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Predicting Systemic Health Features from Retinal Fundus Images Using Transfer-Learning-Based Artificial Intelligence

Nergis C Khan1, Chandrashan Perera1,2, Eliot R Dow1

  • 1Byers Eye Institute at Stanford, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA 94305, USA.

Diagnostics (Basel, Switzerland)
|July 27, 2022
PubMed
Summary

Ocular imaging with deep learning (DL) artificial intelligence (AI) can predict systemic health features. Transfer learning from general image datasets like ImageNet significantly improved AI model accuracy for predicting features from fundus images.

Keywords:
artificial intelligencediabetic retinopathyretinal imagingtransfer learning

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Area of Science:

  • Ophthalmology
  • Medical Imaging
  • Artificial Intelligence

Background:

  • Color fundus photography is standard for diagnosing eye conditions.
  • Ocular imaging data may reveal systemic health insights.
  • Computer vision and DL/AI models can analyze these insights.

Purpose of the Study:

  • To develop a DL model for predicting systemic features from fundus images.
  • To determine the optimal method for constructing such DL models.
  • To assess the predictive performance of different transfer learning approaches.

Main Methods:

  • Collected data from diabetic retinopathy screening patients (March 2020-March 2021).
  • Developed DenseNet201 DL models using two transfer learning strategies: ImageNet and fundus images.
  • Trained models on 1277 fundus images and compared performance using Area Under the Receiver Operating Characteristics Curve (AUROC).

Main Results:

  • ImageNet transfer learning models outperformed fundus image transfer learning models (mean AUROC 0.78 vs. 0.65, p < 0.001).
  • ImageNet pretraining enabled prediction of ethnicity (AUROC 0.93), age > 70 (AUROC 0.90), gender (AUROC 0.85), ACE inhibitor use (AUROC 0.82), and ARB medication use (AUROC 0.78).

Conclusions:

  • Fundus images contain significant information about a patient's systemic health.
  • Transfer learning from generalized image datasets (like ImageNet) is recommended to enhance DL model accuracy for medical image analysis.
  • This approach optimizes DL model performance for predicting systemic features from ocular imaging.