Using Deep Learning to Automate Goldmann Applanation Tonometry Readings.


Journal

Ophthalmology
ISSN: 1549-4713
Titre abrégé: Ophthalmology
Pays: United States
ID NLM: 7802443

Informations de publication

Date de publication:
11 2020
Historique:
received: 11 02 2020
revised: 16 04 2020
accepted: 20 04 2020
pubmed: 29 4 2020
medline: 23 12 2020
entrez: 29 4 2020
Statut: ppublish

Résumé

To develop an objective and automated method for measuring intraocular pressure using deep learning and fixed-force Goldmann applanation tonometry (GAT) techniques. Prospective cross-sectional study. Patients from an academic glaucoma practice. Intraocular pressure was estimated by analyzing videos recorded using a standard slit-lamp microscope and fixed-force GAT. Video frames were labeled to identify the outline of the reference tonometer and the applanation mires. A deep learning model was trained to localize and segment the tonometer and mires. Intraocular pressure values were calculated from the deep learning-predicted tonometer and mire diameters using the Imbert-Fick formula. A separate test set was collected prospectively in which standard and automated GAT measurements were collected in random order by 2 independent masked observers to assess the deep learning model as well as interobserver variability. Intraocular pressure measurements between standard and automated methods were compared. Two hundred sixty-three eyes of 135 patients were included in the training and validation videos. For the test set, 50 eyes from 25 participants were included. Each eye was measured by 2 observers, resulting in 100 videos. Within the test set, the mean difference between automated and standard GAT results was -0.9 mmHg (95% limits of agreement [LoA], -5.4 to 3.6 mmHg). Mean difference between the 2 observers using standard GAT was 0.09 mmHg (LoA,-3.8 to 4.0 mmHg). Mean difference between the 2 observers using automated GAT videos was -0.3 mmHg (LoA, -4.1 to 3.5 mmHg). The coefficients of repeatability for automated and standard GAT were 3.8 and 3.9 mmHg, respectively. The bias for even-numbered measurements was reduced when using automated GAT. Preliminary measurements using deep learning to automate GAT demonstrate results comparable with those of standard GAT. Automated GAT has the potential to improve on our current GAT measurement standards significantly by reducing bias and improving repeatability. In addition, ocular pulse amplitudes could be observed using this technique.

Identifiants

pubmed: 32344074
pii: S0161-6420(20)30412-7
doi: 10.1016/j.ophtha.2020.04.033
pmc: PMC7606368
mid: NIHMS1587910
pii:
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1498-1506

Subventions

Organisme : NEI NIH HHS
ID : K23 EY029246
Pays : United States

Informations de copyright

Copyright © 2020 American Academy of Ophthalmology. All rights reserved.

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Auteurs

Ted Spaide (T)

Department of Ophthalmology, University of Washington, Seattle, Washington.

Yue Wu (Y)

Department of Ophthalmology, University of Washington, Seattle, Washington.

Ryan T Yanagihara (RT)

Department of Ophthalmology, University of Washington, Seattle, Washington.

Shu Feng (S)

Department of Ophthalmology, University of Washington, Seattle, Washington.

Omar Ghabra (O)

Department of Ophthalmology, University of Washington, Seattle, Washington.

Jonathan S Yi (JS)

Department of Ophthalmology, University of Washington, Seattle, Washington.

Philip P Chen (PP)

Department of Ophthalmology, University of Washington, Seattle, Washington.

Francy Moses (F)

Department of Ophthalmology, University of Washington, Seattle, Washington.

Aaron Y Lee (AY)

Department of Ophthalmology, University of Washington, Seattle, Washington. Electronic address: leeay@uw.edu.

Joanne C Wen (JC)

Duke Eye Center, Duke University, Durham, North Carolina. Electronic address: joanne.wen@duke.edu.

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Classifications MeSH