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Timely detection of retinal diseases is crucial for prevent- ing vision loss; yet the limited availability of ophthalmolo- gists and disparities in access to diagnostic services continue to hinder widespread screening, particularly in primary care settings. We present REMEDIS, a Software-as-a-Service (SaaS)–based clinical AI framework for the automated diag- nosis of major retinal diseases, including age-related macu- lar degeneration (AMD), diabetic retinopathy (DR), epireti- nal membrane (ERM), and glaucoma, using fundus images. The system analyzes high-resolution fundus photographs in a secure cloud environment via a Swin-Large–based multi- disease classification network, producing disease-specific probability scores. To ensure clinically meaningful decision- making, Youden’s Index is applied to determine optimized sensitivity–specificity thresholds for each condition. An ex- plainability module based on Grad-CAM generates lesion- localization contour visualizations, providing interpretable evidence that assists ophthalmologists in case review and fa- cilitates integration into electronic medical records (EMR). The framework was evaluated in an IRB-approved multi- center prospective clinical trial conducted under real-world conditions, achieving an average AUC exceeding 0.94 across the four target diseases and demonstrating strong concor- dance with expert diagnoses. To our knowledge, this repre- sents one of the first SaaS-based AI diagnostic frameworks for retinal diseases validated through prospective clinical studies, highlighting its potential as an emerging clinical ap- plication of AI.
