Deep learning to infer visual acuity from optical coherence tomography in diabetic macular edema

作者：Ting‐Yi Lin, Hung-Ruei Chen, Hsin‐Yi Huang, Yu-Ier Hsiao, Zih-Kai Kao, Kao-Jung Chang, Tai‐Chi Lin, Chang‐Hao Yang, Chung‐Lan Kao, Po-Yin Chen, Shih-En Huang, Chih‐Chien Hsu, Yu-Bai Chou, Ying-Chun Jheng, Shih‐Jen Chen, Shih-Hwa Chiou, De‐Kuang Hwang · 发表于：Frontiers in Medicine · 年份：2022 · DOI：10.3389/fmed.2022.1008950 · 被引用次数：15 · 研究领域：Retinal Diseases and Treatments、Retinal Imaging and Analysis、Ophthalmology and Visual Impairment Studies

Purpose: Diabetic macular edema (DME) is one of the leading causes of visual impairment in diabetic retinopathy (DR). Physicians rely on optical coherence tomography (OCT) and baseline visual acuity (VA) to tailor therapeutic regimen. However, best-corrected visual acuity (BCVA) from chart-based examinations may not wholly reflect DME status. Chart-based examinations are subjected findings dependent on the patient's recognition functions and are often confounded by concurrent corneal, lens, retinal, optic nerve, or extraocular disorders. The ability to infer VA from objective optical coherence tomography (OCT) images provides the predicted VA from objective macular structures directly and a better understanding of diabetic macular health. Deviations from chart-based and artificial intelligence (AI) image-based VA will prompt physicians to assess other ocular abnormalities affecting the patients VA and whether pursuing anti-VEGF treatment will likely yield increment in VA. Materials and methods: We enrolled a retrospective cohort of 251 DME patients from Big Data Center (BDC) of Taipei Veteran General Hospital (TVGH) from February 2011 and August 2019. A total of 3,920 OCT images, labeled as "visually impaired" or "adequate" according to baseline VA, were grouped into training (2,826), validation (779), and testing cohort (315). We applied confusion matrix and receiver operating characteristic (ROC) curve to evaluate the performance. Results: We developed an OCT-based convolut...