Artificial intelligence derived grading of mustard gas induced corneal injury and opacity

Artificial intelligence (AI) has emerged as a transformative tool in ophthalmology for disease diagnosis and prognosis. However, use of AI for assessing corneal damage due to chemical injury in live rabbits remains lacking. This study aimed to develop an AI-derived clinical classification model for an objective grading of corneal injury and opacity levels in live rabbits following ocular exposure of sulfur mustard (SM). An automated method to grade corneal injury minimizes diagnostic errors and enhances translational application of preclinical research in better human eyecare. SM induced corneal injury and opacity from 401 in-house rabbit corneal images captured with a clinical stereomicroscope were used. Three independent subject matter specialists classified corneal images into four health grades: healthy, mild, moderate, and severe. Mask-RCNN was employed for precise corneal segmentation and extraction, followed by classification using baseline convolutional neural network and transfer learning algorithms, including VGG16, ResNet101, DenseNet121, InceptionV3, and ResNet50. The ResNet50-based model demonstrated the best performance, achieving 87% training accuracy, and 85% and 83% prediction accuracies on two independent test sets. This deep learning framework, combining Mask-RCNN with ResNet50 allows reliable and uniform grading of SM-induced corneal injury and opacity levels in affected eyes.