Performance of automated machine learning in detecting fundus diseases based on ophthalmologic B-scan ultrasound...

To evaluate the efficacy of automated machine learning (AutoML) models in detecting fundus diseases using ocular B-scan ultrasound images.

Ophthalmologists annotated two B-scan ultrasound image datasets to develop three AutoML models-single-label, multi-class single-label and multi-label-on the Vertex artificial intelligence (AI) platform. Performance of these models was compared among themselves and against existing bespoke models for binary classification tasks.

The training set involved 3938 images from 1378 patients, while batch predictions used an additional set of 336 images from 180 patients. The single-label AutoML model, trained on normal and abnormal fundus images, achieved an area under the precision-recall curve (AUPRC) of 0.9943. The multi-class single-label model, focused on single-pathology images, recorded an AUPRC of 0.9617, with performance metrics of these two single-label models proving comparable to those of previously published models. The multi-label model, designed to detect both single and multiple pathologies, posted an AUPRC of 0.9650. Pathology classification AUPRCs for the multi-class single-label model ranged from 0.9277 to 1.0000 and from 0.8780 to 0.9980 for the multi-label model. Batch prediction accuracies ranged from 86.57% to 97.65% for various fundus conditions in the multi-label AutoML model. Statistical analysis demonstrated that the single-label model significantly outperformed the other two models in all evaluated metrics (p<0.05).

AutoML models, developed by clinicians, effectively detected multiple fundus lesions with performance on par with that of deep-learning models crafted by AI specialists. This underscores AutoML's potential to revolutionise ophthalmologic diagnostics, facilitating broader accessibility and application of sophisticated diagnostic technologies.