Background/Aims Diabetic retinopathy (DR) screening using artificial intelligence (AI) has evolved significantly over the past decade. This study aimed to analyze research trends, developments, and patterns in AI-based fundus image DR screening from 2014 to 2024 through bibliometric analysis.

Methods The study analyzed 1,172 publications from the Web of Science Core Collection database using CiteSpace and Microsoft Excel. The analysis included publication trends, citation patterns, institutional collaborations, and keyword emergence analysis.

Results Publications showed consistent growth from 2014-2022, with a peak in 2021. India (26%), China (20.05%), and USA (9.98%) dominated research output. IEEE ACCESS was the leading publication venue with 44 articles. Research evolved from traditional image processing to deep learning approaches, with recent emphasis on multimodal AI models. The analysis identified three distinct phases: CNN-based systems (2014-2020), Vision Transformers and innovative learning paradigms (2020-2022), and large foundation models (2022-2024).

Conclusion The field shows mature development in traditional AI approaches while transitioning toward multimodal learning technologies. Future directions indicate increased focus on telemedicine integration, innovative AI algorithms, and real-world implementation.

What is already known on this topic

AI-based DR screening has been developing since the 1960s, with significant acceleration after 2014 due to deep learning advances.

Traditional manual analysis of fundus images is time-consuming and error-prone.

What this study adds

Comprehensive mapping of research evolution in AI-based DR screening over the past decade.

Identification of research concentration in specific geographical areas and emerging trends in multimodal AI approaches.

How this study might affect research, practice or policy

Highlights the need for increased international collaboration and technology sharing.

Suggests focus areas for future research, including multimodal learning and real-world implementation.

Provides direction for healthcare organizations and researchers in adopting and developing AI-based DR screening technologies.

The authors have declared no competing interest.

This study did not receive any funding

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↵# Co-first authors

Synopsis/Precis: A comprehensive bibliometric analysis of AI in fundus image-based diabetic retinopathy screening (2014-2024) reveals significant growth in research output, with India, China, and USA leading publications, showing evolution from traditional methods to deep learning approaches.

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