Automatic detection of non-perfusion areas in diabetic macular edema from fundus fluorescein angiography for decision making using deep learning.

Journal: Scientific reports
Published Date:

Abstract

Vision loss caused by diabetic macular edema (DME) can be prevented by early detection and laser photocoagulation. As there is no comprehensive detection technique to recognize NPA, we proposed an automatic detection method of NPA on fundus fluorescein angiography (FFA) in DME. The study included 3,014 FFA images of 221 patients with DME. We use 3 convolutional neural networks (CNNs), including DenseNet, ResNet50, and VGG16, to identify non-perfusion regions (NP), microaneurysms, and leakages in FFA images. The NPA was segmented using attention U-net. To validate its performance, we applied our detection algorithm on 249 FFA images in which the NPA areas were manually delineated by 3 ophthalmologists. For DR lesion classification, area under the curve is 0.8855 for NP regions, 0.9782 for microaneurysms, and 0.9765 for leakage classifier. The average precision of NP region overlap ratio is 0.643. NP regions of DME in FFA images are identified based a new automated deep learning algorithm. This study is an in-depth study from computer-aided diagnosis to treatment, and will be the theoretical basis for the application of intelligent guided laser.

Authors

  • Kai Jin
    Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
  • Xiangji Pan
    Department of Ophthalmology, The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, 310009, China.
  • Kun You
    Merchant Marine College, Shanghai Maritime University, Shanghai 201306, China; Mechanical and Electrical Engineering, Yantai Gold College, Shandong 265400, China.
  • Jian Wu
    Department of Medical Technology, Jiangxi Medical College, Shangrao, Jiangxi, China.
  • Zhifang Liu
    Department of Ophthalmology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
  • Jing Cao
    Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, People's Republic of China.
  • Lixia Lou
    Department of Ophthalmology, College of Medicine, The Second Affiliated Hospital of Zhejiang University, Hangzhou, China.
  • Yufeng Xu
    Department of Ophthalmology, The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, 310009, China.
  • Zhaoan Su
    Department of Ophthalmology, The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, 310009, China.
  • Ke Yao
    Department of Ophthalmology, The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, 310009, China.
  • Juan Ye
    Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.