as the largest basal diameter, thickness, tumor size after updating the criteria, pigmentation, whether complicated with intraocular hemorrhage, ciliary body involvement, extraocular extension and TNM stage. We also constructed comprehensive prognostic models to predict the risk of metastasis within 2 years and death of UM after 2 years following treatment according to clinical characteristics using machine learning. The methods of this study are described in the Supplementary File.The clinical data of the UM patients are shown in Supplementary Table S1. The mean age of subjects was 47.2 ± 12.5 years (median, 48.0 years; range, 5-85 years), indicating that the onset age is much younger than Caucasians [4] for whom it usually occurs in the fifth to sixth decades. This demonstrates one of the racial variations of the disease. Nearly 70% of patients' visual acuity was worse than the 0.30 logarithm of the minimum angle of resolution (LogMAR). Intraocular pressure was within the normal range of 10-21 mmHg in 1279 (85.6%) patients, while it was lower than 10 mmHg in 148 (9.9%) patients and higher than 21 mmHg in 67 (4.5%) patients. The mean largest basal