Matters arising: Utilizing foundation models for developing clinical tools.

Zhang et al. developed a RETFound-enhanced deep learning model to detect multiple eye diseases and tested it in a community-based screening setting. Nevertheless, we believe that more information could be provided to support the claim that the proposed model has better generalizability compared to conventional convolutional neural networks adopted by two commercial models. Thus, we raised four points regarding more details of other models, generalizability, the fine-tuning dataset, and statistical analysis.