Prediction of age-related macular degeneration disease using a sequential deep learning approach on longitudinal SD-OCT imaging biomarkers

• Type of Material: Article
• Authors: Imon Banerjee, Emory University; Luis de Sisternes, Carl Zeiss Meditec Inc; Joelle A. Hallak, University of Illinois; Theodore Leng, Stanford University; Aaron Osborne, Genentech Inc; Philip J. Rosenfeld, University of Miami; Giovanni Gregori, University of Miami; Mary Durbin, Carl Zeiss Meditec Inc; Daniel Rubin, Stanford University
• Language: English
• Date: 2020-09-22
• Publisher: NATURE RESEARCH
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2020
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1038/s41598-020-72359-y
• Title of Journal or Parent Work: SCIENTIFIC REPORTS
• Volume: 10
• Issue: 1
• Start Page: 15434
• End Page: 15434
• Grant/Funding Information: This project was supported by a grant from Genentech Inc. and partially supported by BrightFocus Foundation Grant (JH, LG, DL, TL), Research to Prevent Blindness and NIH grant P30-EY026877.
• Keywords: PREVALENCE; Multidisciplinary Sciences; EYE; Science & Technology - Other Topics; Science & Technology
• Research Categories: Biology, General; Education, Technology

Abstract

We propose a hybrid sequential prediction model called “Deep Sequence”, integrating radiomics-engineered imaging features, demographic, and visual factors, with a recursive neural network (RNN) model in the same platform to predict the risk of exudation within a future time-frame in non-exudative AMD eyes. The proposed model provides scores associated with risk of exudation in the short term (within 3 months) and long term (within 21 months), handling challenges related to variability of OCT scan characteristics and the size of the training cohort. We used a retrospective clinical trial dataset that includes 671 AMD fellow eyes with 13,954 observations before any signs of exudation for training and validation in a tenfold cross validation setting. Deep Sequence achieved high performance for the prediction of exudation within 3 months (0.96 ± 0.02 AUCROC) and within 21 months (0.97 ± 0.02 AUCROC) on cross-validation. Training the proposed model on this clinical trial dataset and testing it on an external real-world clinical dataset showed high performance for the prediction within 3-months (0.82 AUCROC) but a clear decrease in performance for the prediction within 21-months (0.68 AUCROC). While performance differences at longer time intervals may be derived from dataset differences, we believe that the high performance and generalizability achieved in short-term predictions may have a high clinical impact allowing for optimal patient follow-up, adding the possibility of more frequent, detailed screening and tailored treatments for those patients with imminent risk of exudation.