Predicting optical coherence tomography-derived diabetic macular edema grades from fundus photographs using deep learning

Nat Commun. 2020 Jan 8;11(1):130. doi: 10.1038/s41467-019-13922-8.

Abstract

Center-involved diabetic macular edema (ci-DME) is a major cause of vision loss. Although the gold standard for diagnosis involves 3D imaging, 2D imaging by fundus photography is usually used in screening settings, resulting in high false-positive and false-negative calls. To address this, we train a deep learning model to predict ci-DME from fundus photographs, with an ROC-AUC of 0.89 (95% CI: 0.87-0.91), corresponding to 85% sensitivity at 80% specificity. In comparison, retinal specialists have similar sensitivities (82-85%), but only half the specificity (45-50%, p < 0.001). Our model can also detect the presence of intraretinal fluid (AUC: 0.81; 95% CI: 0.81-0.86) and subretinal fluid (AUC 0.88; 95% CI: 0.85-0.91). Using deep learning to make predictions via simple 2D images without sophisticated 3D-imaging equipment and with better than specialist performance, has broad relevance to many other applications in medical imaging.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Deep Learning
  • Diabetic Retinopathy / diagnostic imaging*
  • Diabetic Retinopathy / genetics
  • Female
  • Humans
  • Imaging, Three-Dimensional
  • Macular Edema / diagnostic imaging*
  • Macular Edema / genetics
  • Male
  • Middle Aged
  • Mutation
  • Photography
  • Retina / diagnostic imaging
  • Tomography, Optical Coherence