The study was done to evaluate, with SD-OCT, the glaucoma-diagnostic ability of a deep-learning classifier.

777 Cirrus high-definition SD-OCT image sets of the RNFL and GCIPL of 315 normal subjects, 219 patients with early-stage POAG and 243 patients with moderate-to-severe-stage POAG were aggregated. The image sets were divided into a training data set (252 normal, 174 early POAG and 195 moderate-to-severe POAG) and a test data set (63 normal, 45 early POAG and 48 moderate-to-severe POAG).

For the test data set, DICNN could distinguish between patients with glaucoma and normal subjects accurately (accuracy=92.793%, AUC=0.957 (95% CI 0.943 to 0.966), sensitivity=0.896 (95% CI 0.896 to 0.917), specificity=0.952 (95% CI 0.921 to 0.952)). For distinguishing between patients with early-stage glaucoma and normal subjects, DICNN’s diagnostic ability (accuracy=85.185%, AUC=0.869 (95% CI 0.825 to 0.879), sensitivity=0.921 (95% CI 0.813 to 0.905), specificity=0.756 (95% CI 0.610 to 0.790)]) was higher than convolutional neural network algorithms that trained with RNFL or GCIPL separately.

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The study concluded that the deep-learning algorithm using SD-OCT can distinguish normal subjects not only from established patients with glaucoma but also from patients with early-stage glaucoma. The deep-learning model with DICNN, as trained by both RNFL and GCIPL thickness map data, showed a high diagnostic ability for discriminating patients with early-stage glaucoma from normal subjects.