Quantification of Diabetic Retinopathy Lesions in DME Patients With Intravitreal Conbercept Treatment Using Deep Learning.

Abstract

To quantitatively evaluate diabetic retinopathy (DR) lesions using the authors' validated machine learning algorithms and provide physicians with an automated and precise method to follow the progression of DR and outcome of interventions. Retrospective analyses were conducted of 3,496 color fundus photography images from 19 patients with clinically significant diabetic macular edema receiving conbercept treatment. The modified seven-field fundus images were obtained at baseline and at the third, sixth, and twelfth month visit, whereas the modified two-field fundus images were obtained at the other monthly visits. The area of intraretinal hemorrhage and hard exudate lesions was traced by the authors' validated algorithms. The mean central foveal thickness at baseline was 459.9 μm ± 127.5 μm. Mean central foveal thickness was 316.5 μm ± 53.0 μm at the twelfth month visit, which decreased by 143.4 μm when compared with the baseline optical coherence tomography. The mean total area of intraretinal hemorrhage in the study eye in seven fields was 5.656 ± 1.176 mm2 at baseline, 2.438 ± 0.976 mm2 at the third month, 2.901 ± 0.521 mm2 at the sixth month, and 2.122 ± 0.582 mm2 at the end of the study. The area of intraretinal hemorrhage was reduced by 62.49% from baseline to the end of study (P < .0001). The mean total area of hard exudates in the study eye was 2.549 ± 0.776 mm2 at baseline, 2.233 ± 0.576 mm2 at the third month, 2.710 ± 0.621 mm2 at the sixth month, and 1.473 ± 0.564 mm2 at the end of the study. The mean total area of hard exudates decreased by 41.1% at the twelfth month (P < .0001) compared with the first visit. Significant decrease was observed in the area of intraretinal hemorrhage during conbercept treatment. The hard exudates area fluctuated during loading then subsequently decreased at the twelfth month. The present study quantitatively analyzed the change in the area change of intraretinal hemorrhage and hard exudate lesions during the course of conbercept treatment. The automated system is promising to be a precise and objective method for monitoring the progression of DR and outcomes of interventions in clinical settings. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:95-100.].