医学
激光矫视
圆锥角膜
眼科
验光服务
折射误差
角膜地形图
人工智能
角膜
眼病
计算机科学
作者
Yi Xie,Lanqin Zhao,Xiaonan Yang,Xiaohang Wu,Yahan Yang,Xin Huang,Fang Liu,Jieyun Xu,Limian Lin,Haiqin Lin,Qiting Feng,Haotian Lin,Quan Liu
出处
期刊:JAMA Ophthalmology
[American Medical Association]
日期:2020-05-01
卷期号:138 (5): 519-519
被引量:49
标识
DOI:10.1001/jamaophthalmol.2020.0507
摘要
Importance
Evaluating corneal morphologic characteristics with corneal tomographic scans before refractive surgery is necessary to exclude patients with at-risk corneas and keratoconus. In previous studies, researchers performed screening with machine learning methods based on specific corneal parameters. To date, a deep learning algorithm has not been used in combination with corneal tomographic scans. Objective
To examine the use of a deep learning model in the screening of candidates for refractive surgery. Design, Setting, and Participants
A diagnostic, cross-sectional study was conducted at the Zhongshan Ophthalmic Center, Guangzhou, China, with examination dates extending from July 18, 2016, to March 29, 2019. The investigation was performed from July 2, 2018, to June 28, 2019. Participants included 1385 patients; 6465 corneal tomographic images were used to generate the artificial intelligence (AI) model. The Pentacam HR system was used for data collection. Interventions
The deidentified images were analyzed by ophthalmologists and the AI model. Main Outcomes and Measures
The performance of the AI classification system. Results
A classification system centered on the AI model Pentacam InceptionResNetV2 Screening System (PIRSS) was developed for screening potential candidates for refractive surgery. The model achieved an overall detection accuracy of 94.7% (95% CI, 93.3%-95.8%) on the validation data set. Moreover, on the independent test data set, the PIRSS model achieved an overall detection accuracy of 95% (95% CI, 88.8%-97.8%), which was comparable with that of senior ophthalmologists who are refractive surgeons (92.8%; 95% CI, 91.2%-94.4%) (P = .72). In distinguishing corneas with contraindications for refractive surgery, the PIRSS model performed better than the classifiers (95% vs 81%;P < .001) in the Pentacam HR system on an Asian patient database. Conclusions and Relevance
PIRSS appears to be useful in classifying images to provide corneal information and preliminarily identify at-risk corneas. PIRSS may provide guidance to refractive surgeons in screening candidates for refractive surgery as well as for generalized clinical application for Asian patients, but its use needs to be confirmed in other populations.
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