Deep Learning with Disc Photos or OCT Scans in Glaucoma Detection
Bibliographic record
Abstract
Objective: To determine whether a deep learning (DL) model using retinal nerve fiber layer thickness (RNFLT) maps from OCT scans can detect glaucoma, defined by functional visual field (VF) impairment, more accurately than a DL model using disc photos (DPs). A secondary objective was to assess the diagnostic performance of these DL models across demographic groups (race, sex, and ethnicity). Design: Retrospective cohort study at a tertiary glaucoma center utilizing OCT and DP datasets collected between 2011 and 2022. Participants: Out of the 16 936 DP and OCT image sets, patients with Cirrus OCT images with a quality score ≥6 of 10 and reliable 24-2 Humphrey VF tests (fixation loss ≤33%, false-negative rate ≤20%, false-positive rate ≤20%), taken within 30 days of OCT, were included. Disc photos were obtained within 6 months of OCT. Data were randomly selected for training and testing of the DL models. Testing: Development of DL models utilizing either OCT RNFLT maps or DPs to detect glaucoma based on VF-defined functional impairment. Main Outcome Measures: The primary outcome was the area under the curve (AUC) for glaucoma detection, comparing the OCT-based DL model with the DP-based model. The secondary outcome was the AUC across demographic groups. Results: < 0.005). Conclusions: When glaucoma diagnosis was based on functional deficit, the OCT-based DL model offered greater accuracy in detecting glaucoma than the DP-based model, likely due to its use of objective and quantitative RNFLT measurements. This work supports the use of OCT-based DL models for glaucoma detection, while observed demographic disparities underscore the need for equitable datasets to ensure fair DL-driven glaucoma diagnosis across populations. Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".