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Exploring the effect of hypertension on retinal microvasculature using deep learning on East Asian population

Hypertension is the leading risk factor of cardiovascular disease and has profound effects on both the structure and function of the microvasculature. Abnormalities of the retinal vasculature may reflect the degree of microvascular damage due to hypertension, and these changes can be detected with f...

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Autores principales: Dai, Guangzheng, He, Wei, Xu, Ling, Pazo, Eric E., Lin, Tiezhu, Liu, Shasha, Zhang, Chenguang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7058325/
https://www.ncbi.nlm.nih.gov/pubmed/32134976
http://dx.doi.org/10.1371/journal.pone.0230111
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author Dai, Guangzheng
He, Wei
Xu, Ling
Pazo, Eric E.
Lin, Tiezhu
Liu, Shasha
Zhang, Chenguang
author_facet Dai, Guangzheng
He, Wei
Xu, Ling
Pazo, Eric E.
Lin, Tiezhu
Liu, Shasha
Zhang, Chenguang
author_sort Dai, Guangzheng
collection PubMed
description Hypertension is the leading risk factor of cardiovascular disease and has profound effects on both the structure and function of the microvasculature. Abnormalities of the retinal vasculature may reflect the degree of microvascular damage due to hypertension, and these changes can be detected with fundus photographs. This study aimed to use deep learning technique that can detect subclinical features appearing below the threshold of a human observer to explore the effect of hypertension on morphological features of retinal microvasculature. We collected 2012 retinal photographs which included 1007 from patients with a diagnosis of hypertension and 1005 from normotensive control. By method of vessel segmentation, we removed interference information other than retinal vasculature and contained only morphological information about blood vessels. Using these segmented images, we trained a small convolutional neural networks (CNN) classification model and used a deep learning technique called Gradient-weighted Class Activation Mapping (Grad-CAM) to generate heat maps for the class “hypertension”. Our model achieved an accuracy of 60.94%, a specificity of 51.54%, a precision of 59.27%, and a recall of 70.48%. The AUC was 0.6506. In the heat maps for the class “hypertension”, red patchy areas were mainly distributed on or around arterial/venous bifurcations. This indicated that the model has identified these regions as being the most important for predicting hypertension. Our study suggested that the effect of hypertension on retinal microvascular morphology mainly occurred at branching of vessels. The change of the branching pattern of retinal vessels was probably the most significant in response to elevated blood pressure.
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spelling pubmed-70583252020-03-12 Exploring the effect of hypertension on retinal microvasculature using deep learning on East Asian population Dai, Guangzheng He, Wei Xu, Ling Pazo, Eric E. Lin, Tiezhu Liu, Shasha Zhang, Chenguang PLoS One Research Article Hypertension is the leading risk factor of cardiovascular disease and has profound effects on both the structure and function of the microvasculature. Abnormalities of the retinal vasculature may reflect the degree of microvascular damage due to hypertension, and these changes can be detected with fundus photographs. This study aimed to use deep learning technique that can detect subclinical features appearing below the threshold of a human observer to explore the effect of hypertension on morphological features of retinal microvasculature. We collected 2012 retinal photographs which included 1007 from patients with a diagnosis of hypertension and 1005 from normotensive control. By method of vessel segmentation, we removed interference information other than retinal vasculature and contained only morphological information about blood vessels. Using these segmented images, we trained a small convolutional neural networks (CNN) classification model and used a deep learning technique called Gradient-weighted Class Activation Mapping (Grad-CAM) to generate heat maps for the class “hypertension”. Our model achieved an accuracy of 60.94%, a specificity of 51.54%, a precision of 59.27%, and a recall of 70.48%. The AUC was 0.6506. In the heat maps for the class “hypertension”, red patchy areas were mainly distributed on or around arterial/venous bifurcations. This indicated that the model has identified these regions as being the most important for predicting hypertension. Our study suggested that the effect of hypertension on retinal microvascular morphology mainly occurred at branching of vessels. The change of the branching pattern of retinal vessels was probably the most significant in response to elevated blood pressure. Public Library of Science 2020-03-05 /pmc/articles/PMC7058325/ /pubmed/32134976 http://dx.doi.org/10.1371/journal.pone.0230111 Text en © 2020 Dai et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Dai, Guangzheng
He, Wei
Xu, Ling
Pazo, Eric E.
Lin, Tiezhu
Liu, Shasha
Zhang, Chenguang
Exploring the effect of hypertension on retinal microvasculature using deep learning on East Asian population
title Exploring the effect of hypertension on retinal microvasculature using deep learning on East Asian population
title_full Exploring the effect of hypertension on retinal microvasculature using deep learning on East Asian population
title_fullStr Exploring the effect of hypertension on retinal microvasculature using deep learning on East Asian population
title_full_unstemmed Exploring the effect of hypertension on retinal microvasculature using deep learning on East Asian population
title_short Exploring the effect of hypertension on retinal microvasculature using deep learning on East Asian population
title_sort exploring the effect of hypertension on retinal microvasculature using deep learning on east asian population
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7058325/
https://www.ncbi.nlm.nih.gov/pubmed/32134976
http://dx.doi.org/10.1371/journal.pone.0230111
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