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Background/AimTo train and validate the prediction performance of the deep learning (DL) model to predict visual field (VF) in central 10° from spectral domain optical coherence tomography (SD-OCT).MethodsThis multicentre, cross-sectional study included paired Humphrey field analyser (HFA) 10-2 VF and SD-OCT measurements from 591 eyes of 347 patients with open-angle glaucoma (OAG) or normal subjects for the training data set. We trained a convolutional neural network (CNN) for predicting VF threshold (TH) sensitivity values from the thickness of the three macular layers: retinal nerve fibre layer, ganglion cell layer+inner plexiform layer and outer segment+retinal pigment epithelium. We implemented pattern-based regularisation on top of CNN to avoid overfitting. Using an external testing data set of 160 eyes of 131 patients with OAG, the prediction performance (absolute error (AE) and R2 between predicted and actual TH values) was calculated for (1) mean TH in whole VF and (2) each TH of 68 points. For comparison, we trained support vector machine (SVM) and multiple linear regression (MLR).ResultsAE of whole VF with CNN was 2.84±2.98 (mean±SD) dB, significantly smaller than those with SVM (5.65±5.12 dB) and MLR (6.96±5.38 dB) (all, p<0.001). Mean of point-wise mean AE with CNN was 5.47±3.05 dB, significantly smaller than those with SVM (7.96±4.63 dB) and MLR (11.71±4.15 dB) (all, p<0.001). R2 with CNN was 0.74 for the mean TH of whole VF, and 0.44±0.24 for the overall 68 points.ConclusionDL model showed considerably accurate prediction of HFA 10-2 VF from SD-OCT.

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Conventionally, glaucoma is diagnosed on the basis of visual field sensitivity (VF). However, the VF test is time-consuming, costly, and noisy. Using retinal thickness (RT) for glaucoma diagnosis is currently desirable. Thus, we propose a new methodology for estimating VF from RT in glaucomatous eyes. The key ideas are to use our new methods of pattern-based regularization (PBR) and pattern-based visualization (PBV) with convolutional neural networks (CNNs). PBR effectively conducts supervised learning of RT-VF relations in combination with unsupervised learning from non-paired VF data. We can thereby avoid overfitting of a CNN to small sized data. PBV visualizes functional correspondence between RT and VF with its nonlinearity preserved. We empirically demonstrate with real datasets that a CNN with PBR achieves the highest estimation accuracy to date and that a CNN with PBV is effective for knowledge discovery in an ophthalmological context.

Purpose To investigate whether a correction based on a Humphrey field analyzer (HFA) 24-2/30-2 visual field (VF) can improve the prediction performance of a deep learning model to predict the HFA 10-2 VF test from macular optical coherence tomography (OCT) measurements. Methods This is a multicenter, cross-sectional study. The training dataset comprised 493 eyes of 285 subjects (407, open-angle glaucoma [OAG]; 86, normative) who underwent HFA 10-2 testing and macular OCT. The independent testing dataset comprised 104 OAG eyes of 82 subjects who had undergone HFA 10-2 test, HFA 24-2/30-2 test, and macular OCT. A convolutional neural network (CNN) DL model was trained to predict threshold sensitivity (TH) values in HFA 10-2 from retinal thickness measured by macular OCT. The predicted TH values was modified by pattern-based regularization (PBR) and corrected with HFA 24-2/30-2. Absolute error (AE) of mean TH values and mean absolute error (MAE) of TH values were compared between the CNN-PBR alone model and the CNN-PBR corrected with HFA 24-2/30-2. Results AE of mean TH values was lower in the CNN-PBR with HFA 24-2/30-2 correction than in the CNN-PBR alone (1.9dB vs. 2.6dB; P = 0.006). MAE of TH values was lower in the CNN-PBR with correction compared to the CNN-PBR alone (4.2dB vs. 5.3 dB; P < 0.001). The inferior temporal quadrant showed lower prediction errors compared with other quadrants. Conclusions The performance of a DL model to predict 10-2 VF from macular OCT was improved by the correction with HFA 24-2/30-2. Translational Relevance This model can reduce the burden of additional HFA 10-2 by making the best use of routinely performed HFA 24-2/30-2 and macular OCT.

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