A Deep Learning Segmentation Model for Detection of Active Proliferative Diabetic Retinopathy.

IF 2.6 3区医学 Q2 OPHTHALMOLOGY

Ophthalmology and Therapy Pub Date : 2025-05-01 Epub Date: 2025-03-27 DOI:10.1007/s40123-025-01127-w

Sebastian Dinesen, Marianne G Schou, Christoffer V Hedegaard, Yousif Subhi, Thiusius R Savarimuthu, Tunde Peto, Jakob K H Andersen, Jakob Grauslund

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引用次数: 0

Abstract

Introduction: Existing deep learning (DL) algorithms lack the capability to accurately identify patients in immediate need of treatment for proliferative diabetic retinopathy (PDR). We aimed to develop a DL segmentation model to detect active PDR in six-field retinal images by the annotation of new retinal vessels and preretinal hemorrhages.

Methods: We identified six-field retinal images classified at level 4 of the International Clinical Diabetic Retinopathy Disease Severity Scale collected at the Island of Funen from 2009 to 2019 as part of the Danish screening program for diabetic retinopathy (DR). A certified grader (grader 1) manually dichotomized the images into active or inactive PDR, and the images were then reassessed by two independent certified graders. In cases of disagreement, the final classification decision was made in collaboration between grader 1 and one of the secondary graders. Overall, 637 images were classified as active PDR. We then applied our pre-established DL segmentation model to annotate nine lesion types before training the algorithm. The segmentations of new vessels and preretinal hemorrhages were corrected for any inaccuracies before training the DL algorithm. After the classification and pre-segmentation phases the images were divided into training (70%), validation (10%), and testing (20%) datasets. We added 301 images with inactive PDR to the testing dataset.

Results: We included 637 images of active PDR and 301 images of inactive PDR from 199 individuals. The training dataset had 1381 new vessel and preretinal hemorrhage lesions, while the validation dataset had 123 lesions and the testing dataset 374 lesions. The DL system demonstrated a sensitivity of 90% and a specificity of 70% for annotation-assisted classification of active PDR. The negative predictive value was 94%, while the positive predictive value was 57%.

Conclusions: Our DL segmentation model achieved excellent sensitivity and acceptable specificity in distinguishing active from inactive PDR.

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活动性增殖性糖尿病视网膜病变检测的深度学习分割模型。

现有的深度学习（DL）算法缺乏准确识别急需治疗的增殖性糖尿病视网膜病变（PDR）患者的能力。我们的目的是建立一个DL分割模型，通过注释新的视网膜血管和视网膜前出血来检测六视场视网膜图像中的活性PDR。方法：作为丹麦糖尿病视网膜病变（DR）筛查计划的一部分，我们确定了2009年至2019年在Funen岛收集的国际临床糖尿病视网膜病变疾病严重程度量表中分类为4级的六场视网膜图像。经过认证的评分员（评分员1）手动将图像分为活动或非活动PDR，然后由两个独立的经过认证的评分员重新评估图像。在意见不一致的情况下，最终的分类决定由一年级学生和一名二年级学生共同决定。总共有637张图像被归类为活动PDR。然后，在训练算法之前，我们应用预先建立的深度学习分割模型对9种病变类型进行标注。在训练DL算法之前，对新血管和视网膜前出血的分割进行了任何不准确的校正。经过分类和预分割阶段，将图像分为训练（70%）、验证（10%）和测试（20%）数据集。我们向测试数据集添加了301张具有非活动PDR的图像。结果：共纳入199个个体的活性PDR图像637张，非活性PDR图像301张。训练数据集中有1381个新的血管和视网膜前出血病变，而验证数据集中有123个病变，测试数据集中有374个病变。DL系统对活性PDR的注释辅助分类的灵敏度为90%，特异性为70%。阴性预测值为94%，阳性预测值为57%。结论：我们的DL分割模型在区分活性和非活性PDR方面具有良好的敏感性和可接受的特异性。

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来源期刊

Ophthalmology and Therapy OPHTHALMOLOGY-

CiteScore

4.20

自引率

3.00%

发文量

157

审稿时长

6 weeks

期刊介绍： Aims and Scope Ophthalmology and Therapy is an international, open access, peer-reviewed (single-blind), and rapid publication journal. The scope of the journal is broad and will consider all scientifically sound research from preclinical, clinical (all phases), observational, real-world, and health outcomes research around the use of ophthalmological therapies, devices, and surgical techniques. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/series, trial protocols and short communications such as commentaries and editorials. Ophthalmology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. Rapid Publication The journal’s publication timelines aim for a rapid peer review of 2 weeks. If an article is accepted it will be published 3–4 weeks from acceptance. The rapid timelines are achieved through the combination of a dedicated in-house editorial team, who manage article workflow, and an extensive Editorial and Advisory Board who assist with peer review. This allows the journal to support the rapid dissemination of research, whilst still providing robust peer review. Combined with the journal’s open access model this allows for the rapid, efficient communication of the latest research and reviews, fostering the advancement of ophthalmic therapies. Open Access All articles published by Ophthalmology and Therapy are open access. 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