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Am J Ophthalmol ; 226: 1-12, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-33422464

RESUMEN

PURPOSE: We sought to develop and validate a deep learning model for segmentation of 13 features associated with neovascular and atrophic age-related macular degeneration (AMD). DESIGN: Development and validation of a deep-learning model for feature segmentation. METHODS: Data for model development were obtained from 307 optical coherence tomography volumes. Eight experienced graders manually delineated all abnormalities in 2712 B-scans. A deep neural network was trained with these data to perform voxel-level segmentation of the 13 most common abnormalities (features). For evaluation, 112 B-scans from 112 patients with a diagnosis of neovascular AMD were annotated by 4 independent observers. The main outcome measures were Dice score, intraclass correlation coefficient, and free-response receiver operating characteristic curve. RESULTS: On 11 of 13 features, the model obtained a mean Dice score of 0.63 ± 0.15, compared with 0.61 ± 0.17 for the observers. The mean intraclass correlation coefficient for the model was 0.66 ± 0.22, compared with 0.62 ± 0.21 for the observers. Two features were not evaluated quantitatively because of a lack of data. Free-response receiver operating characteristic analysis demonstrated that the model scored similar or higher sensitivity per false positives compared with the observers. CONCLUSIONS: The quality of the automatic segmentation matches that of experienced graders for most features, exceeding human performance for some features. The quantified parameters provided by the model can be used in the current clinical routine and open possibilities for further research into treatment response outside clinical trials.


Asunto(s)
Neovascularización Coroidal/diagnóstico por imagen , Aprendizaje Profundo , Atrofia Geográfica/diagnóstico por imagen , Drusas Retinianas/diagnóstico por imagen , Degeneración Macular Húmeda/diagnóstico por imagen , Anciano , Anciano de 80 o más Años , Inhibidores de la Angiogénesis/uso terapéutico , Neovascularización Coroidal/tratamiento farmacológico , Neovascularización Coroidal/fisiopatología , Femenino , Atrofia Geográfica/tratamiento farmacológico , Atrofia Geográfica/fisiopatología , Humanos , Inyecciones Intravítreas , Masculino , Persona de Mediana Edad , Modelos Estadísticos , Redes Neurales de la Computación , Curva ROC , Ranibizumab/uso terapéutico , Receptores de Factores de Crecimiento Endotelial Vascular/uso terapéutico , Proteínas Recombinantes de Fusión/uso terapéutico , Drusas Retinianas/tratamiento farmacológico , Drusas Retinianas/fisiopatología , Sensibilidad y Especificidad , Tomografía de Coherencia Óptica , Factor A de Crecimiento Endotelial Vascular/antagonistas & inhibidores , Agudeza Visual/fisiología , Degeneración Macular Húmeda/tratamiento farmacológico , Degeneración Macular Húmeda/fisiopatología
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