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In Retina (Philadelphia, Pa.)

PURPOSE : To predict improvement of best corrected visual acuity(BCVA) 1 year after pars plana vitrectomy (PPV) for epiretinal membrane(ERM) using artificial intelligence(AI) methods on optical coherence tomography(OCT) B-scan images.

METHODS : Four-hundred eleven(411) patients with stage II ERM were divided in a group improvement(IM)(≥ 15 ETDRS letters of VA recovery)and a group no improvement(N-IM)(<15 letters)according to 1-year VA improvement after 25 G PPV with internal limiting membrane(ILM) peeling.Primary outcome was the creation of a deep learning classifier(DLC) based on OCT B-scan images for prediction.Secondary outcome was assessment of the influence of various clinical and imaging predictors on BCVA improvement. Inception-ResNet-V2 was trained using standard augmentation techniques.Testing was performed on an external dataset.For secondary outcome, B-scan acquisitions were analyzed by graders both before and after fibrillary changes(FC) processing-enhancement.

RESULTS : The overall performance of the DLC showed a sensitivity of 87.3% and a specificity of 86.2%. Regression analysis showed a difference in preoperative images prevalence of ectopic inner foveal layer (EIFL),foveal detachment,ellipsoid zone(EZ) interruption, cotton wool sign, unprocessed FC(OR=2.75(CI 2.49-2.96)) and processed FC(OR=5.42(CI 4.81-6.08)) while preoperative BCVA and central macular thickness(CMT) didn't differ between groups.

CONCLUSIONS : The DLC showed high performances in predicting 1-year visual outcome in ERM surgery patients. FC should also be considered as relevant predictors.

Crincoli Emanuele, Savastano Maria Cristina, Savastano Alfonso, Caporossi Tomaso, Bacherini Daniela, Miere Alexandra, Gambini Gloria, De Vico Umberto, Baldascino Antonio, Minnella Angelo Maria, Scupola Andrea, D’Amico Guglielmo, Molle Fernando, Bernardinelli Patrizio, Filippis Alessandro De, Kilian Raphael, Rizzo Clara, Ripa Matteo, Ferrara Silvia, Scampoli Alessandra, Brando Davide, Molle Andrea, Souied Eric H, Rizzo Stanislao