Estimation of current and post-treatment retinal function in chronic central serous chorioretinopathy using artificial intelligence.

Journal: Scientific reports
Published Date:

Abstract

Refined understanding of the association of retinal microstructure with current and future (post-treatment) function in chronic central serous chorioretinopathy (cCSC) may help to identify patients that would benefit most from treatment. In this post-hoc analysis of data from the prospective, randomized PLACE trial (NCT01797861), we aimed to determine the accuracy of AI-based inference of retinal function from retinal morphology in cCSC. Longitudinal spectral-domain optical coherence tomography (SD-OCT) data from 57 eyes of 57 patients from baseline, week 6-8 and month 7-8 post-treatment were segmented using deep-learning software. Fundus-controlled perimetry data were aligned to the SD-OCT data to extract layer thickness and reflectivity values for each test point. Point-wise retinal sensitivity could be inferred with a (leave-one-out) cross-validated mean absolute error (MAE) [95% CI] of 2.93 dB [2.40-3.46] (scenario 1) using random forest regression. With addition of patient-specific baseline data (scenario 2), retinal sensitivity at remaining follow-up visits was estimated even more accurately with a MAE of 1.07 dB [1.06-1.08]. In scenario 3, month 7-8 post-treatment retinal sensitivity was predicted from baseline SD-OCT data with a MAE of 3.38 dB [2.82-3.94]. Our study shows that localized retinal sensitivity can be inferred from retinal structure in cCSC using machine-learning. Especially, prediction of month 7-8 post-treatment sensitivity with consideration of the treatment as explanatory variable constitutes an important step toward personalized treatment decisions in cCSC.

Authors

  • Maximilian Pfau
    Department of Ophthalmology, University of Bonn, Bonn, Germany; GRADE Reading Center, Bonn, Germany; Department of Biomedical Data Science, Stanford University, Stanford, California, USA.
  • Elon H C van Dijk
    Department of Ophthalmology, Leiden University Medical Center, P. O. Box 9600, 2300 RC, Leiden, The Netherlands.
  • Thomas J van Rijssen
    Department of Ophthalmology, Leiden University Medical Center, P. O. Box 9600, 2300 RC, Leiden, The Netherlands.
  • Steffen Schmitz-Valckenberg
    Department of Ophthalmology, University of Bonn, Bonn, Germany; GRADE Reading Center, Bonn, Germany; John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. Electronic address: Steffen.schmitz-valckenberg@ukbonn.de.
  • Frank G Holz
    Department of Ophthalmology, University of Bonn, Bonn, Germany.
  • Monika Fleckenstein
    Department of Ophthalmology, University of Bonn, Bonn, Germany; GRADE Reading Center, Bonn, Germany; John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA.
  • Camiel J F Boon
    Department of Ophthalmology, Leiden University Medical Center, P. O. Box 9600, 2300 RC, Leiden, The Netherlands. cjfboon@hotmail.com.