Predicting optical coherence tomography-derived diabetic macular edema grades from fundus photographs using deep learning
Avinash V. Varadarajan, Pinal Bavishi, Paisan Ruamviboonsuk, Peranut Chotcomwongse, Subhashini Venugopalan, Arunachalam Narayanaswamy, Jorge Cuadros, Kuniyoshi Kanai, George Bresnick, Mongkol Tadarati, Sukhum Silpa-archa, Jirawut Limwattanayingyong, Variya Nganthavee, Joseph R. Ledsam, Pearse A. Keane, Greg S. Corrado, Lily Peng, Dale R. Webster
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.