Deep Learning-Based Automated Classification of Multi-Categorical Abnormalities From Optical Coherence Tomography Images

Purpose: To develop a new intelligent system based on deep learning for automatically optical coherence tomography (OCT) images categorization. Methods: A total of 60,407 OCT images were labeled by 17 licensed retinal experts and 25,134 images were included. One hundred one-layer convolutional neural networks (ResNet) were trained for the categorization. We applied 10-fold cross-validation method to train and optimize our algorithms. The area under the receiver operating characteristic curve (AUC), accuracy and kappa value were calculated to evaluate the performance of the intelligent system in categorizing OCT images. We also compared the performance of the system with results obtained by two experts. Results: The intelligent system achieved an AUC of 0.984 with an accuracy of 0.959 in detecting macular hole, cystoid macular edema, epiretinal membrane, and serous macular detachment. Specifically, the accuracies in discriminating normal images, cystoid macular edema, serous macular detachment, epiretinal membrane, and macular hole were 0.973, 0.848, 0.947, 0.957, and 0.978, respectively. The system had a kappa value of 0.929, while the two physicians' kappa values were 0.882 and 0.889 independently. Conclusions: This deep learning-based system is able to automatically detect and differentiate various OCT images with excellent accuracy. Moreover, the performance of the system is at a level comparable to or better than that of human experts. This study is a promising step in revolutionizing current disease diagnostic pattern and has the potential to generate a significant clinical impact. Translational Relevance: This intelligent system has great value in increasing retinal diseases' diagnostic efficiency in clinical circumstances.