In Ophthalmology. Glaucoma
PURPOSE : To develop and validate a deep learning (DL) model for detection of glaucoma progression using spectral-domain optical coherence tomography (SDOCT) measurements of retinal nerve fiber layer (RNFL) thickness.
DESIGN : Retrospective cohort study.
PARTICIPANTS : A total of 14,034 SDOCT scans from 816 eyes from 462 individuals.
METHODS : A DL convolutional neural network was trained to assess SDOCT RNFL thickness measurements of two visits (a baseline and a follow-up) along with time between visits to predict the probability of glaucoma progression. The ground truth was defined by consensus from subjective grading by glaucoma specialists. Diagnostic performance was summarized by the area under the receiver operator characteristic curve (AUC), sensitivity, and specificity, and was compared to conventional trend-based analyses of change. Interval likelihood ratios were calculated to determine the impact of DL model results in changing the post-test probability of progression.
MAIN OUTCOME MEASURES : AUC, sensitivity, and specificity of the DL model.
RESULTS : The DL model had an AUC of 0.938 (95% confidence interval [CI]: 0.921, 0.955), with sensitivity of 87.3% (95% CI: 83.6%, 91.6%) and specificity of 86.4% (95% CI: 79.9%, 89.6%). When matched for the same specificity, the DL model significantly outperformed trend-based analyses. Likelihood ratios for the deep learning model were associated with large changes in probability of progression in the vast majority of SDOCT tests.
CONCLUSIONS : A DL model was able to assess the probability of glaucomatous structural progression from SDOCT RNFL thickness measurements. The model agreed well with expert judgements and outperformed conventional trend-based analyses of change, while also providing indication of the likely locations of change.
Mariottoni Eduardo B, Datta Shounak, Shigueoka Leonardo S, Jammal Alessandro A, Tavares Ivan M, Henao Ricardo, Carin Lawrence, Medeiros Felipe A
2022-Nov-18
OCT, artificial intelligence, deep learning, glaucoma, progression
