Introduction and Context
Age-related macular degeneration (AMD) is the leading cause of irreversible central vision loss in older adults in high-income countries and a rapidly growing public‑health challenge globally. Early identification of AMD—especially the sight-threatening neovascular (wet) form and geographic atrophy (GA)—enables timely referral and management that can preserve vision. Artificial intelligence (AI) screening models applied to retinal images have shown promise for detecting undiagnosed eye disease at scale in non-specialist settings (primary care, community screening, teleophthalmology). However, reliable algorithm development and comparison require a consistent, reproducible reference standard for labeling images used in training and validation.
In April 2026, a multi‑disciplinary panel of retina specialists, general ophthalmologists, imaging experts, and AI specialists published a modified Delphi consensus that defines a reference standard for labeling AMD in images intended for validation of screening algorithms (Domalpally et al., Ophthalmology 2026). The guidance aims to harmonize how images are annotated and interpreted for AI validation, not to replace clinical practice guidelines for patient management.
