Bowd C, Belghith A, Rezapour J, Christopher M, Jonas JB, Hyman L, Fazio MA, Weinreb RN, Zangwill LM. Multimodal Deep Learning Classifier for Primary Open Angle Glaucoma Diagnosis Using Wide-Field Optic Nerve Head Cube Scans in Eyes With and Without High Myopia.
J Glaucoma 2023;
32:841-847. [PMID:
37523623 DOI:
10.1097/ijg.0000000000002267]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 06/18/2023] [Indexed: 08/02/2023]
Abstract
PRCIS
An optical coherence tomography (OCT)-based multimodal deep learning (DL) classification model, including texture information, is introduced that outperforms single-modal models and multimodal models without texture information for glaucoma diagnosis in eyes with and without high myopia.
BACKGROUND/AIMS
To evaluate the diagnostic accuracy of a multimodal DL classifier using wide OCT optic nerve head cube scans in eyes with and without axial high myopia.
MATERIALS AND METHODS
Three hundred seventy-one primary open angle glaucoma (POAG) eyes and 86 healthy eyes, all without axial high myopia [axial length (AL) ≤ 26 mm] and 92 POAG eyes and 44 healthy eyes, all with axial high myopia (AL > 26 mm) were included. The multimodal DL classifier combined features of 3 individual VGG-16 models: (1) texture-based en face image, (2) retinal nerve fiber layer (RNFL) thickness map image, and (3) confocal scanning laser ophthalmoscope (cSLO) image. Age, AL, and disc area adjusted area under the receiver operating curves were used to compare model accuracy.
RESULTS
Adjusted area under the receiver operating curve for the multimodal DL model was 0.91 (95% CI = 0.87, 0.95). This value was significantly higher than the values of individual models [0.83 (0.79, 0.86) for texture-based en face image; 0.84 (0.81, 0.87) for RNFL thickness map; and 0.68 (0.61, 0.74) for cSLO image; all P ≤ 0.05]. Using only highly myopic eyes, the multimodal DL model showed significantly higher diagnostic accuracy [0.89 (0.86, 0.92)] compared with texture en face image [0.83 (0.78, 0.85)], RNFL [0.85 (0.81, 0.86)] and cSLO image models [0.69 (0.63, 0.76)] (all P ≤ 0.05).
CONCLUSIONS
Combining OCT-based RNFL thickness maps with texture-based en face images showed a better ability to discriminate between healthy and POAG than thickness maps alone, particularly in high axial myopic eyes.
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