Dataset Information

Artificial Intelligence Mapping of Structure to Function in Glaucoma.

ABSTRACT: Purpose:To develop an artificial intelligence (AI)-based structure-function (SF) map relating retinal nerve fiber layer (RNFL) damage on spectral domain optical coherence tomography (SDOCT) to functional loss on standard automated perimetry (SAP). Methods:The study included 26,499 pairs of SAP and SDOCT from 15,173 eyes of 8878 patients with glaucoma or suspected of having the disease extracted from the Duke Glaucoma Registry. The data set was randomly divided at the patient level in training and test sets. A convolutional neural network (CNN) was initially trained and validated to predict the 52 sensitivity threshold points of the 24-2 SAP from the 768 RNFL thickness points of the SDOCT peripapillary scan. Simulated localized RNFL defects of varied locations and depths were created by modifying the normal average peripapillary RNFL profile. The simulated profiles were then fed to the previously trained CNN, and the topographic SF relationships between structural defects and SAP functional losses were investigated. Results:The CNN predictions had an average correlation coefficient of 0.60 (P < 0.001) with the measured values from SAP and a mean absolute error of 4.25 dB. Simulated RNFL defects led to well-defined arcuate or paracentral visual field losses in the opposite hemifield, which varied according to the location and depth of the simulations. Conclusions:A CNN was capable of predicting SAP sensitivity thresholds from SDOCT RNFL thickness measurements and generate an SF map from simulated defects. Translational Relevance:AI-based SF map improves the understanding of how SDOCT losses translate into detectable SAP damage.

SUBMITTER: Mariottoni EB

PROVIDER: S-EPMC7395675 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Artificial Intelligence Mapping of Structure to Function in Glaucoma.

Mariottoni Eduardo B EB Datta Shounak S Dov David D Jammal Alessandro A AA Berchuck Samuel I SI Tavares Ivan M IM Carin Lawrence L Medeiros Felipe A FA

Translational vision science & technology 20200330 2

<h4>Purpose</h4>To develop an artificial intelligence (AI)-based structure-function (SF) map relating retinal nerve fiber layer (RNFL) damage on spectral domain optical coherence tomography (SDOCT) to functional loss on standard automated perimetry (SAP).<h4>Methods</h4>The study included 26,499 pairs of SAP and SDOCT from 15,173 eyes of 8878 patients with glaucoma or suspected of having the disease extracted from the Duke Glaucoma Registry. The data set was randomly divided at the patient level ...[more]

PMID: 32818080

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Project description:PurposeTo quantify the central visual field (VF) loss patterns in glaucoma using artificial intelligence.DesignRetrospective study.ParticipantsVFs of 8712 patients with 13 951 Humphrey 10-2 test results from 13 951 eyes for cross-sectional analyses, and 824 patients with at least 5 reliable 10-2 test results at 6-month intervals or more from 1191 eyes for longitudinal analyses.MethodsTotal deviation values were used to determine the central VF patterns using the most recent 10-2 test results. A 24-2 VF within a 3-month window of the 10-2 tests was used to stage eyes into mild, moderate, or severe functional loss using the Hodapp-Anderson-Parrish scale at baseline. Archetypal analysis was applied to determine the central VF patterns. Cross-validation was performed to determine the optimal number of patterns. Stepwise regression was applied to select the optimal feature combination of global indices, average baseline decomposition coefficients from central VFs archetypes, and other factors to predict central VF mean deviation (MD) slope based on the Bayesian information criterion (BIC).Main outcome measuresThe central VF patterns stratified by severity stage based on 24-2 test results and a model to predict the central VF MD change over time using baseline test results.ResultsFrom cross-sectional analysis, 17 distinct central VF patterns were determined for the 13 951 eyes across the spectrum of disease severity. These central VF patterns could be divided into isolated superior loss, isolated inferior loss, diffuse loss, and other loss patterns. Notably, 4 of the 5 patterns of diffuse VF loss preserved the less vulnerable inferotemporal zone, whereas they lost most of the remaining more vulnerable zone described by the Hood model. Inclusion of coefficients from central VF archetypical patterns strongly improved the prediction of central VF MD slope (BIC decrease, 35; BIC decrease of >6 indicating strong prediction improvement) than using only the global indices of 2 baseline VF results. Eyes with baseline VF results with more superonasal and inferonasal loss were more likely to show worsening MD over time.ConclusionsWe quantified central VF patterns in glaucoma, which were used to improve the prediction of central VF worsening compared with using only global indices.

Project description:PurposePrior artificial intelligence (AI) models for predicting glaucoma progression have used traditional classifiers that do not consider the longitudinal nature of patients' follow-up. In this study, we developed survival-based AI models for predicting glaucoma patients' progression to surgery, comparing performance of regression-, tree-, and deep learning-based approaches.DesignRetrospective observational study.SubjectsPatients with glaucoma seen at a single academic center from 2008 to 2020 identified from electronic health records (EHRs).MethodsFrom the EHRs, we identified 361 baseline features, including demographics, eye examinations, diagnoses, and medications. We trained AI survival models to predict patients' progression to glaucoma surgery using the following: (1) a penalized Cox proportional hazards (CPH) model with principal component analysis (PCA); (2) random survival forests (RSFs); (3) gradient-boosting survival (GBS); and (4) a deep learning model (DeepSurv). The concordance index (C-index) and mean cumulative/dynamic area under the curve (mean AUC) were used to evaluate model performance on a held-out test set. Explainability was investigated using Shapley values for feature importance and visualization of model-predicted cumulative hazard curves for patients with different treatment trajectories.Main outcome measuresProgression to glaucoma surgery.ResultsOf the 4512 patients with glaucoma, 748 underwent glaucoma surgery, with a median follow-up of 1038 days. The DeepSurv model performed best overall (C-index, 0.775; mean AUC, 0.802) among the models studied in this article (CPH with PCA: C-index, 0.745; mean AUC, 0.780; RSF: C-index, 0.766; mean AUC, 0.804; GBS: C-index, 0.764; mean AUC, 0.791). Predicted cumulative hazard curves demonstrate how models could distinguish between patient who underwent early surgery and patients who underwent surgery after > 3000 days of follow-up or no surgery.ConclusionsArtificial intelligence survival models can predict progression to glaucoma surgery using structured data from EHRs. Tree-based and deep learning-based models performed better at predicting glaucoma progression to surgery than the CPH regression model, potentially because of their better suitability for high-dimensional data sets. Future work predicting ophthalmic outcomes should consider using tree-based and deep learning-based survival AI models. Additional research is needed to develop and evaluate more sophisticated deep learning survival models that can incorporate clinical notes or imaging.Financial disclosuresProprietary or commercial disclosure may be found after the references.

Project description:ImportanceAlthough the central visual field (VF) in end-stage glaucoma may substantially vary among patients, structure-function studies and quality-of-life assessments are impeded by the lack of appropriate characterization of end-stage VF loss.ObjectiveTo provide a quantitative characterization and classification of central VF loss in end-stage glaucoma.Design, setting, and participantsThis retrospective cohort study collected data from 5 US glaucoma services from June 1, 1999, through October 1, 2014. A total of 2912 reliable 10-2 VFs of 1103 eyes from 1010 patients measured after end-stage 24-2 VFs with a mean deviation (MD) of -22 dB or less were included in the analysis. Data were analyzed from March 28, 2018, through May 23, 2019.Main outcomes and measuresCentral VF patterns were determined by an artificial intelligence algorithm termed archetypal analysis. Longitudinal analyses were performed to investigate whether the development of central VF defect mostly affects specific vulnerability zones.ResultsAmong the 1103 patients with the most recent VFs, mean (SD) age was 70.4 (14.3) years; mean (SD) 10-2 MD, -21.5 (5.6) dB. Fourteen central VF patterns were determined, including the most common temporal sparing patterns (304 [27.5%]), followed by mostly nasal loss (280 [25.4%]), hemifield loss (169 [15.3%]), central island (120 [10.9%]), total loss (91 [8.3%]), nearly intact field (56 [5.1%]), inferonasal quadrant sparing (42 [3.8%]), and nearly total loss (41 [3.7%]). Location-specific median total deviation analyses partitioned the central VF into a more vulnerable superonasal zone and a less vulnerable inferotemporal zone. At 1-year and 2-year follow-up, new defects mostly occurred in the more vulnerable zone. Initial encroachments on an intact central VF at follow-up were more likely to be from nasal loss (11 [18.4%]; P < .001). One of the nasal loss patterns had a substantial chance at 2-year follow-up (8 [11.0%]; P = .004) to shift to total loss, whereas others did not.Conclusions and relevanceIn this study, central VF loss in end-stage glaucoma was found to exhibit characteristic patterns that might be associated with different subtypes. Initial central VF loss is likely to be nasal loss, and 1 specific type of nasal loss is likely to develop into total loss.

Project description:The drug development process is a major challenge in the pharmaceutical industry since it takes a substantial amount of time and money to move through all the phases of developing of a new drug. One extensively used method to minimize the cost and time for the drug development process is computer-aided drug design (CADD). CADD allows better focusing on experiments, which can reduce the time and cost involved in researching new drugs. In this context, structure-based virtual screening (SBVS) is robust and useful and is one of the most promising in silico techniques for drug design. SBVS attempts to predict the best interaction mode between two molecules to form a stable complex, and it uses scoring functions to estimate the force of non-covalent interactions between a ligand and molecular target. Thus, scoring functions are the main reason for the success or failure of SBVS software. Many software programs are used to perform SBVS, and since they use different algorithms, it is possible to obtain different results from different software using the same input. In the last decade, a new technique of SBVS called consensus virtual screening (CVS) has been used in some studies to increase the accuracy of SBVS and to reduce the false positives obtained in these experiments. An indispensable condition to be able to utilize SBVS is the availability of a 3D structure of the target protein. Some virtual databases, such as the Protein Data Bank, have been created to store the 3D structures of molecules. However, sometimes it is not possible to experimentally obtain the 3D structure. In this situation, the homology modeling methodology allows the prediction of the 3D structure of a protein from its amino acid sequence. This review presents an overview of the challenges involved in the use of CADD to perform SBVS, the areas where CADD tools support SBVS, a comparison between the most commonly used tools, and the techniques currently used in an attempt to reduce the time and cost in the drug development process. Finally, the final considerations demonstrate the importance of using SBVS in the drug development process.

Dataset Information

Artificial Intelligence Mapping of Structure to Function in Glaucoma.

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Artificial Intelligence Mapping of Structure to Function in Glaucoma.

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