Accuracy of a Deep Learning System for Classification of Papilledema Severity on Ocular Fundus Photographs.

Journal: Neurology
Published Date:

Abstract

OBJECTIVE: To evaluate the performance of a deep learning system (DLS) in classifying the severity of papilledema associated with increased intracranial pressure on standard retinal fundus photographs.

Authors

  • Caroline Vasseneix
    From the Singapore National Eye Center (D.M., D.T., S.S., C.-Y.C., T.Y.W.), Singapore Eye Research Institute (D.M., R.P.N., D.T., C.V., S.S., C.-Y.C., T.Y.W.), Duke-NUS Medical School (D.M., R.P.N., D.T., S.S., C.-Y.C., T.Y.W.), Institute of High Performance Computing, Agency for Science, Technology, and Research (J.Z., X.X., Y.L.), and Yong Loo Lin School of Medicine, National University of Singapore (S.S., T.Y.W.) - all in Singapore; Farabi Eye Hospital, Tehran University of Medical Science, Tehran, Iran (M.A.F.); the Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra, and the Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal (P.F.); the Department of Ophthalmology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (K.V.); the Eye Center, Medical Center, University of Freiburg, Freiburg (W.A.L.), and the Department of Ophthalmology, Ruprecht Karl University of Heidelberg, Mannheim (J.B.J.) - both in Germany; IRCCS Istituto delle Scienze Neurologiche di Bologna, Unità Operativa Complessa Clinica Neurologica, and Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy (C.L.M.); the Department of Ophthalmology and Visual Sciences, Chinese University of Hong Kong, Hong Kong (C.Y.C.), and Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou (H.Y.) - both in China; the Department of Ophthalmology, Rigshospitalet, University of Copenhagen, Glostrup, Denmark (S.H.); the Department of Ophthalmology, University Hospital of Grenoble-Alpes, and Grenoble-Alpes University, HP2 Laboratory, INSERM Unité 1042, Grenoble (C.C.), Service d'Ophtalmologie, Unité Rétine-Uvéites-Neuro-Ophtalmologie, Hôpital Pellegrin, Centre Hospitalier Universitaire de Bordeaux, Bordeaux (M.-B.R.), the Department of Ophthalmology, Lille Catholic Hospital, Lille Catholic University, and INSERM Unité 1171, Lille (T.T.H.C.), the Department of Ophthalmology, University Hospital Angers, Angers (P.G.), and Rothschild Foundation Hospital, Paris (C.C.-V.) - all in France; the Department of Clinical Neurosciences, Geneva University Hospital, Geneva (N.S.); the Department of Neurology, SUNY Upstate Medical University, Syracuse, NY (L.J.M.); the American Eye Center, Mandaluyong City, Philippines (R.K.); Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, University College London, London (P.Y.-W.-M.), and Cambridge Eye Unit, Addenbrooke's Hospital, Cambridge University Hospitals, and Cambridge Centre for Brain Repair and Medical Research Council Mitochondrial Biology Unit, Department of Clinical Neurosciences, University of Cambridge, Cambridge (P.Y.-W.-M.) - all in the United Kingdom; the Save Sight Institute, Faculty of Health and Medicine, University of Sydney, Sydney (C.L.F.); the Department of Ophthalmology and Neurology, Mayo Clinic, Rochester, MN (J.J.C.); the Department of Neuro-ophthalmology, Sankara Nethralaya, Medical Research Foundation, Chennai, India (S.A.); the Departments of Ophthalmology, Neurology, and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore (N.R.M.); and the Departments of Ophthalmology and Neurology, Emory University School of Medicine, Atlanta (N.J.N., V.B.).
  • Raymond P Najjar
    Singapore Eye Research Institute.
  • Xinxing Xu
    A*STAR, Singapore, Singapore.
  • Zhiqun Tang
    Visual Neuroscience Group, Singapore Eye Research Institute, Singapore.
  • Jing Liang Loo
    From the Singapore Eye Research Institute (C.V., R.P.N., Z.T., J.L.L., S.S., S.T., D.S.W.T., T.Y.W., D.M.); Duke-NUS Medical School (R.P.N., J.L.L., S.S., S.T., T.Y.W., D.M.); Institute of High Performance Computing (X.X., Y.L.), Agency for Science, Technology and Research (A*STAR); Singapore National Eye Centre (J.L.L., S.S., S.T., D.S.W.T., T.Y.W., D.M.); University of Berkeley (L.M.), CA; Departments of Ophthalmology and Neurology (N.J.N., V.B.), Emory University School of Medicine, Atlanta, GA; and Copenhagen University Hospital (D.M.), Denmark.
  • Shweta Singhal
    Singapore National Eye Centre.
  • Sharon Tow
    From the Singapore Eye Research Institute (C.V., R.P.N., Z.T., J.L.L., S.S., S.T., D.S.W.T., T.Y.W., D.M.); Duke-NUS Medical School (R.P.N., J.L.L., S.S., S.T., T.Y.W., D.M.); Institute of High Performance Computing (X.X., Y.L.), Agency for Science, Technology and Research (A*STAR); Singapore National Eye Centre (J.L.L., S.S., S.T., D.S.W.T., T.Y.W., D.M.); University of Berkeley (L.M.), CA; Departments of Ophthalmology and Neurology (N.J.N., V.B.), Emory University School of Medicine, Atlanta, GA; and Copenhagen University Hospital (D.M.), Denmark.
  • Leonard Milea
    From the Singapore Eye Research Institute (C.V., R.P.N., Z.T., J.L.L., S.S., S.T., D.S.W.T., T.Y.W., D.M.); Duke-NUS Medical School (R.P.N., J.L.L., S.S., S.T., T.Y.W., D.M.); Institute of High Performance Computing (X.X., Y.L.), Agency for Science, Technology and Research (A*STAR); Singapore National Eye Centre (J.L.L., S.S., S.T., D.S.W.T., T.Y.W., D.M.); University of Berkeley (L.M.), CA; Departments of Ophthalmology and Neurology (N.J.N., V.B.), Emory University School of Medicine, Atlanta, GA; and Copenhagen University Hospital (D.M.), Denmark. dan.milea@snec.com.sg.
  • Daniel Shu Wei Ting
    Singapore National Eye Center, Singapore Eye Research Institute Singapore Health Service Singapore Singapore.
  • Yong Liu
    Department of Critical care medicine, Shenzhen Hospital, Southern Medical University, Guangdong, Shenzhen, China.
  • Tien Y Wong
    Singapore National Eye Center, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore.
  • Nancy J Newman
    From the Singapore National Eye Center (D.M., D.T., S.S., C.-Y.C., T.Y.W.), Singapore Eye Research Institute (D.M., R.P.N., D.T., C.V., S.S., C.-Y.C., T.Y.W.), Duke-NUS Medical School (D.M., R.P.N., D.T., S.S., C.-Y.C., T.Y.W.), Institute of High Performance Computing, Agency for Science, Technology, and Research (J.Z., X.X., Y.L.), and Yong Loo Lin School of Medicine, National University of Singapore (S.S., T.Y.W.) - all in Singapore; Farabi Eye Hospital, Tehran University of Medical Science, Tehran, Iran (M.A.F.); the Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra, and the Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal (P.F.); the Department of Ophthalmology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (K.V.); the Eye Center, Medical Center, University of Freiburg, Freiburg (W.A.L.), and the Department of Ophthalmology, Ruprecht Karl University of Heidelberg, Mannheim (J.B.J.) - both in Germany; IRCCS Istituto delle Scienze Neurologiche di Bologna, Unità Operativa Complessa Clinica Neurologica, and Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy (C.L.M.); the Department of Ophthalmology and Visual Sciences, Chinese University of Hong Kong, Hong Kong (C.Y.C.), and Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou (H.Y.) - both in China; the Department of Ophthalmology, Rigshospitalet, University of Copenhagen, Glostrup, Denmark (S.H.); the Department of Ophthalmology, University Hospital of Grenoble-Alpes, and Grenoble-Alpes University, HP2 Laboratory, INSERM Unité 1042, Grenoble (C.C.), Service d'Ophtalmologie, Unité Rétine-Uvéites-Neuro-Ophtalmologie, Hôpital Pellegrin, Centre Hospitalier Universitaire de Bordeaux, Bordeaux (M.-B.R.), the Department of Ophthalmology, Lille Catholic Hospital, Lille Catholic University, and INSERM Unité 1171, Lille (T.T.H.C.), the Department of Ophthalmology, University Hospital Angers, Angers (P.G.), and Rothschild Foundation Hospital, Paris (C.C.-V.) - all in France; the Department of Clinical Neurosciences, Geneva University Hospital, Geneva (N.S.); the Department of Neurology, SUNY Upstate Medical University, Syracuse, NY (L.J.M.); the American Eye Center, Mandaluyong City, Philippines (R.K.); Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, University College London, London (P.Y.-W.-M.), and Cambridge Eye Unit, Addenbrooke's Hospital, Cambridge University Hospitals, and Cambridge Centre for Brain Repair and Medical Research Council Mitochondrial Biology Unit, Department of Clinical Neurosciences, University of Cambridge, Cambridge (P.Y.-W.-M.) - all in the United Kingdom; the Save Sight Institute, Faculty of Health and Medicine, University of Sydney, Sydney (C.L.F.); the Department of Ophthalmology and Neurology, Mayo Clinic, Rochester, MN (J.J.C.); the Department of Neuro-ophthalmology, Sankara Nethralaya, Medical Research Foundation, Chennai, India (S.A.); the Departments of Ophthalmology, Neurology, and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore (N.R.M.); and the Departments of Ophthalmology and Neurology, Emory University School of Medicine, Atlanta (N.J.N., V.B.).
  • Valérie Biousse
    From the Singapore National Eye Center (D.M., D.T., S.S., C.-Y.C., T.Y.W.), Singapore Eye Research Institute (D.M., R.P.N., D.T., C.V., S.S., C.-Y.C., T.Y.W.), Duke-NUS Medical School (D.M., R.P.N., D.T., S.S., C.-Y.C., T.Y.W.), Institute of High Performance Computing, Agency for Science, Technology, and Research (J.Z., X.X., Y.L.), and Yong Loo Lin School of Medicine, National University of Singapore (S.S., T.Y.W.) - all in Singapore; Farabi Eye Hospital, Tehran University of Medical Science, Tehran, Iran (M.A.F.); the Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra, and the Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal (P.F.); the Department of Ophthalmology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (K.V.); the Eye Center, Medical Center, University of Freiburg, Freiburg (W.A.L.), and the Department of Ophthalmology, Ruprecht Karl University of Heidelberg, Mannheim (J.B.J.) - both in Germany; IRCCS Istituto delle Scienze Neurologiche di Bologna, Unità Operativa Complessa Clinica Neurologica, and Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy (C.L.M.); the Department of Ophthalmology and Visual Sciences, Chinese University of Hong Kong, Hong Kong (C.Y.C.), and Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou (H.Y.) - both in China; the Department of Ophthalmology, Rigshospitalet, University of Copenhagen, Glostrup, Denmark (S.H.); the Department of Ophthalmology, University Hospital of Grenoble-Alpes, and Grenoble-Alpes University, HP2 Laboratory, INSERM Unité 1042, Grenoble (C.C.), Service d'Ophtalmologie, Unité Rétine-Uvéites-Neuro-Ophtalmologie, Hôpital Pellegrin, Centre Hospitalier Universitaire de Bordeaux, Bordeaux (M.-B.R.), the Department of Ophthalmology, Lille Catholic Hospital, Lille Catholic University, and INSERM Unité 1171, Lille (T.T.H.C.), the Department of Ophthalmology, University Hospital Angers, Angers (P.G.), and Rothschild Foundation Hospital, Paris (C.C.-V.) - all in France; the Department of Clinical Neurosciences, Geneva University Hospital, Geneva (N.S.); the Department of Neurology, SUNY Upstate Medical University, Syracuse, NY (L.J.M.); the American Eye Center, Mandaluyong City, Philippines (R.K.); Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, University College London, London (P.Y.-W.-M.), and Cambridge Eye Unit, Addenbrooke's Hospital, Cambridge University Hospitals, and Cambridge Centre for Brain Repair and Medical Research Council Mitochondrial Biology Unit, Department of Clinical Neurosciences, University of Cambridge, Cambridge (P.Y.-W.-M.) - all in the United Kingdom; the Save Sight Institute, Faculty of Health and Medicine, University of Sydney, Sydney (C.L.F.); the Department of Ophthalmology and Neurology, Mayo Clinic, Rochester, MN (J.J.C.); the Department of Neuro-ophthalmology, Sankara Nethralaya, Medical Research Foundation, Chennai, India (S.A.); the Departments of Ophthalmology, Neurology, and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore (N.R.M.); and the Departments of Ophthalmology and Neurology, Emory University School of Medicine, Atlanta (N.J.N., V.B.).
  • Dan Milea
    Singapore National Eye Centre.