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Published in: Ophthalmology and Therapy 1/2024

Open Access 13-11-2023 | Refractive Errors | ORIGINAL RESEARCH

Deep Transfer Learning for Ethnically Distinct Populations: Prediction of Refractive Error Using Optical Coherence Tomography

Authors: Rishabh Jain, Tae Keun Yoo, Ik Hee Ryu, Joanna Song, Nitin Kolte, Ashiyana Nariani

Published in: Ophthalmology and Therapy | Issue 1/2024

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Abstract

Introduction

The mismatch between training and testing data distribution causes significant degradation in the deep learning model performance in multi-ethnic scenarios. To reduce the performance differences between ethnic groups and image domains, we built a deep transfer learning model with adaptation training to predict uncorrected refractive errors using posterior segment optical coherence tomography (OCT) images of the macula and optic nerve.

Methods

Observational, cross-sectional, multicenter study design. We pre-trained a deep learning model on OCT images from the B&VIIT Eye Center (Seoul, South Korea) (N = 2602 eyes of 1301 patients). OCT images from Poona Eye Care (Pune, India) were chronologically sorted into adaptation training data (N = 60 eyes of 30 patients) for transfer learning and test data (N = 142 eyes of 71 patients) for validation. Deep learning models were trained to predict spherical equivalent (SE) and mean keratometry (K) values via transfer learning for domain adaptation.

Results

Both adaptation models for SE and K were significantly better than those without adaptation (P < 0.001). In myopia/hyperopia classification, the model trained on circular optic disc OCT images yielded the best performance (accuracy = 74.7%). It also performed best in estimating SE with the lowest mean absolute error (MAE) of 1.58 D. For classifying the degree of corneal curvature, the optic nerve vertical algorithm performed best (accuracy = 65.7%). The optic nerve horizontal model achieved the lowest MAE (1.85 D) when predicting the K value. Saliency maps frequently highlighted the retinal nerve fiber layers.

Conclusions

Adaptation training via transfer learning is an effective technique for estimating refractive errors and K values using macular and optic nerve OCT images from ethnically heterogeneous populations. Further studies with larger sample sizes and various data sources are needed to confirm the feasibility of the proposed algorithm.
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Literature
1.
2.
go back to reference Gulshan V, Peng L, Coram M, Stumpe MC, Wu D, Narayanaswamy A, et al. Development and validation of a deep learning algorithm for detection of diabetic retinopathy in retinal fundus photographs. JAMA. 2016;316:2402–10.CrossRefPubMed Gulshan V, Peng L, Coram M, Stumpe MC, Wu D, Narayanaswamy A, et al. Development and validation of a deep learning algorithm for detection of diabetic retinopathy in retinal fundus photographs. JAMA. 2016;316:2402–10.CrossRefPubMed
3.
go back to reference De Fauw J, Ledsam JR, Romera-Paredes B, Nikolov S, Tomasev N, Blackwell S, et al. Clinically applicable deep learning for diagnosis and referral in retinal disease. Nat Med. 2018;24:1342–50.CrossRefPubMed De Fauw J, Ledsam JR, Romera-Paredes B, Nikolov S, Tomasev N, Blackwell S, et al. Clinically applicable deep learning for diagnosis and referral in retinal disease. Nat Med. 2018;24:1342–50.CrossRefPubMed
6.
go back to reference Ho H, Tham Y-C, Chee ML, Shi Y, Tan NYQ, Wong K-H, et al. Retinal nerve fiber layer thickness in a multiethnic normal Asian population: the Singapore epidemiology of eye diseases study. Ophthalmology. 2019;126:702–11.CrossRefPubMed Ho H, Tham Y-C, Chee ML, Shi Y, Tan NYQ, Wong K-H, et al. Retinal nerve fiber layer thickness in a multiethnic normal Asian population: the Singapore epidemiology of eye diseases study. Ophthalmology. 2019;126:702–11.CrossRefPubMed
7.
go back to reference Weiss K, Khoshgoftaar TM, Wang D. A survey of transfer learning. J Big Data. 2016;3:9.CrossRef Weiss K, Khoshgoftaar TM, Wang D. A survey of transfer learning. J Big Data. 2016;3:9.CrossRef
8.
go back to reference Wang R, Chaudhari P, Davatzikos C. Embracing the disharmony in medical imaging: a simple and effective framework for domain adaptation. Med Image Anal. 2022;76: 102309.CrossRefPubMed Wang R, Chaudhari P, Davatzikos C. Embracing the disharmony in medical imaging: a simple and effective framework for domain adaptation. Med Image Anal. 2022;76: 102309.CrossRefPubMed
10.
go back to reference Yoo TK, Kim SH, Kim M, Lee CS, Byeon SH, Kim SS, et al. DeepPDT-Net: predicting the outcome of photodynamic therapy for chronic central serous chorioretinopathy using two-stage multimodal transfer learning. Sci Rep. 2022;12:18689.CrossRefPubMedPubMedCentral Yoo TK, Kim SH, Kim M, Lee CS, Byeon SH, Kim SS, et al. DeepPDT-Net: predicting the outcome of photodynamic therapy for chronic central serous chorioretinopathy using two-stage multimodal transfer learning. Sci Rep. 2022;12:18689.CrossRefPubMedPubMedCentral
11.
go back to reference Naidoo KS, Leasher J, Bourne RR, Flaxman SR, Jonas JB, Keeffe J, et al. Global vision impairment and blindness due to uncorrected refractive error, 1990–2010. Optom Vis Sci. 2016;93:227.CrossRefPubMed Naidoo KS, Leasher J, Bourne RR, Flaxman SR, Jonas JB, Keeffe J, et al. Global vision impairment and blindness due to uncorrected refractive error, 1990–2010. Optom Vis Sci. 2016;93:227.CrossRefPubMed
12.
go back to reference Burton MJ, Ramke J, Marques AP, Bourne RRA, Congdon N, Jones I, et al. The Lancet Global Health Commission on global eye health: vision beyond 2020. Lancet Glob Health. 2021;9:e489-551.CrossRefPubMedPubMedCentral Burton MJ, Ramke J, Marques AP, Bourne RRA, Congdon N, Jones I, et al. The Lancet Global Health Commission on global eye health: vision beyond 2020. Lancet Glob Health. 2021;9:e489-551.CrossRefPubMedPubMedCentral
13.
go back to reference Shen L, Melles RB, Metlapally R, Barcellos L, Schaefer C, Risch N, et al. The association of refractive error with glaucoma in a multiethnic population. Ophthalmology. 2016;123:92–101.CrossRefPubMed Shen L, Melles RB, Metlapally R, Barcellos L, Schaefer C, Risch N, et al. The association of refractive error with glaucoma in a multiethnic population. Ophthalmology. 2016;123:92–101.CrossRefPubMed
14.
go back to reference Avila MP, Weiter JJ, Jalkh AE, Trempe CL, Pruett RC, Schepens CL. Natural history of choroidal neovascularization in degenerative myopia. Ophthalmology. 1984;91:1573–81.CrossRefPubMed Avila MP, Weiter JJ, Jalkh AE, Trempe CL, Pruett RC, Schepens CL. Natural history of choroidal neovascularization in degenerative myopia. Ophthalmology. 1984;91:1573–81.CrossRefPubMed
15.
go back to reference Sunness JS, El Annan J. Improvement of visual acuity by refraction in a low-vision population. Ophthalmology. 2010;117:1442–6.CrossRefPubMed Sunness JS, El Annan J. Improvement of visual acuity by refraction in a low-vision population. Ophthalmology. 2010;117:1442–6.CrossRefPubMed
16.
go back to reference Varadarajan AV, Poplin R, Blumer K, Angermueller C, Ledsam J, Chopra R, et al. Deep learning for predicting refractive error from retinal fundus images. Invest Ophthalmol Vis Sci. 2018;59:2861–8.CrossRefPubMed Varadarajan AV, Poplin R, Blumer K, Angermueller C, Ledsam J, Chopra R, et al. Deep learning for predicting refractive error from retinal fundus images. Invest Ophthalmol Vis Sci. 2018;59:2861–8.CrossRefPubMed
17.
go back to reference Luft N, Siedlecki J, Reinking F, Mayer WJ, Schworm B, Kassumeh S, et al. Impact of extreme (flat and steep) keratometry on the safety and efficacy of small incision lenticule extraction (SMILE). Sci Rep. 2021;11:17854.CrossRefPubMedPubMedCentral Luft N, Siedlecki J, Reinking F, Mayer WJ, Schworm B, Kassumeh S, et al. Impact of extreme (flat and steep) keratometry on the safety and efficacy of small incision lenticule extraction (SMILE). Sci Rep. 2021;11:17854.CrossRefPubMedPubMedCentral
18.
go back to reference Reitblat O, Levy A, Kleinmann G, Lerman TT, Assia EI. Intraocular lens power calculation for eyes with high and low average keratometry readings: comparison between various formulas. J Cataract Refract Surg. 2017;43:1149–56.CrossRefPubMed Reitblat O, Levy A, Kleinmann G, Lerman TT, Assia EI. Intraocular lens power calculation for eyes with high and low average keratometry readings: comparison between various formulas. J Cataract Refract Surg. 2017;43:1149–56.CrossRefPubMed
19.
go back to reference Wang J, Deng G, Li W, Chen Y, Gao F, Liu H, et al. Deep learning for quality assessment of retinal OCT images. Biomed Opt Express BOE. 2019;10:6057–72.CrossRefPubMed Wang J, Deng G, Li W, Chen Y, Gao F, Liu H, et al. Deep learning for quality assessment of retinal OCT images. Biomed Opt Express BOE. 2019;10:6057–72.CrossRefPubMed
20.
go back to reference Choi KJ, Choi JE, Roh HC, Eun JS, Kim JM, Shin YK, et al. Deep learning models for screening of high myopia using optical coherence tomography. Sci Rep. 2021;11:21663.CrossRefPubMedPubMedCentral Choi KJ, Choi JE, Roh HC, Eun JS, Kim JM, Shin YK, et al. Deep learning models for screening of high myopia using optical coherence tomography. Sci Rep. 2021;11:21663.CrossRefPubMedPubMedCentral
21.
go back to reference Choi JY, Yoo TK, Seo JG, Kwak J, Um TT, Rim TH. Multi-categorical deep learning neural network to classify retinal images: a pilot study employing small database. PLoS ONE. 2017;12: e0187336.CrossRefPubMedPubMedCentral Choi JY, Yoo TK, Seo JG, Kwak J, Um TT, Rim TH. Multi-categorical deep learning neural network to classify retinal images: a pilot study employing small database. PLoS ONE. 2017;12: e0187336.CrossRefPubMedPubMedCentral
22.
go back to reference Fluss R, Faraggi D, Reiser B. Estimation of the Youden Index and its associated cutoff point. Biom J. 2005;47:458–72.CrossRefPubMed Fluss R, Faraggi D, Reiser B. Estimation of the Youden Index and its associated cutoff point. Biom J. 2005;47:458–72.CrossRefPubMed
23.
go back to reference Yoo TK, Choi JY, Kim HK, Ryu IH, Kim JK. Adopting low-shot deep learning for the detection of conjunctival melanoma using ocular surface images. Comput Methods Progr Biomed. 2021;205: 106086.CrossRef Yoo TK, Choi JY, Kim HK, Ryu IH, Kim JK. Adopting low-shot deep learning for the detection of conjunctival melanoma using ocular surface images. Comput Methods Progr Biomed. 2021;205: 106086.CrossRef
24.
go back to reference Chicco D, Warrens MJ, Jurman G. The Matthews correlation coefficient (MCC) is more informative than Cohen’s Kappa and brier score in binary classification assessment. IEEE Access. 2021;9:78368–81.CrossRef Chicco D, Warrens MJ, Jurman G. The Matthews correlation coefficient (MCC) is more informative than Cohen’s Kappa and brier score in binary classification assessment. IEEE Access. 2021;9:78368–81.CrossRef
26.
go back to reference Huang D, Qian Y, Yan Q, Ling S, Dong Z, Ke X, et al. Prevalence of fundus tessellation and its screening based on artificial intelligence in Chinese children: the Nanjing Eye Study. Ophthalmol Ther. 2023;12:2671–85.CrossRefPubMedPubMedCentral Huang D, Qian Y, Yan Q, Ling S, Dong Z, Ke X, et al. Prevalence of fundus tessellation and its screening based on artificial intelligence in Chinese children: the Nanjing Eye Study. Ophthalmol Ther. 2023;12:2671–85.CrossRefPubMedPubMedCentral
27.
go back to reference Yoo TK, Ryu IH, Kim JK, Lee IS. Deep learning for predicting uncorrected refractive error using posterior segment optical coherence tomography images. Eye. 2022;36:1959–65.CrossRefPubMed Yoo TK, Ryu IH, Kim JK, Lee IS. Deep learning for predicting uncorrected refractive error using posterior segment optical coherence tomography images. Eye. 2022;36:1959–65.CrossRefPubMed
28.
go back to reference Rim TH, Lee AY, Ting DS, Teo K, Betzler BK, Teo ZL, et al. Detection of features associated with neovascular age-related macular degeneration in ethnically distinct data sets by an optical coherence tomography: trained deep learning algorithm. Br J Ophthalmol. 2021;105:1133–9.CrossRefPubMed Rim TH, Lee AY, Ting DS, Teo K, Betzler BK, Teo ZL, et al. Detection of features associated with neovascular age-related macular degeneration in ethnically distinct data sets by an optical coherence tomography: trained deep learning algorithm. Br J Ophthalmol. 2021;105:1133–9.CrossRefPubMed
29.
go back to reference Willemink MJ, Roth HR, Sandfort V. Toward foundational deep learning models for medical imaging in the new era of transformer networks. Radiol Artif Intell. 2022;4: e210284.CrossRefPubMedPubMedCentral Willemink MJ, Roth HR, Sandfort V. Toward foundational deep learning models for medical imaging in the new era of transformer networks. Radiol Artif Intell. 2022;4: e210284.CrossRefPubMedPubMedCentral
30.
go back to reference Dogan E, Akbas Kocaoglu F, Yalniz-Akkaya Z, Elbeyli A, Burcu A, Ornek F. Scheimpflug imaging in dermatochalasis patients before and after upper eyelid blepharoplasty. Semin Ophthalmol. 2015;30:193–6.CrossRefPubMed Dogan E, Akbas Kocaoglu F, Yalniz-Akkaya Z, Elbeyli A, Burcu A, Ornek F. Scheimpflug imaging in dermatochalasis patients before and after upper eyelid blepharoplasty. Semin Ophthalmol. 2015;30:193–6.CrossRefPubMed
31.
go back to reference Flitcroft DI. The complex interactions of retinal, optical and environmental factors in myopia aetiology. Prog Retin Eye Res. 2012;31:622–60.CrossRefPubMed Flitcroft DI. The complex interactions of retinal, optical and environmental factors in myopia aetiology. Prog Retin Eye Res. 2012;31:622–60.CrossRefPubMed
32.
go back to reference Sung MS, Heo H, Piao H, Guo Y, Park SW. Parapapillary atrophy and changes in the optic nerve head and posterior pole in high myopia. Sci Rep. 2020;10:4607.CrossRefPubMedPubMedCentral Sung MS, Heo H, Piao H, Guo Y, Park SW. Parapapillary atrophy and changes in the optic nerve head and posterior pole in high myopia. Sci Rep. 2020;10:4607.CrossRefPubMedPubMedCentral
33.
34.
go back to reference Jonas JB, Holbach L, Panda-Jonas S. Bruch’s membrane thickness in high myopia. Acta Ophthalmol. 2014;92:e470-474.CrossRefPubMed Jonas JB, Holbach L, Panda-Jonas S. Bruch’s membrane thickness in high myopia. Acta Ophthalmol. 2014;92:e470-474.CrossRefPubMed
Metadata
Title
Deep Transfer Learning for Ethnically Distinct Populations: Prediction of Refractive Error Using Optical Coherence Tomography
Authors
Rishabh Jain
Tae Keun Yoo
Ik Hee Ryu
Joanna Song
Nitin Kolte
Ashiyana Nariani
Publication date
13-11-2023
Publisher
Springer Healthcare
Published in
Ophthalmology and Therapy / Issue 1/2024
Print ISSN: 2193-8245
Electronic ISSN: 2193-6528
DOI
https://doi.org/10.1007/s40123-023-00842-6

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