[关键词]
[摘要]
玻璃体腔内注射抗血管内皮生长因子(VEGF)治疗已得到广泛应用,但其疗效的差异制约个体化治疗。人工智能(AI)通过大数据学习可有效预测疗效,其核心分支包括机器学习(mML)及深度学习(DL)。文章系统检索并分析了截至2025年4月的41篇相关研究。综合分析表明,AI预测模型正从预测单一终点(如视力或中心视网膜厚度)向整合多维指标(解剖、功能、治疗需求)及生成预测图像演进。技术路径上,深度学习模型(28篇,68.3%)因其强大的图像解析能力占据主导,机器学习模型(10篇,24.4%)在结构化临床数据分析中仍有价值。跨疾病比较显示,ARMD与DME的研究最为集中,模型构建思路有共通之处,但各自关注的解剖学及功能学指标存在差异。当前领域面临临床前瞻性验证不足、模型可解释性以及高质量多中心数据稀缺等挑战。未来需推进真实世界验证,并发展可解释AI,以加速其临床转化。
[Key word]
[Abstract]
Intravitreal anti-vascular endothelial growth factor(anti-VEGF)therapy has been widely used, but the variability in its therapeutic efficacy limits individualized treatment. In recent years, the application of artificial intelligence(AI)has opened up new avenues for personalized treatment response prediction, and its core branches include machine learning(ML)and deep learning(DL). This review systematically retrieved and analyzed 41 relevant studies published up to April 2025. Comprehensive analysis reveals that AI predictive models are evolving from forecasting single endpoints(such as visual acuity or central retinal thickness)to integrating multi-dimensional endpoints(encompassing anatomical, functional, and treatment demand parameters)and generating predictive imaging outputs. In terms of technical approaches, DL models(28 studies, accounting for 68.3%)dominate this field due to their robust image interpretation capabilities, while ML models(10 studies, 24.4%)retain significant value in the analysis of structured clinical data. Cross-disease comparisons indicate that research efforts are most concentrated on age-related macular degeneration(ARMD)and diabetic macular edema(DME), with shared conceptual frameworks for model construction, yet distinct anatomical and functional indicators are prioritized for each disease. Currently, the field confronts several key challenges, including insufficient prospective clinical validation, limited model interpretability(the “black box problem”), and a scarcity of high-quality multi-center datasets. Moving forward, it is imperative to advance real-world validation and develop explainable AI techniques to expedite the clinical translation of these predictive models.
[中图分类号]
[基金项目]
山东省自然科学基金面上项目(No.ZR2023MH139)