Prediction of treatment outcome in neovascular age-related macular degeneration using a novel convolutional neural network

Sci Rep. 2022 Apr 7;12(1):5871. doi: 10.1038/s41598-022-09642-7.

Abstract

While prognosis and risk of progression are crucial in developing precise therapeutic strategy in neovascular age-related macular degeneration (nAMD), limited predictive tools are available. We proposed a novel deep convolutional neural network that enables feature extraction through image and non-image data integration to seize imperative information and achieve highly accurate outcome prediction. The Heterogeneous Data Fusion Net (HDF-Net) was designed to predict visual acuity (VA) outcome (improvement ≥ 2 line or not) at 12th months after anti-VEGF treatment. A set of pre-treatment optical coherence tomography (OCT) image and non-image demographic features were employed as input data and the corresponding 12th-month post-treatment VA as the target data to train, validate, and test the HDF-Net. This newly designed HDF-Net demonstrated an AUC of 0.989 (95% CI 0.970-0.999), accuracy of 0.936 [95% confidence interval (CI) 0.889-0.964], sensitivity of 0.933 (95% CI 0.841-0.974), and specificity of 0.938 (95% CI 0.877-0.969). By simulating the clinical decision process with mixed pre-treatment information from raw OCT images and numeric data, HDF-Net demonstrated promising performance in predicting individualized treatment outcome. The results highlight the potential of deep learning to simultaneously process a broad range of clinical data to weigh and leverage the complete information of the patient. This novel approach is an important step toward real-world personalized therapeutic strategy for typical nAMD.

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Humans
  • Intravitreal Injections
  • Macular Degeneration* / diagnostic imaging
  • Macular Degeneration* / drug therapy
  • Neural Networks, Computer
  • Retrospective Studies
  • Tomography, Optical Coherence / methods
  • Treatment Outcome
  • Visual Acuity
  • Wet Macular Degeneration* / diagnostic imaging
  • Wet Macular Degeneration* / drug therapy

Substances

  • Angiogenesis Inhibitors