TY - JOUR
T1 - Deep-learning-based prediction of glaucoma conversion in normotensive glaucoma suspects
AU - Ha, Ahnul
AU - Sun, Sukkyu
AU - Kim, Young Kook
AU - Jeoung, Jin Wook
AU - Kim, Hee Chan
AU - Park, Ki Ho
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2023
Y1 - 2023
N2 - Background/aims: To assess the performance of deep-learning (DL) models for prediction of conversion to normal-tension glaucoma (NTG) in normotensive glaucoma suspect (GS) patients. Methods: Datasets of 12 458 GS eyes were reviewed. Two hundred and ten eyes (105 eyes showing NTG conversion and 105 without conversion), followed up for a minimum of 7 years during which intraocular pressure (IOP) was lower than 21 mm Hg, were included. The features of two fundus images (optic disc photography and red-free retinal nerve fibre layer (RNFL) photography) were extracted by convolutional auto encoder. The extracted features as well as 15 clinical features including age, sex, IOP, spherical equivalent, central corneal thickness, axial length, average circumpapillary RNFL thickness, systolic/diastolic blood pressure and body mass index were used to predict NTG conversion. Prediction was performed using three machine-learning classifiers (ie, XGBoost, Random Forest, Gradient Boosting) with different feature combinations. Results: All three algorithms achieved high diagnostic accuracy for NTG conversion prediction. The AUCs ranged from 0.987 (95% CI 0.978 to 1.000; Random Forest trained with both fundus images and clinical features) and 0.994 (95% CI 0.984 to 1.000; XGBoost trained with both fundus images and clinical features). XGBoost showed the best prediction performance for time to NTG conversion (mean squared error, 2.24). The top three important clinical features for time-to-conversion prediction were baseline IOP, diastolic blood pressure and average circumpapillary RNFL thickness. Conclusion: DL models, trained with both fundus images and clinical data, showed the potential to predict whether and when normotensive GS patients will show conversion to NTG.
AB - Background/aims: To assess the performance of deep-learning (DL) models for prediction of conversion to normal-tension glaucoma (NTG) in normotensive glaucoma suspect (GS) patients. Methods: Datasets of 12 458 GS eyes were reviewed. Two hundred and ten eyes (105 eyes showing NTG conversion and 105 without conversion), followed up for a minimum of 7 years during which intraocular pressure (IOP) was lower than 21 mm Hg, were included. The features of two fundus images (optic disc photography and red-free retinal nerve fibre layer (RNFL) photography) were extracted by convolutional auto encoder. The extracted features as well as 15 clinical features including age, sex, IOP, spherical equivalent, central corneal thickness, axial length, average circumpapillary RNFL thickness, systolic/diastolic blood pressure and body mass index were used to predict NTG conversion. Prediction was performed using three machine-learning classifiers (ie, XGBoost, Random Forest, Gradient Boosting) with different feature combinations. Results: All three algorithms achieved high diagnostic accuracy for NTG conversion prediction. The AUCs ranged from 0.987 (95% CI 0.978 to 1.000; Random Forest trained with both fundus images and clinical features) and 0.994 (95% CI 0.984 to 1.000; XGBoost trained with both fundus images and clinical features). XGBoost showed the best prediction performance for time to NTG conversion (mean squared error, 2.24). The top three important clinical features for time-to-conversion prediction were baseline IOP, diastolic blood pressure and average circumpapillary RNFL thickness. Conclusion: DL models, trained with both fundus images and clinical data, showed the potential to predict whether and when normotensive GS patients will show conversion to NTG.
KW - Glaucoma
UR - http://www.scopus.com/inward/record.url?scp=85176593933&partnerID=8YFLogxK
U2 - 10.1136/bjo-2022-323167
DO - 10.1136/bjo-2022-323167
M3 - Article
C2 - 37918891
AN - SCOPUS:85176593933
SN - 0007-1161
JO - British Journal of Ophthalmology
JF - British Journal of Ophthalmology
M1 - bjo-2022-323167
ER -