{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T16:09:55Z","timestamp":1787587795301,"version":"build-2736575974"},"reference-count":22,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T00:00:00Z","timestamp":1754524800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Government of Salzburg","award":["9\/1-60,712\/1-1996"],"award-info":[{"award-number":["9\/1-60,712\/1-1996"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background: In glaucoma screening programs, a large proportion of patients remain free of open-angle glaucoma (OAG) or have no need of intraocular eye pressure (IOP)-lowering therapy within 10 years of follow-up. Is it possible to identify a large proportion of patients already at the initial examination and, thus, to safely exclude them already at this point? Methods: A total of 6889 subjects received a complete ophthalmological examination, including objective optic nerve head and quantitative disc measurements at the initial examination, and after an average follow-up period of 11.1 years, complete data were available of 585 individuals. Two neural network models were trained and extensively tested. To allow the models to refuse to make a prediction in doubtful cases, a reject option was included. Results: A prediction for the first endpoint, \u2018remaining OAG-free and no IOP-lowering therapy within 10 years\u2019, was rejected in 57% of cases, and in the remaining cases (43%), 253\/253 (=100%) received a correct prediction. The second prediction model for the second endpoint \u2018remaining OAG-free within 10 years\u2019 refused to make a prediction for 46.4% of all subjects. In the remaining cases (53.6%), 271\/271 (=100%) were correctly predicted. Conclusions: Most importantly, no eye was predicted false-negatively or false-positively. Overall, 43% all eyes can safely be excluded from a glaucoma screening program for up to 10 years to be certain that the eye remains OAG-free and will not need IOP-lowering therapy. The corresponding model significantly reduces the screening performed by and work load of ophthalmologists. In the future, better predictors and models may increase the number of patients with a safe prediction, further economizing time and healthcare budgets in glaucoma screening.<\/jats:p>","DOI":"10.3390\/jpm15080361","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T08:09:35Z","timestamp":1754640575000},"page":"361","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Two Machine Learning Models to Economize Glaucoma Screening Programs: An Approach Based on Neural Nets"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7696-1479","authenticated-orcid":false,"given":"Wolfgang","family":"Hitzl","sequence":"first","affiliation":[{"name":"Department of Ophthalmology and Optometry, Paracelsus Medical University, University Hospital Salzburg, Muellner Hauptstrasse 48, 5020 Salzburg, Austria"},{"name":"Research Program Experimental Ophthalmology and Glaucoma Research, Paracelsus Medical University, Muellner Hauptstrasse 48, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Lenzhofer","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Optometry, Paracelsus Medical University, University Hospital Salzburg, Muellner Hauptstrasse 48, 5020 Salzburg, Austria"},{"name":"Research Program Experimental Ophthalmology and Glaucoma Research, Paracelsus Medical University, Muellner Hauptstrasse 48, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melchior","family":"Hohensinn","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Optometry, Paracelsus Medical University, University Hospital Salzburg, Muellner Hauptstrasse 48, 5020 Salzburg, Austria"},{"name":"Research Program Experimental Ophthalmology and Glaucoma Research, Paracelsus Medical University, Muellner Hauptstrasse 48, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herbert Anton","family":"Reitsamer","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Optometry, Paracelsus Medical University, University Hospital Salzburg, Muellner Hauptstrasse 48, 5020 Salzburg, Austria"},{"name":"Research Program Experimental Ophthalmology and Glaucoma Research, Paracelsus Medical University, Muellner Hauptstrasse 48, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Vision Loss Expert Group of the Global Burden of Disease Study, and GBD 2019 Blindness and Vision Impairment Collaborators (2025). 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