Abstract

Neovascular age-related macular degeneration (nAMD) is among the main causes of visual impairment worldwide. We built a deep learning model to distinguish the subtypes of nAMD using spectral domain optical coherence tomography (SD-OCT) images. Data from SD-OCT images of nAMD (polypoidal choroidal vasculopathy, retinal angiomatous proliferation, and typical nAMD) and normal healthy patients were analyzed using a convolutional neural network (CNN). The model was trained and validated based on 4749 SD-OCT images from 347 patients and 50 healthy controls. To adopt an accurate and robust image classification architecture, we evaluated three well-known CNN structures (VGG-16, VGG-19, and ResNet) and two customized classification layers (fully connected layer with dropout vs. global average pooling). Following the test set performance, the model with the highest classification accuracy was used. Transfer learning and data augmentation were applied to improve the robustness and accuracy of the model. Our proposed model showed an accuracy of 87.4% on the test data (920 images), scoring higher than ten ophthalmologists, for the same data. Additionally, the part that our model judged to be important in classification was confirmed through Grad-CAM images, and consequently, it has a similar judgment criteria to that of ophthalmologists. Thus, we believe that our model can be used as an auxiliary tool in clinical practice.

Highlights

  • Neovascular age-related macular degeneration is among the main causes of visual impairment worldwide

  • We presented a deep learning model and investigated its performance in distinguishing several subtypes of Neovascular age-related macular degeneration (nAMD) using spectral domain optical coherence tomography (SD-optical coherence tomography (OCT)) images

  • Our model correctly classified the images with incorrect readings by more than half of the ophthalmologists participating in the test, demonstrating that our model could provide additional help in nAMD classification by ophthalmologists

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Summary

Introduction

Neovascular age-related macular degeneration (nAMD) is among the main causes of visual impairment worldwide. We built a deep learning model to distinguish the subtypes of nAMD using spectral domain optical coherence tomography (SD-OCT) images. Data from SD-OCT images of nAMD (polypoidal choroidal vasculopathy, retinal angiomatous proliferation, and typical nAMD) and normal healthy patients were analyzed using a convolutional neural network (CNN). Our proposed model showed an accuracy of 87.4% on the test data (920 images), scoring higher than ten ophthalmologists, for the same data. NAMD can be classified into one of the three s­ ubtypes[3]: (i) typical nAMD, (ii) polypoidal choroidal vasculopathy (PCV), and (iii) retinal angiomatous proliferation (RAP). Modalities, optical coherence tomography (OCT) is noninvasive and is often used to evaluate the structural abnormalities associated with nAMD, and is used as an adjunct to these angiography m­ ethods[7,14]

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