1. Assessing the Impact of Image Quality on Deep Learning Classification of Infectious Keratitis
- Author
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Adam Hanif, MD, N. Venkatesh Prajna, MD, Prajna Lalitha, MD, Erin NaPier, BA, Maria Parker, MD, Peter Steinkamp, MS, Jeremy D. Keenan, MD, MPH, J. Peter Campbell, MD, MPH, Xubo Song, PhD, and Travis K. Redd, MD, MPH
- Subjects
Artificial intelligence ,Deep learning ,External photograph ,Image quality ,Infectious keratitis ,Ophthalmology ,RE1-994 - Abstract
Objective: To investigate the impact of corneal photograph quality on convolutional neural network (CNN) predictions. Design: A CNN trained to classify bacterial and fungal keratitis was evaluated using photographs of ulcers labeled according to 5 corneal image quality parameters: eccentric gaze direction, abnormal eyelid position, over/under-exposure, inadequate focus, and malpositioned light reflection. Participants: All eligible subjects with culture and stain-proven bacterial and/or fungal ulcers presenting to Aravind Eye Hospital in Madurai, India, between January 1, 2021 and December 31, 2021. Methods: Convolutional neural network classification performance was compared for each quality parameter, and gradient class activation heatmaps were generated to visualize regions of highest influence on CNN predictions. Main Outcome Measures: Area under the receiver operating characteristic and precision recall curves were calculated to quantify model performance. Bootstrapped confidence intervals were used for statistical comparisons. Logistic loss was calculated to measure individual prediction accuracy. Results: Individual presence of either light reflection or eyelids obscuring the corneal surface was associated with significantly higher CNN performance. No other quality parameter significantly influenced CNN performance. Qualitative review of gradient class activation heatmaps generally revealed the infiltrate as having the highest diagnostic relevance. Conclusions: The CNN demonstrated expert-level performance regardless of image quality. Future studies may investigate use of smartphone cameras and image sets with greater variance in image quality to further explore the influence of these parameters on model performance. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
- Published
- 2023
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