Prediction of visual field progression with serial optic disc photographs using deep learning

Abstract

AimWe tested the hypothesis that visual field (VF) progression can be predicted with a deep learning model based on longitudinal pairs of optic disc photographs (ODP) acquired at earlier time points during follow-up.Methods3919 eyes (2259 patients) with ≥2 ODPs at least 2 years apart, and ≥5 24–2 VF exams spanning ≥3 years of follow-up were included. Serial VF mean deviation (MD) rates of change were estimated starting at the fifth visit and subsequently by adding visits until final visit. VF progression was defined as a statistically significant negative slope at two consecutive visits and final visit. We built a twin-neural network with ResNet50-backbone. A pair of ODPs acquired up to a year before the VF progression date or the last VF in non-progressing eyes were included as input. Primary outcome measures were area under the receiver operating characteristic curve (AUC) and model accuracy.ResultsThe average (SD) follow-up time and baseline VF MD were 8.1 (4.8) years and –3.3 (4.9) dB, respectively. VF progression was identified in 761 eyes (19%). The median (IQR) time to progression in progressing eyes was 7.3 (4.5–11.1) years. The AUC and accuracy for predicting VF progression were 0.862 (0.812–0.913) and 80.0% (73.9%–84.6%). When only fast-progressing eyes were considered (MD rate < –1.0 dB/year), AUC increased to 0.926 (0.857–0.994).ConclusionsA deep learning model can predict subsequent glaucoma progression from longitudinal ODPs with clinically relevant accuracy. This model may be implemented, after validation, for predicting glaucoma progression in the clinical setting.