Abstract

PurposeTo predict the fundus tessellation (FT) severity with machine learning methods.MethodsA population-based cross-sectional study with 3,468 individuals (mean age of 64.6 ± 9.8 years) based on Beijing Eye Study 2011. Participants underwent detailed ophthalmic examinations including fundus images. Five machine learning methods including ordinal logistic regression, ordinal probit regression, ordinal log-gamma regression, ordinal forest and neural network were used.Main Outcome MeasureFT precision, recall, F1-score, weighted-average F1-score and AUC value.ResultsObserved from the in-sample fitting performance, the optimal model was ordinal forest, which had correct classification rate (precision) of 81.28%, while 34.75, 93.73, 70.03, and 24.82% in each classified group by FT severity. The AUC value was 0.7249. And the F1-score was 65.05%, weighted-average F1-score was 79.64% on the whole dataset. For out-of-sample prediction performance, the optimal model was ordinal logistic regression, which had precision of 77.12% on the validation dataset, while 19.57, 92.68, 64.74, and 6.76% in each classified group by FT severity. The AUC value was 0.7187. The classification accuracy of light FT group was the highest, while that of severe FT group was the lowest. And the F1-score was 54.46%, weighted-average F1-score was 74.19% on the whole dataset.ConclusionsThe ordinal forest and ordinal logistic regression model had the strong prediction in-sample and out-sample performance, respectively. The threshold ranges of the ordinal forest model for no FT and light, moderate, severe FT were [0, 0.3078], [0.3078, 0.3347], [0.3347, 0.4048], [0.4048, 1], respectively. Likewise, the threshold ranges of ordinal logistic regression model were ≤ 3.7389, [3.7389, 10.5053], [10.5053, 13.9323], > 13.9323. These results can be applied to guide clinical fundus disease screening and FT severity assessment.

Highlights

  • Artificial intelligence has been widely applied to image identification [1], speech recognition [2], and natural language processing [3], its impact on medical care is only beginning

  • The threshold ranges of the ordinal forest model for no fundus tessellation (FT) and light, moderate, severe FT were [0, 0.3078], [0.3078, 0.3347], [0.3347, 0.4048], [0.4048, 1], respectively

  • Our findings suggest that observed from the in-sample fitting performance, the optimal model was ordinal forest

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Summary

Introduction

Artificial intelligence has been widely applied to image identification [1], speech recognition [2], and natural language processing [3], its impact on medical care is only beginning. Machine learning has been applied to fundus images, optical coherence tomography, and visual field analysis in ophthalmology. It demonstrated excellent classification performance for diabetic retinopathy [4], macular edema [5], glaucoma [6], AMD [7], and retinopathy of prematurity [8]. Previous research has linked fundus tessellated density (FTD) to age and myopic refractive error, and it has been regarded as one of the most critical early signs of pathological myopia [11, 12]. FT has been linked to several ocular illnesses, including age-related macular degeneration (AMD) [13], choroidal neovascularization [11], central serous chorioretinopathy [14], etc

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