Back to Search
Start Over
Evaluation of a Deep Learning System For Identifying Glaucomatous Optic Neuropathy Based on Color Fundus Photographs
- Source :
- Journal of Glaucoma. 28:1029-1034
- Publication Year :
- 2019
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2019.
-
Abstract
- Precis Pegasus outperformed 5 of the 6 ophthalmologists in terms of diagnostic performance, and there was no statistically significant difference between the deep learning system and the "best case" consensus between the ophthalmologists. The agreement between Pegasus and gold standard was 0.715, whereas the highest ophthalmologist agreement with the gold standard was 0.613. Furthermore, the high sensitivity of Pegasus makes it a valuable tool for screening patients with glaucomatous optic neuropathy. Purpose The purpose of this study was to evaluate the performance of a deep learning system for the identification of glaucomatous optic neuropathy. Materials and methods Six ophthalmologists and the deep learning system, Pegasus, graded 110 color fundus photographs in this retrospective single-center study. Patient images were randomly sampled from the Singapore Malay Eye Study. Ophthalmologists and Pegasus were compared with each other and to the original clinical diagnosis given by the Singapore Malay Eye Study, which was defined as the gold standard. Pegasus' performance was compared with the "best case" consensus scenario, which was the combination of ophthalmologists whose consensus opinion most closely matched the gold standard. The performance of the ophthalmologists and Pegasus, at the binary classification of nonglaucoma versus glaucoma from fundus photographs, was assessed in terms of sensitivity, specificity and the area under the receiver operating characteristic curve (AUROC), and the intraobserver and interobserver agreements were determined. Results Pegasus achieved an AUROC of 92.6% compared with ophthalmologist AUROCs that ranged from 69.6% to 84.9% and the "best case" consensus scenario AUROC of 89.1%. Pegasus had a sensitivity of 83.7% and a specificity of 88.2%, whereas the ophthalmologists' sensitivity ranged from 61.3% to 81.6% and specificity ranged from 80.0% to 94.1%. The agreement between Pegasus and gold standard was 0.715, whereas the highest ophthalmologist agreement with the gold standard was 0.613. Intraobserver agreement ranged from 0.62 to 0.97 for ophthalmologists and was perfect (1.00) for Pegasus. The deep learning system took ∼10% of the time of the ophthalmologists in determining classification. Conclusions Pegasus outperformed 5 of the 6 ophthalmologists in terms of diagnostic performance, and there was no statistically significant difference between the deep learning system and the "best case" consensus between the ophthalmologists. The high sensitivity of Pegasus makes it a valuable tool for screening patients with glaucomatous optic neuropathy. Future work will extend this study to a larger sample of patients.
- Subjects :
- Adult
Male
Optic Disk
Glaucoma
Diagnostic Techniques, Ophthalmological
Fundus (eye)
Sensitivity and Specificity
Glaucomatous optic neuropathy
Optic neuropathy
03 medical and health sciences
Deep Learning
0302 clinical medicine
Optic Nerve Diseases
Photography
Humans
Medicine
Diagnosis, Computer-Assisted
Intraocular Pressure
Aged
Retrospective Studies
Observer Variation
Ophthalmologists
Receiver operating characteristic
business.industry
Significant difference
Gold standard (test)
Middle Aged
medicine.disease
Ophthalmology
ROC Curve
Area Under Curve
Clinical diagnosis
030221 ophthalmology & optometry
Optometry
Female
business
Glaucoma, Open-Angle
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 10570829
- Volume :
- 28
- Database :
- OpenAIRE
- Journal :
- Journal of Glaucoma
- Accession number :
- edsair.doi.dedup.....cb09439e6a6c506c2178f6867150fc09