International Multi-Centre Validation of Unsupervised Domain Adaptation for Precise Discrimination between Normal and Abnormal Retinal Development

Abstract

Purpose : This study aims to develop an artificial intelligence (AI)-based system for accurately grading arrested retinal development using optical coherence tomography (OCT) across various manufacturers. We employ deep learning techniques, specifically Unsupervised Domain Adaptation (UDA), to create a device-agnostic classification model distinguishing normal and abnormal retinal development.

Methods : Foveal scans from three OCT manufacturers (TM-OCT1, HH-OCT1, TM-OCT2, TM-OCT3) were collected and annotated from datasets exceeding 20,000 OCT scans. The dataset was divided into training (80%) and testing (20%) sets. We utilised Convolutional Neural Networks (CNN) with ResNet50 backbone, assessing each pair as the source (for supervised training) and target (for unsupervised training). The diagnostic accuracy of the AI models was compared to seven clinician graders with varying experience (1 to 10 years), evaluating sensitivity, specificity, and overall accuracy.

Results : The cross-domain binary classification demonstrated exceptional diagnostic accuracy ranging from 87.75% to 96.06%. Sensitivity and specificity metrics further validated the robustness of our AI system (sensitivity: 88.68% to 98.38%, specificity: 78.00% to 98.02%). Notably, the model trained on TM-OCT1 and HH-OCT1 achieved 96.06% accuracy, 98.38% sensitivity, and 89.11% specificity on the HH-OCT1 test set, with an Area Under the Curve (AUC) of 99.4 (95% CI). These outcomes highlight the system's ability to distinguish normal and abnormal retinal development across diverse OCT devices.

Conclusions : Our study demonstrates, for the first time, the feasibility of employing a device-agnostic AI system in paediatric OCT interpretation without additional labelled data. The AI system's diagnostic performance is comparable to a clinician with over 10 years of experience, showcasing its potential to reduce inter-examiner variability and enhance clinical care pathways. With integration of paediatric OCT into routine clinical assessment, our AI system serves as a robust foundation for the development of a real-time, frontline diagnostic tool for retinal developmental disorders.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.