Feasibility of support vector machine learning in age-related macular degeneration using small sample yielding sparse optical coherence tomography data.

Abstract

A retrospective pilot study is conducted to demonstrate the utility of a novel support vector machine learning (SVML) algorithm in a small three-dimensional (3D) sample yielding sparse optical coherence tomography (spOCT) data for the automatic monitoring of neovascular (wet) age-related macular degeneration (wAMD). From the anti-vascular endothelial growth factor injection database, 588 consecutive pairs of OCT volumes (57.624 B-scans) were selected in 70 randomly chosen wAMD patients treated with ranibizumab. The SVML algorithm was applied to 183 OCT volume pairs (17.934 B-scans) in 30 patients. Four independent, diagnosis-blinded retina specialists indicated whether wAMD activity was present between 100 pairs of consecutive OCT volumes (9800 B-scans) in the remaining 40 patients for comparison with the SVML algorithm and a non-complex baseline algorithm using only retinal thickness. The SVML algorithm was assessed using inter-observer variability and receiver operating characteristic (ROC) analyses. The retina specialists showed an average Cohen's κ of 0.57±0.13 (minimum: 0.41, maximum: 0.83). The average κ between the proposed algorithm and the retina specialists was 0.62±0.05 and 0.43±0.14 between the baseline algorithm and the retina specialists. Using each of the four retina specialists as the reference, the proposed method showed a superior area under the ROC curve of 0.91±0.03 compared to the ROC 0.81±0.05 shown by the baseline algorithm. The SVML algorithm was as effective as the retina specialists were in detecting activity in wAMD. Support vector machine learning (SVML) may be a useful monitoring tool in wAMD suited for small samples that yield sparse OCT data possibly derived from self-measuring OCT-robots.