Abstract
Subretinal fluid (SRF) can lead to irreversible visual loss in patients with central serous chorioretinopathy (CSC) if not absorbed in time. Early detection and intervention of SRF can help improve visual prognosis and reduce irreversible damage to the retina. As fundus image is the most commonly used and easily obtained examination for patients with CSC, the purpose of our research is to investigate whether and to what extent SRF depicted on fundus images can be assessed using deep learning technology. In this study, we developed a cascaded deep learning system based on fundus image for automated SRF detection and macula-on/off serous retinal detachment discerning. The performance of our system is reliable, and its accuracy of SRF detection is higher than that of experienced retinal specialists. In addition, the system can automatically indicate whether the SRF progression involves the macula to provide guidance of urgency for patients. The implementation of our deep learning system could effectively reduce the extent of vision impairment resulting from SRF in patients with CSC by providing timely identification and referral.
Highlights
As the fourth most common nonsurgical retinopathy, central serous chorioretinopathy (CSC) is an idiopathic ophthalmopathy in which the neurosensory retina is often detached in the central macular region due to serous leakage from defects of the retinal pigment epithelium, causing a condition where fluid accumulates under the retina and causes a visual impairment (Wang et al, 2008; Manayath et al, 2018)
The first artificial intelligence (AI) system designed to identify serous retinal detachments (SRDs) was developed using 10,558 fundus photographs, 1,183 of which were classified as SRD, whereas the remaining 9,375 images were classified as non-SRD
We developed a cascaded deep learning system containing two models based on 11,087 fundus images and verified its feasibility
Summary
As the fourth most common nonsurgical retinopathy, central serous chorioretinopathy (CSC) is an idiopathic ophthalmopathy in which the neurosensory retina is often detached in the central macular region due to serous leakage from defects of the retinal pigment epithelium, causing a condition where fluid accumulates under the retina and causes a visual impairment (Wang et al, 2008; Manayath et al, 2018). There have been some efforts on assessing CSC based on FFA and OCT (Narendra Rao et al, 2019; Zhen et al, 2020); considering the clinical practicality, a fundus photograph is the best imaging manner to routinely detect status and severity of patients with CSC. It is not easy, even for experienced ophthalmologists, to reliably identify CSC on fundus photography.
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