Primary angle-closed diseases recognition through artificial intelligence-based anterior segment-optical coherence tomography imaging.

Purpose: In this study, artificial intelligence (AI) was used to deeply learn the classification of the anterior segment-Optical Coherence Tomography (AS-OCT) images. This AI systems automatically analyzed the angular structure of the AS-OCT images and automatically classified anterior chamber angle. It would improve the efficiency of AS-OCT image analysis.

Methods: The subjects were from the glaucoma disease screening and prevention project for elderly people in Shanghai community. Each scan contained 72 cross-sectional AS-OCT frames. We developed a deep learning-based AS-OCT image automatic anterior chamber angle analysis software. Classifier performance was evaluated against glaucoma experts' grading of AS-OCT images as standard. Outcome evaluation included accuracy (ACC) and area under the receiver operator curve (AUC).

Results: 94895 AS-OCT images were collected from 687 participants, in which 69,243 images were annotated as open, 16,433 images were annotated as closed, and 9219 images were annotated as non-gradable. The class-balanced train data were formed from randomly extracting the same number of open angle images as the closed angle images, which contained 22,393 images (11127 open, 11256 closed). The best-performing classifier was developed by applying transfer learning to the ResNet-50 architecture. against experts' grading, this classifier achieved an AUC of 0.9635.

Conclusion: Deep learning classifiers effectively detect angle closure based on automated analysis of AS-OCT images. This system could be used to automate clinical evaluations of the anterior chamber angle and improve efficiency of interpreting AS-OCT images. The results demonstrated the potential of the deep learning system for rapid recognition of high-risk populations of PACD.