论文标题
使用人工智能描述青光眼视神经头的结构表型
Describing the Structural Phenotype of the Glaucomatous Optic Nerve Head Using Artificial Intelligence
论文作者
论文摘要
视神经头(ONH)通常会随着青光眼的发育和进展而经历复杂的神经和结缔组织结构变化,并且监测这些变化对于改善青光眼诊所的诊断和预后至关重要。在临床上评估ONH的结构变化的金标准技术是光学相干断层扫描(OCT)。但是,OCT仅限于测量一些手工设计的参数,例如视网膜神经纤维层的厚度(RNFL),并且尚未获得用于青光眼诊断和预后应用的独立装置。我们认为这是因为ONH的3d OCT扫描中可用的大量信息尚未得到充分利用。在这项研究中,我们提出了一种深度学习方法,可以:\ textbf {(1)}完全利用ONH的OCT扫描中的信息; \ textbf {(2)}描述了青光眼ONH的结构表型;并且可以将其用作强大的青光眼诊断工具。具体而言,发现我们算法确定的结构特征与青光眼的临床观察有关。这些结构功能的诊断准确性为$ 92.0 \ pm 2.3 \%$,灵敏度为$ 90.0 \ pm 2.4 \%$ $($ 95 \%$ $特异性)。通过改变脚步的幅度,我们能够揭示ONH的形态如何变化,因为一个人从“非糖果瘤”过渡到``青光眼''条件。我们认为,我们的工作可能对我们对青光眼发病机理的理解具有很大的临床意义,并且可以在将来改善以预测未来视力丧失。
The optic nerve head (ONH) typically experiences complex neural- and connective-tissue structural changes with the development and progression of glaucoma, and monitoring these changes could be critical for improved diagnosis and prognosis in the glaucoma clinic. The gold-standard technique to assess structural changes of the ONH clinically is optical coherence tomography (OCT). However, OCT is limited to the measurement of a few hand-engineered parameters, such as the thickness of the retinal nerve fiber layer (RNFL), and has not yet been qualified as a stand-alone device for glaucoma diagnosis and prognosis applications. We argue this is because the vast amount of information available in a 3D OCT scan of the ONH has not been fully exploited. In this study we propose a deep learning approach that can: \textbf{(1)} fully exploit information from an OCT scan of the ONH; \textbf{(2)} describe the structural phenotype of the glaucomatous ONH; and that can \textbf{(3)} be used as a robust glaucoma diagnosis tool. Specifically, the structural features identified by our algorithm were found to be related to clinical observations of glaucoma. The diagnostic accuracy from these structural features was $92.0 \pm 2.3 \%$ with a sensitivity of $90.0 \pm 2.4 \% $ (at $95 \%$ specificity). By changing their magnitudes in steps, we were able to reveal how the morphology of the ONH changes as one transitions from a `non-glaucoma' to a `glaucoma' condition. We believe our work may have strong clinical implication for our understanding of glaucoma pathogenesis, and could be improved in the future to also predict future loss of vision.