NEW ARTIFICIAL INTELLIGENCE ANALYSIS FOR PREDICTION OF LONG-TERM VISUAL IMPROVEMENT AFTER EPIRETINAL MEMBRANE SURGERY

玻璃体切除术 视网膜前膜 眼科 医学 置信区间 光学相干层析成像 优势比 视力 扁平部 外科 病理 内科学
作者
Emanuele Crincoli,Maria Cristina Savastano,Alfonso Savastano,Tomaso Caporossi,Daniela Bacherini,Alexandra Mière,Gloria Gambini,Umberto De Vico,Antonio Baldascino,Angelo Maria Minnella,Andrea Scupola,Guglielmo D’Amico,Fernando Molle,Patrizio Bernardinelli,Alessandro De Filippis,Raphael Kilian,Clara Rizzo,Matteo Ripa,Silvia Ferrara,Alessandra Scampoli
出处
期刊:Retina-the Journal of Retinal and Vitreous Diseases [Lippincott Williams & Wilkins]
卷期号:43 (2): 173-181 被引量:20
标识
DOI:10.1097/iae.0000000000003646
摘要

To predict improvement of best-corrected visual acuity (BCVA) 1 year after pars plana vitrectomy for epiretinal membrane (ERM) using artificial intelligence methods on optical coherence tomography B-scan images.Four hundred and eleven (411) patients with Stage II ERM were divided in a group improvement (IM) (≥15 ETDRS letters of VA recovery) and a group no improvement (N-IM) (<15 letters) according to 1-year VA improvement after 25-G pars plana vitrectomy with internal limiting membrane peeling. Primary outcome was the creation of a deep learning classifier (DLC) based on optical coherence tomography B-scan images for prediction. Secondary outcome was assessment of the influence of various clinical and imaging predictors on BCVA improvement. Inception-ResNet-V2 was trained using standard augmentation techniques. Testing was performed on an external data set. For secondary outcome, B-scan acquisitions were analyzed by graders both before and after fibrillary change processing enhancement.The overall performance of the DLC showed a sensitivity of 87.3% and a specificity of 86.2%. Regression analysis showed a difference in preoperative images prevalence of ectopic inner foveal layer, foveal detachment, ellipsoid zone interruption, cotton wool sign, unprocessed fibrillary changes (odds ratio = 2.75 [confidence interval: 2.49-2.96]), and processed fibrillary changes (odds ratio = 5.42 [confidence interval: 4.81-6.08]), whereas preoperative BCVA and central macular thickness did not differ between groups.The DLC showed high performances in predicting 1-year visual outcome in ERM surgery patients. Fibrillary changes should also be considered as relevant predictors.
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