Prediction of Visual Acuity After Cataract Surgery by Deep Learning Methods Using Clinical Information and Color Fundus Photography

Purpose To examine the performance of deep-learning models that predicts the visual acuity after cataract surgery using preoperative clinical information and color fundus photography (CFP).Methods We retrospectively collected the age, sex, and logMAR preoperative best corrected visual acuity (preoperative-BCVA) and CFP from patients who underwent cataract surgeries from 2020 to 2021 at National Taiwan University Hospital. Feature extraction of CFP was performed using a pre-existing image classification model, Xception. The CFP-extracted features and pre-operative clinical information were then fed to a downstream neural network for final prediction. We assessed the model performance by calculating the mean absolute error (MAE) between the predicted and the true logMAR of postoperative BCVA. A nested 10-fold cross-validation was performed for model validation.Results A total of 673 fundus images from 446 patients were collected. The mean preoperative BCVA and postoperative BCVA was 0.60 ± 0.39 and 0.14 ± 0.18, respectively. The model using age and sex as predictors achieved an MAE of 0.121 ± 0.016 in postoperative BCVA prediction. The inclusion of CFP as additional predictor in the model (predictors: age, sex and CFP) did not further improve the predictive performance (MAE = 0.120 ± 0.023, p = 0.375), while adding the preoperative BCVA as an additional predictor resulted in a 4.13% improvement (predictors: age, sex and preoperative BCVA, MAE = 0.116 ± 0.016, p = 0.013).Conclusions Our multimodal models including both CFP and clinical information achieved excellent accuracy in predicting BCVA after cataract surgery, while the learning models input with only clinical information performed similarly. Future studies are needed to clarify the effects of multimodal input on this task.