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In Diabetes care ; h5-index 125.0

OBJECTIVE : Diabetic macular edema (DME) is the primary cause of vision loss among individuals with diabetes mellitus (DM). We developed, validated, and tested a deep learning (DL) system for classifying DME using images from three common commercially available optical coherence tomography (OCT) devices.

RESEARCH DESIGN AND METHODS : We trained and validated two versions of a multitask convolution neural network (CNN) to classify DME (center-involved DME [CI-DME], non-CI-DME, or absence of DME) using three-dimensional (3D) volume scans and 2D B-scans, respectively. For both 3D and 2D CNNs, we used the residual network (ResNet) as the backbone. For the 3D CNN, we used a 3D version of ResNet-34 with the last fully connected layer removed as the feature extraction module. A total of 73,746 OCT images were used for training and primary validation. External testing was performed using 26,981 images across seven independent data sets from Singapore, Hong Kong, the U.S., China, and Australia.

RESULTS : In classifying the presence or absence of DME, the DL system achieved area under the receiver operating characteristic curves (AUROCs) of 0.937 (95% CI 0.920-0.954), 0.958 (0.930-0.977), and 0.965 (0.948-0.977) for the primary data set obtained from CIRRUS, SPECTRALIS, and Triton OCTs, respectively, in addition to AUROCs >0.906 for the external data sets. For further classification of the CI-DME and non-CI-DME subgroups, the AUROCs were 0.968 (0.940-0.995), 0.951 (0.898-0.982), and 0.975 (0.947-0.991) for the primary data set and >0.894 for the external data sets.

CONCLUSIONS : We demonstrated excellent performance with a DL system for the automated classification of DME, highlighting its potential as a promising second-line screening tool for patients with DM, which may potentially create a more effective triaging mechanism to eye clinics.

Tang Fangyao, Wang Xi, Ran An-Ran, Chan Carmen K M, Ho Mary, Yip Wilson, Young Alvin L, Lok Jerry, Szeto Simon, Chan Jason, Yip Fanny, Wong Raymond, Tang Ziqi, Yang Dawei, Ng Danny S, Chen Li Jia, Brelén Marten, Chu Victor, Li Kenneth, Lai Tracy H T, Tan Gavin S, Ting Daniel S W, Huang Haifan, Chen Haoyu, Ma Jacey Hongjie, Tang Shibo, Leng Theodore, Kakavand Schahrouz, Mannil Suria S, Chang Robert T, Liew Gerald, Gopinath Bamini, Lai Timothy Y Y, Pang Chi Pui, Scanlon Peter H, Wong Tien Yin, Tham Clement C, Chen Hao, Heng Pheng-Ann, Cheung Carol Y