ABSTRACT
Objective:To develop a fully automatic detection system based on the deep convolution neural network (DCNN) for screening myopic maculopathy (MMD) and identifying its severity.Methods:Six thousand and sixty-eight fundus images were collected from Anhui No.2 Provincial People's Hospital to construct the training set, and the public fundus images data set was selected to construct the test set.The fundus images were preprocessed and amplified, and the grade of MMD lesions was labeled and the data was cleaned.The automatic MMD detection system proposed was composed of two-level network.The first level network structure was used to identify the presence of MMD, and the second level network structure was used to diagnose the severity of MMD lesions.The accuracy, specificity, sensitivity, precision, F1 value, area under curve (AUC) and Kappa coefficient of four commonly used DCNN network methods, VGG-16, ResNet50, Inception-V3 and Densenet, in MMD screening and severity recognition tasks were compared and analyzed.The study protocol adhered to the Declaration of Helsinki and was approved by a Medical Ethics Committee of Anhui No.2 Provincial People's Hospital ([L]2019-013).Results:The performance of Densenet network model was the best in the MMD screening task, with the sensitivity, specificity, accuracy, F1 value and AUC of 0.898, 0.918, 0.919, 0.908 and 0.962, respectively.The Inception-v3 network model was the best in MMD severity recognition task, with sensitivity, specificity, accuracy, F1 value and AUC of 0.839, 0.952, 0.952, 0.892, and 0.965, respectively.The visualization results showed that the network structure model used in this study could automatically learn the clinical characteristics of MMD severity, and accurately identify diffuse and focal chorioretinal atrophy areas.Conclusions:The MMD screening method using fundus images based on DCNN can automatically extract the effective features of MMD, and accurately screen MMD and judge its severity, which can provide effective assistance in clinical practice.
ABSTRACT
Background Attack of primary acute angle-closure glaucoma (PAACG) often cause damage of retinal function.To measure the structural change after acute angle-closure glaucoma attack is of an important clinical significance.Flourier domain OCT(FD-OCT) is available.Objective This study was to measure and compare the thickness of peripapillary and macular retinal nerve fiber layer (RNFL) and macular volume in PAACG patients and normal subjects.Methods A case-controlled study was designed.Twenty-five eyes after acute angle-closure glaucoma attack and 25 fellow eyes were collected from April,2011 to February,2012 in Affiliated Eye Hospital of Wenzhou Medical College,and 25 eyes of normal subjects with the matched age and gender were enrolled at the same period.The thicknesses of RNFL and macula as well as the volumes of macula were measured by FD-OCT in all the eyes 2 weeks after acute angle-closure glaucoma attack.The outcomes were compared among the attacked eyes,fellow eyes and normal control eyes.Results The average thicknesses of RNFL were (125.72 ± 28.57),(108.36 ±9.31) and (106.10± 10.97)μm in the attacked eyes,fellow eyes and normal control eyes,showing a significant increase in the attacked eyes (all at P ＜ 0.05).The RNFL thickness values in the superior,interior and nasal quadrants at optical disc were significantly higher in the attacked eyes than those of the fellow eyes and normal control eyes (all at P＜0.05),but no significant differences were found in temporal and temporal-lower quadrants among the three groups (P=0.081,0.766).The thickness values of macular area were (283.72 ± 18.33),(280.28 ± 16.85) and (289.14±10.60)μm in the attacked eyes,fellow eyes and normal control eyes,with no significant difference among them (Fgroup =2.048,P =0.136),and fellow eyes were significantly reduced in comparison with the normal control group (P＜0.05),and those in the attacked eyes was not significantly reduced in comparison with the normal control group (P =0.224).The macular volumes were (5.589±0.355),(5.532±0.325) and (5.720±0.241)mm3in the attacked eyes,fellow eyes and normal eyes,without statistically significant difference among them (Fgup =1.027,P=0.363).The macular thickness values were lower in the outer race than those of the inner race and followed the pattern of nasal ＞superior＞ inferior＞temporal quadrants.At the temporal,superior,nasal and inferior quadrants of inner race,the temporal quadrant of the outer race,the central area,the macular thickness and volume values were declined in the attacked eyes and fellow eyes compared with the normal control eyes (all at P＜0.05).Conclusions The edema of RNFL is more serious than that of macula in the eyes within 2 weeks after acute angleclosure glaucoma attack.The retinas of macular zone are thinner,and the macular volumes are smaller in the attacked eyes and fellow eyes than those in the normal control eyes.