Abstract

PurposeInfiltration of activated dendritic cells and inflammatory cells in cornea represents an important marker for defining corneal inflammation. Deep transfer learning has presented a promising potential and is gaining more importance in computer assisted diagnosis. This study aimed to develop deep transfer learning models for automatic detection of activated dendritic cells and inflammatory cells using in vivo confocal microscopy images.MethodsA total of 3453 images was used to train the models. External validation was performed on an independent test set of 558 images. A ground-truth label was assigned to each image by a panel of cornea specialists. We constructed a deep transfer learning network that consisted of a pre-trained network and an adaptation layer. In this work, five pre-trained networks were considered, namely VGG-16, ResNet-101, Inception V3, Xception, and Inception-ResNet V2. The performance of each transfer network was evaluated by calculating the area under the curve (AUC) of receiver operating characteristic, accuracy, sensitivity, specificity, and G mean.ResultsThe best performance was achieved by Inception-ResNet V2 transfer model. In the validation set, the best transfer system achieved an AUC of 0.9646 (P<0.001) in identifying activated dendritic cells (accuracy, 0.9319; sensitivity, 0.8171; specificity, 0.9517; and G mean, 0.8872), and 0.9901 (P<0.001) in identifying inflammatory cells (accuracy, 0.9767; sensitivity, 0.9174; specificity, 0.9931; and G mean, 0.9545).ConclusionsThe deep transfer learning models provide a completely automated analysis of corneal inflammatory cellular components with high accuracy. The implementation of such models would greatly benefit the management of corneal diseases and reduce workloads for ophthalmologists.

Highlights

  • Inflammation and immune activation are the underlying process of a wide range of corneal diseases such as infective keratitis, immune and autoimmune corneal diseases [1,2]

  • The deep transfer learning models provide a completely automated analysis of corneal inflammatory cellular components with high accuracy. The implementation of such models would greatly benefit the management of corneal diseases and reduce workloads for ophthalmologists

  • Deep transfer learning for corneal inflammation when consistent diagnostic outcomes were achieved by the three ophthalmologists

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Summary

Introduction

Inflammation and immune activation are the underlying process of a wide range of corneal diseases such as infective keratitis, immune and autoimmune corneal diseases [1,2]. Persistent inflammation can result in corneal opacity, significant visual impairment and even blindness. Patients with corneal inflammatory diseases may benefit from rational anti-inflammatory strategies. It is of high importance that the anti-inflammatory regimen should be dynamically adjusted according to the level of inflammatory response. Close monitoring of corneal inflammatory activity is warranted. Symptoms and slit-lamp examination provide only rather rough estimates of ocular responses, making it difficult to accurately assess the inflammatory reaction and the effect of anti-inflammatory treatments

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