Model-to-Data Approach for Deep Learning in Optical Coherence Tomography Intraretinal Fluid Segmentation

JAMA Ophthalmol. 2020 Oct 1;138(10):1017-1024. doi: 10.1001/jamaophthalmol.2020.2769.

Abstract

Importance: Amid an explosion of interest in deep learning in medicine, including within ophthalmology, concerns regarding data privacy, security, and sharing are of increasing importance. A model-to-data approach, in which the model itself is transferred rather than data, can circumvent many of these challenges but has not been previously demonstrated in ophthalmology.

Objective: To determine whether a model-to-data deep learning approach (ie, validation of the algorithm without any data transfer) can be applied in ophthalmology.

Design, setting, and participants: This single-center cross-sectional study included patients with active exudative age-related macular degeneration undergoing optical coherence tomography (OCT) at the New England Eye Center from August 1, 2018, to February 28, 2019. Data were primarily analyzed from March 1 to June 20, 2019.

Main outcomes and measures: Training of the deep learning model, using a model-to-data approach, in recognizing intraretinal fluid (IRF) on OCT B-scans.

Results: The model was trained (learning curve Dice coefficient, >80%) using 400 OCT B-scans from 128 participants (69 female [54%] and 59 male [46%]; mean [SD] age, 77.5 [9.1] years). In comparing the model with manual human grading of IRF pockets, no statistically significant difference in Dice coefficients or intersection over union scores was found (P > .05).

Conclusions and relevance: A model-to-data approach to deep learning applied in ophthalmology avoided many of the traditional hurdles in large-scale deep learning, including data sharing, security, and privacy concerns. Although the clinical relevance of these results is limited at this time, this proof-of-concept study suggests that such a paradigm should be further examined in larger-scale, multicenter deep learning studies.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Algorithms
  • Cross-Sectional Studies
  • Deep Learning*
  • Female
  • Humans
  • Male
  • Neural Networks, Computer*
  • Reproducibility of Results
  • Subretinal Fluid / diagnostic imaging*
  • Tomography, Optical Coherence / methods*
  • Wet Macular Degeneration / diagnosis*