Zhang Wanyun, Chen Zhijun, Zhang Han, Su Guannan, Chang Rui, Chen Lin, Zhu Ying, Cao Qingfeng, Zhou Chunjiang, Wang Yao, Yang Peizeng
The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology and Chongqing Eye Institute, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing, China.
School of Computer Science and Technology, Harbin Institute of Technology, Harbin, China.
Front Cell Dev Biol. 2021 Jun 18;9:684522. doi: 10.3389/fcell.2021.684522. eCollection 2021.
Fuchs' uveitis syndrome (FUS) is one of the most under- or misdiagnosed uveitis entities. Many undiagnosed FUS patients are unnecessarily overtreated with anti-inflammatory drugs, which may lead to serious complications. To offer assistance for ophthalmologists in the screening and diagnosis of FUS, we developed seven deep convolutional neural networks (DCNNs) to detect FUS using slit-lamp images. We also proposed a new optimized model with a mixed "attention" module to improve test accuracy. In the same independent set, we compared the performance between these DCNNs and ophthalmologists in detecting FUS. Seven different network models, including Xception, Resnet50, SE-Resnet50, ResNext50, SE-ResNext50, ST-ResNext50, and SET-ResNext50, were used to predict FUS automatically with the area under the receiver operating characteristic curves (AUCs) that ranged from 0.951 to 0.977. Our proposed SET-ResNext50 model (accuracy = 0.930; Precision = 0.918; Recall = 0.923; F1 measure = 0.920) with an AUC of 0.977 consistently outperformed the other networks and outperformed general ophthalmologists by a large margin. Heat-map visualizations of the SET-ResNext50 were provided to identify the target areas in the slit-lamp images. In conclusion, we confirmed that a trained classification method based on DCNNs achieved high effectiveness in distinguishing FUS from other forms of anterior uveitis. The performance of the DCNNs was better than that of general ophthalmologists and could be of value in the diagnosis of FUS.
富克斯葡萄膜炎综合征(FUS)是最容易被漏诊或误诊的葡萄膜炎类型之一。许多未被诊断出的FUS患者被不必要地过度使用抗炎药物治疗,这可能会导致严重的并发症。为了帮助眼科医生进行FUS的筛查和诊断,我们开发了7个深度卷积神经网络(DCNN),用于使用裂隙灯图像检测FUS。我们还提出了一种带有混合“注意力”模块的新优化模型,以提高测试准确性。在同一独立数据集中,我们比较了这些DCNN与眼科医生在检测FUS方面的表现。使用7种不同的网络模型,包括Xception、Resnet50、SE-Resnet50、ResNext50、SE-ResNext50、ST-ResNext50和SET-ResNext50,通过接收器操作特征曲线(AUC)下的面积自动预测FUS,AUC范围为0.951至0.977。我们提出的SET-ResNext50模型(准确率=0.930;精确率=0.918;召回率=0.923;F1值=0.920),AUC为0.977,始终优于其他网络,并且比普通眼科医生的表现高出一大截。提供了SET-ResNext50的热图可视化,以识别裂隙灯图像中的目标区域。总之,我们证实基于DCNN的训练分类方法在区分FUS与其他形式的前葡萄膜炎方面具有很高的有效性。DCNN的表现优于普通眼科医生,在FUS的诊断中可能具有价值。