{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T10:05:22Z","timestamp":1790244322402,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"53","license":[{"start":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T00:00:00Z","timestamp":1782518400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T00:00:00Z","timestamp":1782518400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["advanced.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Advanced Science"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Age\u2010related macular degeneration (AMD) is an ordered, bilateral, and longitudinal disease, yet many artificial intelligence systems treat it as static binary image classification. We developed ORBIT\u2010AMD, a multimodal trajectory\u2010learning framework integrating color fundus photography and optical coherence tomography, bilateral eye\u2010graph attention, concept bottlenecks, ordinal staging, cause\u2010specific discrete\u2010time survival prediction, and protocol alignment. In a UK Biobank development\/internal\u2010testing cohort of 58\u00a0214 participants and 109\u00a0691 eyes, and an external Tianjin Medical University Eye Hospital cohort of 1996 participants and 3780 eyes, ORBIT\u2010AMD achieved AUROC values of 0.984 internally and 0.975 externally for prevalent late\u2010AMD detection. Five\u2010year late\u2010AMD progression prediction achieved AUROC values of 0.825 and 0.767, respectively. Calibration and threshold analyses showed cohort\u2010dependent workload and absolute\u2010risk behavior, supporting site\u2010specific calibration assessment and clinical\u2010workflow evaluation before deployment. The concept bottleneck provided auditable lesion\u2010level explanations, but these outputs should be interpreted as structured predictive explanations rather than causal evidence. ORBIT\u2010AMD provides a trajectory\u2010aware framework for AMD risk stratification and review prioritization, with prospective validation required before clinical implementation.<\/jats:p>","DOI":"10.1002\/advs.76361","type":"journal-article","created":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T11:44:21Z","timestamp":1782560661000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["ORBIT\u2010AMD: Ordinal Risk, Bilateral Imaging, and Trajectory Learning for Age\u2010Related Macular Degeneration in Multi\u2010Cohorts"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6460-2783","authenticated-orcid":false,"given":"Xuehao","family":"Cui","sequence":"first","affiliation":[{"name":"Eye Institute and School of Optometry Tianjin Medical University Eye Hospital  Tianjin China"},{"name":"Tianjin Key Laboratory of Retinal Functions and Diseases  Tianjin China"},{"name":"John Van 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