Keratitis is the main cause of corneal blindness worldwide. Most vision loss caused by keratitis can be avoidable via early detection and treatment. The diagnosis of keratitis often requires skilled ophthalmologists. However, the world is short of ophthalmologists, especially in resource-limited settings, making the early diagnosis of keratitis challenging. Here, we develop a deep learning system for the automated classification of keratitis, other cornea abnormalities, and normal cornea based on 6,567 slit-lamp images. Our system exhibits remarkable performance in cornea images captured by the different types of digital slit lamp cameras and a smartphone with the super macro mode (all AUCs>0.96). The comparable sensitivity and specificity in keratitis detection are observed between the system and experienced cornea specialists. Our system has the potential to be applied to both digital slit lamp cameras and smartphones to promote the early diagnosis and treatment of keratitis, preventing the corneal blindness caused by keratitis.

Currently, myopic retinopathy is the most common irreversible blinding disease but its pathophysiology is not completely clear. A cross-sectional, observational study was conducted in a single center to analyze aqueous samples from highly myopic eyes (axial length >25 mm, n = 92) and ametropic or mild myopic eyes (n = 88) for inflammatory cytokines. Vascular endothelial growth factor (VEGF), Interleukin 6 (IL-6), and matrix metalloproteinase-2 (MMP-2) were measured using an enzyme-linked immunosorbent assay. IL-6 and MMP-2 were significantly higher in the highly myopic eyes than in the non-high myopic eyes (IL-6: 11.90 vs. 4.38 pg/mL, p < 0.0001; MMP-2: 13.10 vs. 8.82 ng/mL, p = 0.0003) while adjusting for age, gender, and intraocular pressure. There was a significant positive association between levels of IL-6 and MMP-2 in aqueous humor and the axial lengths of the eye globes (IL-6, β = 0.065, p < 0.0001, n = 134; MMP-2, β = 0.097, p < 0.0001, n = 131). Conversely, VEGF in aqueous humor was significantly lower in the highly myopic eyes than in the non-high myopic eyes (45.56 vs. 96.90 pg/mL, p < 0.0001, n = 153) while age, gender, and intraocular pressure were adjusted. The results suggest that low-grade intraocular inflammation may play an important role in the development and progression of high myopia and myopic retinopathy.

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