Automatic diagnosis of diabetic retinopathy using vision transformer based on wide-field optical coherence tomography angiography

Diabetic retinopathy (DR) is one of the major causes of visual impairment in adults with diabetes. Optical coherence tomography angiography (OCTA) is nowadays widely used as the golden criterion for diagnosing DR. Recently, wide-field OCTA (WF-OCTA) provided more abundant information including that of the peripheral retinal degenerative changes and it can contribute in accurately diagnosing DR. The need for an automatic DR diagnostic system based on WF-OCTA pictures attracts more and more attention due to the large diabetic population and the prevalence of retinopathy cases. In this study, automatic diagnosis of DR using vision transformer was performed using WF-OCTA images (12[Formula: see text]mm × 12[Formula: see text]mm single-scan) centered on the fovea as the dataset. WF-OCTA images were automatically classified into four classes: No DR, mild nonproliferative diabetic retinopathy (NPDR), moderate to severe NPDR, and proliferative diabetic retinopathy (PDR). The proposed method for detecting DR on the test set achieves accuracy of 99.55%, sensitivity of 99.49%, and specificity of 99.57%. The accuracy of the method for DR staging reaches up to 99.20%, which has been proven to be higher than that attained by classical convolutional neural network models. Results show that the automatic diagnosis of DR based on vision transformer and WF-OCTA pictures is more effective for detecting and staging DR.