A deep learning approach for automated detection of geographic atrophy from color fundus photographs

Purpose: To assess the utility of deep learning in the detection of geographic atrophy (GA) from color fundus photographs; secondary aim to explore potential utility in detecting central GA (CGA). Design: A deep learning model was developed to detect the presence of GA in color fundus photographs, and two additional models to detect CGA in different scenarios. Participants: 59,812 color fundus photographs from longitudinal follow up of 4,582 participants in the AREDS dataset. Gold standard labels were from human expert reading center graders using a standardized protocol. Methods: A deep learning model was trained to use color fundus photographs to predict GA presence from a population of eyes with no AMD to advanced AMD. A second model was trained to predict CGA presence from the same population. A third model was trained to predict CGA presence from the subset of eyes with GA. For training and testing, 5-fold cross-validation was employed. For comparison with human clinician performance, model performance was compared with that of 88 retinal specialists. Results: The deep learning models (GA detection, CGA detection from all eyes, and centrality detection from GA eyes) had AUC of 0.933-0.976, 0.939-0.976, and 0.827-0.888, respectively. The GA detection model had accuracy, sensitivity, specificity, and precision of 0.965, 0.692, 0.978, and 0.584, respectively. The CGA detection model had equivalent values of 0.966, 0.763, 0.971, and 0.394. The centrality detection model had equivalent values of 0.762, 0.782, 0.729, and 0.799. Conclusions: A deep learning model demonstrated high accuracy for the automated detection of GA. The AUC was non-inferior to that of human retinal specialists. Deep learning approaches may also be applied to the identification of CGA. The code and pretrained models are publicly available at https://github.com/ncbi-nlp/DeepSeeNet.