Radial polarisation patterns identify macular damage: a machine learning approach.

Clinical relevance: Identifying polarisation-modulated patterns may be an effective method for both detecting and monitoring macular damage.

Background: The aim of this work is to determine the effectiveness of polarisation-modulated patterns in identifying macular damage and foveolar involvement using a methodology that involved feature selection, Naïve Bayes supervised machine learning, cross validation, and use of an interpretable nomogram.

Methods: A cross-sectional study involving 520 eyes was undertaken, encompassing both normal and abnormal cases, including those with age-related macular disease, diabetic retinopathy or epiretinal membrane. Macular damage and foveolar integrity were assessed using optical coherence tomography. Various polarisation-modulated geometrical and optotype patterns were employed, along with traditional methods for visual function measurement, to complete perceptual detection and identification measures. Other variables assessed included age, sex, eye (right, left) and ocular media (normal, pseudophakic, cataract). Redundant variables were removed using a Fast Correlation-Based Filter. The area under the receiver operating characteristic curve and Matthews correlation coefficient were calculated, following 5-fold stratified cross validation, for Naïve Bayes models describing the relationship between the selected predictors of macular damage and foveolar involvement.

Results: Only radially structured polarisation-modulated patterns and age emerged as predictors of macular damage and foveolar involvement. All other variables, including traditional logMAR measures of visual acuity, were identified as redundant. Naïve Bayes, utilising the Fast Correlation-Based Filter selected features, provided a good prediction for macular damage and foveolar involvement, with an area under the receiver operating curve exceeding 0.7. Additionally, Matthews correlation coefficient showed a medium size effect for both conditions.

Conclusions: Radially structured polarisation-modulated geometric patterns outperform polarisation-modulated optotypes and standard logMAR acuity measures in predicting macular damage, regardless of foveolar involvement.