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Realistic fundus photograph generation for improving automated disease classification
Prashant U Pandey1, Jonathan A Micieli2,3,4, Stephan Ong Tone2,3,5,6
1School of Biomedical Engineering, The University of British Columbia, Vancouver, British Columbia, Canada.
The British Journal of Ophthalmology
|February 12, 2025
Summary
Denoising diffusion probabilistic models (DDPMs) generated realistic retinal images, improving deep convolutional neural network (CNN) performance for disease classification without needing more real patient data.
Area of Science:
- Ophthalmology
- Artificial Intelligence
- Medical Imaging
Background:
- Deep convolutional neural networks (CNNs) show promise in classifying retinal diseases.
- Generating realistic medical images is crucial for AI model training.
- Denoising diffusion probabilistic models (DDPMs) are advanced generative models.
Purpose of the Study:
- To assess if DDPMs can create realistic retinal images.
- To evaluate if these generated images can enhance CNN performance for retinal disease classification.
- To compare AI performance against human experts in retinal disease detection.
Main Methods:
- DDPMs were trained to generate retinal fundus images for diabetic retinopathy, age-related macular degeneration, and glaucoma.
- Ophthalmologists evaluated the realism of generated images and performed disease classification.
- Generated images were used to augment training data for CNN ensembles.
Main Results:
- Ophthalmologists achieved 61.1% accuracy in distinguishing real from generated retinal images.
- Augmenting CNN training with 238 generated images significantly improved classification F-score (5.3%) and accuracy (5.8%).
- The enhanced CNN model outperformed the baseline trained solely on real images.
Conclusions:
- DDPMs successfully generate highly realistic retinal images, validated by expert ophthalmologists.
- Incorporating synthetic retinal images into training datasets boosts CNN performance for disease classification.
- This approach enhances diagnostic AI without requiring additional real patient data, addressing data scarcity issues.

