Development of a deep residual learning algorithm to screen for glaucoma from fundus photography.

The Purpose of the study was to develop a deep residual learning algorithm to screen for glaucoma from fundus photography and measure its diagnostic performance compared to Residents in Ophthalmology. A training dataset consisted of 1,364 color fundus photographs with glaucomatous indications and 1,768 color fundus photographs without glaucomatous features. A testing dataset consisted of 60 eyes of 60 glaucoma patients and 50 eyes of 50 normal subjects. Using the training dataset, a deep learning algorithm known as Deep Residual Learning for Image Recognition (ResNet) was developed to discriminate glaucoma, and its diagnostic accuracy was validated in the testing dataset, using the area under the receiver operating characteristic curve (AROC). The Deep Residual Learning for Image Recognition was constructed using the training dataset and validated using the testing dataset. The presence of glaucoma in the testing dataset was also confirmed by three Residents in Ophthalmology. The deep learning algorithm achieved significantly higher diagnostic performance compared to Residents in Ophthalmology; with ResNet, the AROC from all testing data was 96.5 (95% confidence interval [CI]: 93.5 to 99.6)% while the AROCs obtained by the three Residents were between 72.6% and 91.2%.