A Structure-Related Fine-Grained Deep Learning System With Diversity Data for Universal Glaucoma Visual Field Grading

PURPOSE: Glaucoma is the main cause of irreversible blindness worldwide. However, the diagnosis and treatment of glaucoma remain difficult because of the lack of an effective glaucoma grading measure. In this study, we aimed to propose an artificial intelligence system to provide adequate assessment of glaucoma patients. METHODS: A total of 16,356 visual fields (VFs) measured by Octopus perimeters and Humphrey Field Analyzer (HFA) were collected, from three hospitals in China and the public Harvard database. We developed a fine-grained grading deep learning system, named FGGDL, to evaluate the VF loss, compared to ophthalmologists. Subsequently, we discuss the relationship between structural and functional damage for the comprehensive evaluation of glaucoma level. In addition, we developed an interactive interface and performed a cross-validation study to test its auxiliary ability. The performance was valued by F1 score, overall accuracy and area under the curve (AUC). RESULTS: The FGGDL achieved a high accuracy of 85 and 90%, and AUC of 0.93 and 0.90 for HFA and Octopus data, respectively. It was significantly superior (p < 0.01) to that of medical students and nearly equal (p = 0.614) to that of ophthalmic clinicians. For the cross-validation study, the diagnosis accuracy was almost improved (p < 0.05). CONCLUSION: We proposed a deep learning system to grade VF of glaucoma with a high detection accuracy, for effective and adequate assessment for glaucoma patients. Besides, with the convenient and credible interface, this system can promote telemedicine and be used as a self-assessment tool for patients with long-duration diseases.