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A Deep Learning-Based Algorithm Identifies Glaucomatous Discs Using Monoscopic Fundus Photographs

PurposeTo develop and test the performance of a deep learning-based algorithm for glaucomatous disc identification using monoscopic fundus photographs.DesignFundus photograph database study.ParticipantsFour thousand three hundred ninety-four fundus photographs, including 3768 images from previous Sydney-based clinical studies and 626 images from publicly available online RIM-ONE and High-Resolution Fundus (HRF) databases with definitive diagnoses.MethodsWe merged all databases except the HRF database, and then partitioned the dataset into a training set (80% of all cases) and a testing set (20% of all cases). We used the HRF images as an additional testing set. We compared the performance of the artificial intelligence (AI) system against a panel of practicing ophthalmologists including glaucoma subspecialists from Australia, New Zealand, Canada, and the United Kingdom.Main Outcome MeasuresThe sensitivity and specificity of the AI system in detecting glaucomatous optic discs.ResultsBy using monoscopic fundus photographs, the AI system demonstrated a high accuracy rate in glaucomatous disc identification (92.7%; 95% confidence interval [CI], 91.2%–94.2%), achieving 89.3% sensitivity (95% CI, 86.8%–91.7%) and 97.1% specificity (95% CI, 96.1%–98.1%), with an area under the receiver operating characteristic curve of 0.97 (95% CI, 0.96–0.98). Using the independent online HRF database (30 images), the AI system again accomplished high accuracy, with 86.7% in both sensitivity and specificity (for ophthalmologists, 75.6% sensitivity and 77.8% specificity) and an area under the receiver operating characteristic curve of 0.89 (95% CI, 0.76–1.00).ConclusionsThis study demonstrated that a deep learning-based algorithm can identify glaucomatous discs at high accuracy level using monoscopic fundus images. Given that it is far easier to obtain monoscopic disc images than high-quality stereoscopic images, this study highlights the algorithm’s potential application in large population-based disease screening or telemedicine programs.

یک الگوریتم مبتنی بر یادگیری عمیق با استفاده از Fundus فوتوگراف های تک مکانی، معایب بزرگ را شناسایی می‌کند.

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