Google Health, Palo Alto, CA, USA.
Artera, Mountain View, CA, USA.
Nat Biomed Eng. 2022 Dec;6(12):1370-1383. doi: 10.1038/s41551-022-00867-5. Epub 2022 Mar 29.
Retinal fundus photographs can be used to detect a range of retinal conditions. Here we show that deep-learning models trained instead on external photographs of the eyes can be used to detect diabetic retinopathy (DR), diabetic macular oedema and poor blood glucose control. We developed the models using eye photographs from 145,832 patients with diabetes from 301 DR screening sites and evaluated the models on four tasks and four validation datasets with a total of 48,644 patients from 198 additional screening sites. For all four tasks, the predictive performance of the deep-learning models was significantly higher than the performance of logistic regression models using self-reported demographic and medical history data, and the predictions generalized to patients with dilated pupils, to patients from a different DR screening programme and to a general eye care programme that included diabetics and non-diabetics. We also explored the use of the deep-learning models for the detection of elevated lipid levels. The utility of external eye photographs for the diagnosis and management of diseases should be further validated with images from different cameras and patient populations.
眼底照片可用于检测多种视网膜疾病。在这里,我们展示了经过训练的深度学习模型可以利用外部眼部照片来检测糖尿病性视网膜病变(DR)、糖尿病性黄斑水肿和血糖控制不佳。我们使用来自 301 个 DR 筛查点的 145832 名糖尿病患者的眼部照片开发了这些模型,并在四项任务和四个验证数据集中进行了评估,这些数据集共有来自 198 个额外筛查点的 48644 名患者。对于所有四项任务,深度学习模型的预测性能均明显高于使用自我报告的人口统计学和医疗史数据的逻辑回归模型的性能,而且预测结果可以推广到瞳孔放大的患者、来自不同 DR 筛查计划的患者以及包含糖尿病患者和非糖尿病患者的普通眼科护理计划的患者。我们还探索了使用深度学习模型来检测血脂升高的情况。外部眼部照片在疾病诊断和管理中的应用价值需要通过来自不同相机和患者群体的图像进行进一步验证。
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