Marker-Free, Automated Eyelid Assessment in Thyroid Eye Disease Using Artificial Intelligence: A Multicenter Validation Study.

In the internal validation, the artificial intelligence system demonstrated high geometric precision (Intersection over Union 0.94).

In the external validation using smartphone images without markers, the system maintained high reliability.

For MRD1, it achieved a pearson correlation coefficient of 0.94 and a mean absolute percentage error of 9.06%.

Although MRD2 showed a slightly higher mean absolute percentage error (15.07%), likely due to manual measurement variability in clinical records, the correlation remained strong (pearson correlation coefficient 0.93).