Abstract

PurposeTo develop deep learning classifiers and evaluate their diagnostic performance in detecting the static gonioscopic angle closure and peripheral anterior synechia (PAS) based on swept source optical coherence tomography (SS-OCT) images.Materials and MethodsSubjects were recruited from the Glaucoma Service at Zhongshan Ophthalmic Center of Sun Yat-sun University, Guangzhou, China. Each subject underwent a complete ocular examination, such as gonioscopy and SS-OCT imaging. Two deep learning classifiers, using convolutional neural networks (CNNs), were developed to diagnose the static gonioscopic angle closure and to differentiate appositional from synechial angle closure based on SS-OCT images. Area under the receiver operating characteristic (ROC) curve (AUC) was used as outcome measure to evaluate the diagnostic performance of two deep learning systems.ResultsA total of 439 eyes of 278 Chinese patients, which contained 175 eyes of positive PAS, were recruited to develop diagnostic models. For the diagnosis of static gonioscopic angle closure, the first deep learning classifier achieved an AUC of 0.963 (95% CI, 0.954–0.972) with a sensitivity of 0.929 and a specificity of 0.877. The AUC of the second deep learning classifier distinguishing appositional from synechial angle closure was 0.873 (95% CI, 0.864–0.882) with a sensitivity of 0.846 and a specificity of 0.764.ConclusionDeep learning systems based on SS-OCT images showed good diagnostic performance for gonioscopic angle closure and moderate performance in the detection of PAS.

Highlights

  • Glaucoma is the main cause of irreversible blindness [1], affecting an estimated 76 million people worldwide [2]

  • Two deep learning classifiers, using convolutional neural networks (CNNs), were developed to diagnose the static gonioscopic angle closure and to differentiate appositional from synechial angle closure based on Swept source optical coherence tomography (SS-OCT) images

  • For the diagnosis of static gonioscopic angle closure, the first deep learning classifier achieved an area under the ROC curve (AUC) of 0.963 with a sensitivity of 0.929 and a specificity of 0.877

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Summary

Introduction

Glaucoma is the main cause of irreversible blindness [1], affecting an estimated 76 million people worldwide [2]. In Asia, the prevalence of primary angle closure disease (PACD) is expected to increase significantly to reach 34 million in 2040 [2]. PACD has chronic and acute forms, which may lead to severe eye pain and rapid loss of vision, or irreversible blindness if untreated [3]. Intervention and treatment of PACD depend on early detection, which requires assessment of the anterior chamber angle (ACA). Gonioscopy is a gold standard for assessing the ACA configuration and detecting PAS in clinics. It is a contact examination that should not be used on some patients due to safety concerns

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