A Multi-Task Deep-Learning System to Classify Diabetic Macular Edema for Different Optical Coherence Tomography Devices: A Multi-Centre Analysis

2020 ◽  
Author(s):  
Fangyao Tang ◽  
Xi Wang ◽  
An-Ran Ran ◽  
Carmen K. M. Chan ◽  
Mary Ho ◽  
...  
2021 ◽  
Author(s):  
Fangyao Tang ◽  
Xi Wang ◽  
An-ran Ran ◽  
Carmen KM Chan ◽  
Mary Ho ◽  
...  

<a><b>Objective:</b></a> 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. <p><b>Research Design and Methods:</b> We trained and validated two versions of a multi-task 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 two-dimensional (2D) B-scans respectively. For both 3D and 2D CNNs, we employed 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 datasets from Singapore, Hong Kong, the US, China, and Australia. </p> <p><b>Results:</b> 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 primary dataset obtained from Cirrus, Spectralis, and Triton OCTs respectively, in addition to AUROCs greater than 0.906 for the external datasets. For the 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 dataset and greater than 0.894 for the external datasets. </p> <p><b>Conclusion:</b> 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. </p>


2021 ◽  
Author(s):  
Fangyao Tang ◽  
Xi Wang ◽  
An-ran Ran ◽  
Carmen KM Chan ◽  
Mary Ho ◽  
...  

<a><b>Objective:</b></a> 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. <p><b>Research Design and Methods:</b> We trained and validated two versions of a multi-task 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 two-dimensional (2D) B-scans respectively. For both 3D and 2D CNNs, we employed 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 datasets from Singapore, Hong Kong, the US, China, and Australia. </p> <p><b>Results:</b> 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 primary dataset obtained from Cirrus, Spectralis, and Triton OCTs respectively, in addition to AUROCs greater than 0.906 for the external datasets. For the 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 dataset and greater than 0.894 for the external datasets. </p> <p><b>Conclusion:</b> 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. </p>


2020 ◽  
pp. bjophthalmol-2020-317825
Author(s):  
Yonghao Li ◽  
Weibo Feng ◽  
Xiujuan Zhao ◽  
Bingqian Liu ◽  
Yan Zhang ◽  
...  

Background/aimsTo apply deep learning technology to develop an artificial intelligence (AI) system that can identify vision-threatening conditions in high myopia patients based on optical coherence tomography (OCT) macular images.MethodsIn this cross-sectional, prospective study, a total of 5505 qualified OCT macular images obtained from 1048 high myopia patients admitted to Zhongshan Ophthalmic Centre (ZOC) from 2012 to 2017 were selected for the development of the AI system. The independent test dataset included 412 images obtained from 91 high myopia patients recruited at ZOC from January 2019 to May 2019. We adopted the InceptionResnetV2 architecture to train four independent convolutional neural network (CNN) models to identify the following four vision-threatening conditions in high myopia: retinoschisis, macular hole, retinal detachment and pathological myopic choroidal neovascularisation. Focal Loss was used to address class imbalance, and optimal operating thresholds were determined according to the Youden Index.ResultsIn the independent test dataset, the areas under the receiver operating characteristic curves were high for all conditions (0.961 to 0.999). Our AI system achieved sensitivities equal to or even better than those of retina specialists as well as high specificities (greater than 90%). Moreover, our AI system provided a transparent and interpretable diagnosis with heatmaps.ConclusionsWe used OCT macular images for the development of CNN models to identify vision-threatening conditions in high myopia patients. Our models achieved reliable sensitivities and high specificities, comparable to those of retina specialists and may be applied for large-scale high myopia screening and patient follow-up.


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