Diagnostic Performance of Deep Learning Classifiers in Measuring Peripheral Anterior Synechia Based on Swept Source Optical Coherence Tomography Images

PURPOSE: To develop deep learning classifiers and evaluate their diagnostic performance in detecting the static gonioscopic angle closure and peripheral anterior synechia (PAS) based on swept source optical coherence tomography (SS-OCT) images. MATERIALS AND METHODS: Subjects were recruited from the Glaucoma Service at Zhongshan Ophthalmic Center of Sun Yat-sun University, Guangzhou, China. Each subject underwent a complete ocular examination, such as gonioscopy and SS-OCT imaging. Two deep learning classifiers, using convolutional neural networks (CNNs), were developed to diagnose the static gonioscopic angle closure and to differentiate appositional from synechial angle closure based on SS-OCT images. Area under the receiver operating characteristic (ROC) curve (AUC) was used as outcome measure to evaluate the diagnostic performance of two deep learning systems. RESULTS: A total of 439 eyes of 278 Chinese patients, which contained 175 eyes of positive PAS, were recruited to develop diagnostic models. For the diagnosis of static gonioscopic angle closure, the first deep learning classifier achieved an AUC of 0.963 (95% CI, 0.954–0.972) with a sensitivity of 0.929 and a specificity of 0.877. The AUC of the second deep learning classifier distinguishing appositional from synechial angle closure was 0.873 (95% CI, 0.864–0.882) with a sensitivity of 0.846 and a specificity of 0.764. CONCLUSION: Deep learning systems based on SS-OCT images showed good diagnostic performance for gonioscopic angle closure and moderate performance in the detection of PAS.