{"title":"增强病理性近视诊断:一种双峰人工智能方法,整合眼底和光学相干断层成像,用于精确的萎缩、牵引和新生血管分级。","authors":"Zhiyan Xu,Yajie Yang,Huan Chen,Ruo'an Han,Xiaoxu Han,Jianchun Zhao,Weihong Yu,Zhikun Yang,Youxin Chen","doi":"10.1136/bjo-2024-326252","DOIUrl":null,"url":null,"abstract":"BACKGROUND\r\nPathological myopia (PM) has emerged as a leading cause of global visual impairment, early detection and precise grading of PM are crucial for timely intervention. The atrophy, traction and neovascularisation (ATN) system is applied to define PM progression and stages with precision. This study focuses on constructing a comprehensive PM image dataset comprising both fundus and optical coherence tomography (OCT) images and developing a bimodal artificial intelligence (AI) classification model for ATN grading in PM.\r\n\r\nMETHODS\r\nThis single-centre retrospective cross-sectional study collected 2760 colour fundus photographs and matching OCT images of PM from January 2019 to November 2022 at Peking Union Medical College Hospital. Ophthalmology specialists labelled and inspected all paired images using the ATN grading system. The AI model used a ResNet-50 backbone and a multimodal multi-instance learning module to enhance interaction across instances from both modalities.\r\n\r\nRESULTS\r\nPerformance comparisons among single-modality fundus, OCT and bimodal AI models were conducted for ATN grading in PM. The bimodality model, dual-deep learning (DL), demonstrated superior accuracy in both detailed multiclassification and biclassification of PM, which aligns well with our observation from instance attention-weight activation maps. The area under the curve for severe PM using dual-DL was 0.9635 (95% CI 0.9380 to 0.9890), compared with 0.9359 (95% CI 0.9027 to 0.9691) for the solely OCT model and 0.9268 (95% CI 0.8915 to 0.9621) for the fundus model.\r\n\r\nCONCLUSIONS\r\nOur novel bimodal AI multiclassification model for PM ATN staging proves accurate and beneficial for public health screening and prompt referral of PM patients.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"28 1","pages":""},"PeriodicalIF":3.7000,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Enhancing pathological myopia diagnosis: a bimodal artificial intelligence approach integrating fundus and optical coherence tomography imaging for precise atrophy, traction and neovascularisation grading.\",\"authors\":\"Zhiyan Xu,Yajie Yang,Huan Chen,Ruo'an Han,Xiaoxu Han,Jianchun Zhao,Weihong Yu,Zhikun Yang,Youxin Chen\",\"doi\":\"10.1136/bjo-2024-326252\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"BACKGROUND\\r\\nPathological myopia (PM) has emerged as a leading cause of global visual impairment, early detection and precise grading of PM are crucial for timely intervention. The atrophy, traction and neovascularisation (ATN) system is applied to define PM progression and stages with precision. This study focuses on constructing a comprehensive PM image dataset comprising both fundus and optical coherence tomography (OCT) images and developing a bimodal artificial intelligence (AI) classification model for ATN grading in PM.\\r\\n\\r\\nMETHODS\\r\\nThis single-centre retrospective cross-sectional study collected 2760 colour fundus photographs and matching OCT images of PM from January 2019 to November 2022 at Peking Union Medical College Hospital. Ophthalmology specialists labelled and inspected all paired images using the ATN grading system. The AI model used a ResNet-50 backbone and a multimodal multi-instance learning module to enhance interaction across instances from both modalities.\\r\\n\\r\\nRESULTS\\r\\nPerformance comparisons among single-modality fundus, OCT and bimodal AI models were conducted for ATN grading in PM. The bimodality model, dual-deep learning (DL), demonstrated superior accuracy in both detailed multiclassification and biclassification of PM, which aligns well with our observation from instance attention-weight activation maps. The area under the curve for severe PM using dual-DL was 0.9635 (95% CI 0.9380 to 0.9890), compared with 0.9359 (95% CI 0.9027 to 0.9691) for the solely OCT model and 0.9268 (95% CI 0.8915 to 0.9621) for the fundus model.\\r\\n\\r\\nCONCLUSIONS\\r\\nOur novel bimodal AI multiclassification model for PM ATN staging proves accurate and beneficial for public health screening and prompt referral of PM patients.\",\"PeriodicalId\":9313,\"journal\":{\"name\":\"British Journal of Ophthalmology\",\"volume\":\"28 1\",\"pages\":\"\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2025-05-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"British Journal of Ophthalmology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/bjo-2024-326252\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"British Journal of Ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/bjo-2024-326252","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
病理性近视(PM)已成为全球视力损害的主要原因,PM的早期发现和精确分级对于及时干预至关重要。萎缩、牵引和新生血管(ATN)系统用于精确定义PM的进展和分期。本研究的重点是构建一个包括眼底和光学相干断层扫描(OCT)图像的综合PM图像数据集,并开发一个用于PM中ATN分级的双峰人工智能(AI)分类模型。方法本研究为单中心回顾性横断面研究,收集2019年1月至2022年11月北京协和医院PM彩色眼底照片及匹配OCT图像2760张。眼科专家使用ATN分级系统标记和检查所有配对图像。人工智能模型使用ResNet-50骨干网和多模态多实例学习模块来增强两种模态实例之间的交互。结果比较了单模态眼底、OCT和双模态AI模型对PM的ATN评分的效果。双峰模型,即双深度学习(DL),在PM的详细多分类和双分类中都表现出了卓越的准确性,这与我们从实例注意权重激活图中观察到的结果非常吻合。双dl治疗严重PM的曲线下面积为0.9635 (95% CI 0.9380 ~ 0.9890),而单纯OCT模型的曲线下面积为0.9359 (95% CI 0.9027 ~ 0.9691),眼底模型的曲线下面积为0.9268 (95% CI 0.8915 ~ 0.9621)。结论新型的双峰AI多分类PM ATN分期模型准确,有利于PM患者的公共卫生筛查和及时转诊。
Enhancing pathological myopia diagnosis: a bimodal artificial intelligence approach integrating fundus and optical coherence tomography imaging for precise atrophy, traction and neovascularisation grading.
BACKGROUND
Pathological myopia (PM) has emerged as a leading cause of global visual impairment, early detection and precise grading of PM are crucial for timely intervention. The atrophy, traction and neovascularisation (ATN) system is applied to define PM progression and stages with precision. This study focuses on constructing a comprehensive PM image dataset comprising both fundus and optical coherence tomography (OCT) images and developing a bimodal artificial intelligence (AI) classification model for ATN grading in PM.
METHODS
This single-centre retrospective cross-sectional study collected 2760 colour fundus photographs and matching OCT images of PM from January 2019 to November 2022 at Peking Union Medical College Hospital. Ophthalmology specialists labelled and inspected all paired images using the ATN grading system. The AI model used a ResNet-50 backbone and a multimodal multi-instance learning module to enhance interaction across instances from both modalities.
RESULTS
Performance comparisons among single-modality fundus, OCT and bimodal AI models were conducted for ATN grading in PM. The bimodality model, dual-deep learning (DL), demonstrated superior accuracy in both detailed multiclassification and biclassification of PM, which aligns well with our observation from instance attention-weight activation maps. The area under the curve for severe PM using dual-DL was 0.9635 (95% CI 0.9380 to 0.9890), compared with 0.9359 (95% CI 0.9027 to 0.9691) for the solely OCT model and 0.9268 (95% CI 0.8915 to 0.9621) for the fundus model.
CONCLUSIONS
Our novel bimodal AI multiclassification model for PM ATN staging proves accurate and beneficial for public health screening and prompt referral of PM patients.
期刊介绍:
The British Journal of Ophthalmology (BJO) is an international peer-reviewed journal for ophthalmologists and visual science specialists. BJO publishes clinical investigations, clinical observations, and clinically relevant laboratory investigations related to ophthalmology. It also provides major reviews and also publishes manuscripts covering regional issues in a global context.