利用人工智能检测糖尿病黄斑水肿的临床特征

Jeffrey Liu, Doaa Hassan Salem, Hunter Jill, S. Janga, Amir Hajrasouliha
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摘要

背景:视力是生命中宝贵的一部分:影响我们对世界和记忆的感知。糖尿病,尤其是糖尿病视网膜病变(DR)会影响我们的视力,如果不及时治疗,可能会永久性地夺走我们的视力。目前,糖尿病视网膜病变是导致成人失明的主要原因,而且随着成人糖尿病发病率的增加,其发病率还将继续上升。糖尿病性黄斑水肿(DME)是糖尿病性视网膜病变的并发症之一,眼科医生使用光学相干断层扫描(OCT)对其进行诊断;然而,与糖尿病性黄斑水肿相关的大量成像给眼科医生造成了时间压力,从而产生了进一步优化图像阅读过程的需求。在本研究中,我们假设通过在基层医疗诊所引入基于人工智能的方法来提高 DME 的诊断率和简易性,将提高糖尿病患者眼部健康的长期保护率。方法:由于我们的研究属于回顾性队列研究,因此未征得患者同意,同时也对图像进行了去标识化处理。我们按照 HbA1c、非增殖性糖尿病视网膜病变(NPDR)严重程度和增殖性糖尿病视网膜病变(PDR)对 676 份患者档案进行了分类。对视网膜 OCT 图像进行了注释,以识别黄斑中心水肿,这是 DME 的常见特征。此外,还对视网膜眼底图像进行了注释,以识别微动脉瘤和出血,这是检测 DR 或 DME 的另外两个常用特征。结果:我们准备了一个病变特征数据集来训练人工智能模型。我们提取了 OCT 和眼底成像特征,并将其结合起来训练用于 DME 检测的人工智能模型。从内部黄斑厚度数据集的注释中可以看出,在总共 389 名糖尿病视网膜病变患者中,有 167 名患者患有 DME。结论:我们将继续为人工智能准备更多像黄斑厚度数据集这样的数据集。我们预测,在我们的人工智能接受了大量的数据集训练后,人工智能将有可能显示出诊断 DME 的某些能力,从而支持其在医疗诊断中的应用。
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Clinical Features for Detecting Diabetic Macular Edema using Artificial Intelligence
Background:Vision is a valuable part of life: influencing our perception of the world and of memories. Diabetes, and more specifically, Diabetic Retinopathy (DR) can affect our vision, taking away sight potentially permanently if left untreated. Currently, Diabetic Retinopathy is the leading cause for adult blindness and will continue to rise with increasing prevalence of adult diabetes. Diabetic Macular Edema (DME), a complication of DR, is diagnosed by ophthalmologists using optical coherence tomography (OCT); however, the sheer amount of DME-related imaging creates a time strain on ophthalmologists, creating a demand to further optimize the image reading process. In this study, we hypothesize that increasing the rate and ease of diagnosing DME by introducing artificial intelligence-based methods in primary medical clinics will increase the long-term preservation of ocular health in diabetic patients. Methods:Due to the nature of our retrospective cohort study, consent was not acquired and images were also de-identified. We categorized 676 patient files by HbA1c, non-proliferative diabetic retinopathy (NPDR) severity, and proliferative diabetic retinopathy (PDR). Retinal OCT images were annotated to identify central macular edema, a common feature of DME. Retinal fundus images were also annotated to identify microaneurysms and hemorrhages, two additional features commonly used for detecting either DR or DME. Results:A lesion features dataset was prepared to train our AI model. OCT and fundus imaging features were extracted and combined to train the AI model for DME detection. From annotations of the in-house Macular thickness dataset, it was seen that 167 patients had DME from the total 389 diabetic retinopathy patients. Conclusion:We will continue to prepare more datasets like the macular thickness dataset for our AI. We predict that after our AI receives substantial training with the datasets, the AI will potentially demonstrate some capability of diagnosing DME, supporting its use in medical diagnostics.
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