Deep learning methods for ophthalmic diagnosis have shown considerable success in tasks like segmentation and classification. However, their widespread application is limited due to the models being opaque and vulnerable to making a wrong decision in complicated cases. Explainability methods show the features that a system used to make prediction while uncertainty awareness is the ability of a system to highlight when it is not sure about the decision. This is one of the first studies using uncertainty and explanations for informed clinical decision making. We perform uncertainty analysis of a deep learning model for diagnosis of four retinal diseases - age-related macular degeneration (AMD), central serous retinopathy (CSR), diabetic retinopathy (DR), and macular hole (MH) using images from a publicly available (OCTID) dataset. Monte Carlo (MC) dropout is used at the test time to generate a distribution of parameters and the predictions approximate the predictive posterior of a Bayesian model. A threshold is computed using the distribution and uncertain cases can be referred to the ophthalmologist thus avoiding an erroneous diagnosis. The features learned by the model are visualized using a proven attribution method from a previous study. The effects of uncertainty on model performance and the relationship between uncertainty and explainability are discussed in terms of clinical significance. The uncertainty information along with the heatmaps make the system more trustworthy for use in clinical settings.
Optical coherence tomography (OCT) images suffer from speckle noise. The presence of noise may degrade the quality of the images which may further make diagnosis difficult. In this work, a wavelet transform based deep generative modeling based method has been proposed to extract multi-scale features to denoise OCT images. The OCT images contain edge information of different retinal layers, to avoid the over-smoothing effect and edge content loss, the Sobel edge detector based loss function has been designed to retain the edge information. The method is compared with other traditional and deep learning based methods in terms of commonly used image quality measures such as peak-signal-to-noise-ratio (PSNR), structural similarity (SSIM) and edge information with the variance of Laplacian.
Optical coherence tomography (OCT) and retinal fundus images are widely used for detecting retinal pathology. In particular, these images are used by deep learning methods for classification of retinal disease. The main hurdle for widespread deployment of AI-based decision making in healthcare is a lack of interpretability of the cutting-edge deep learning-based methods. Conventionally, decision making by deep learning methods is considered to be a black box. Recently, there is a focus on developing techniques for explaining the decisions taken by deep neural networks, i.e. Explainable AI (XAI) to improve their acceptability for medical applications. In this study, a framework for interpreting the decision making of a deep learning network for retinal OCT image classification is proposed. An Inception-v3 based model was trained to detect choroidal neovascularization (CNV), diabetic macular edema (DME) and drusen from a dataset of over 80,000 OCT images. We visualized and compared various interpretability methods for the three disease classes. The attributions from various approaches are compared and discussed with respect to clinical significance. Results showed a successful attribution of the specific pathological regions of the OCT that are responsible for a given condition in the absence of any pixel-level annotations.
Globally Diabetic retinopathy (DR) is one of the leading causes of blindness. But due to low patient to doctor ratio performing clinical retinal screening processes for all such patients is not always possible. In this paper a deep learning based automated diabetic retinopathy detection method is presented . Though different frameworks exist for classifying different retinal diseases with both shallow machine learning algorithms and deep learning algorithms, there is very little literature on the problem of variation of sources between training and test data. Kaggle EYEPACS data was used in this study for training the dataset and the Messidor dataset was used for testing the efficiency of the model. With proper data sampling, augmentation and pre-processing techniques it was possible to achieve state-of-the-art accuracy of classification using Messidor dataset (which had a different camera settings and resolutions of images). The model achieved significant performance with a sensitivity of almost 90% and specificity of 91. 94% with an average accuracy of 90. 4
Comparison of deep learning results from various studies for glaucoma diagnosis is essentially meaningless since private data sets are often used. Another challenge is overfitting of the deep learning models with relatively small public datasets. This overfitting leads to poor generalization. Here, we propose a practical approach for fine tuning an existing state-of-the art deep learning model, namely, the Inception-v3 for glaucoma detection.. A two pronged approach using a transfer learning methodology combined with data augmentation and normalization is proposed herein. We used a publicly available dataset, RIM-ONE which has 624 monocular and 159 stereoscopic retinal fundus images. Data augmentation operations mimicking the natural deformations in fundus images along with Contrast Limited Adaptive Histogram Equalization (CLAHE) and normalization were applied to the images. The weights of Inception-v3 network were pretrained on the ImageNet dataset which consists of real-world objects. We finetuned this network for the RIM-ONE dataset to get the deep features required for glaucoma detection without overfitting. Even though we used a small dataset, the results obtained from this network are comparable to that reported in the literature.
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