Deep learning segmentation of hyperautofluorescent fleck lesions in Stargardt disease

Sci Rep. 2020 Oct 5;10(1):16491. doi: 10.1038/s41598-020-73339-y.

Abstract

Stargardt disease is one of the most common forms of inherited retinal disease and leads to permanent vision loss. A diagnostic feature of the disease is retinal flecks, which appear hyperautofluorescent in fundus autofluorescence (FAF) imaging. The size and number of these flecks increase with disease progression. Manual segmentation of flecks allows monitoring of disease, but is time-consuming. Herein, we have developed and validated a deep learning approach for segmenting these Stargardt flecks (1750 training and 100 validation FAF patches from 37 eyes with Stargardt disease). Testing was done in 10 separate Stargardt FAF images and we observed a good overall agreement between manual and deep learning in both fleck count and fleck area. Longitudinal data were available in both eyes from 6 patients (average total follow-up time 4.2 years), with both manual and deep learning segmentation performed on all (n = 82) images. Both methods detected a similar upward trend in fleck number and area over time. In conclusion, we demonstrated the feasibility of utilizing deep learning to segment and quantify FAF lesions, laying the foundation for future studies using fleck parameters as a trial endpoint.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Deep Learning
  • Electroretinography / methods
  • Female
  • Fluorescein Angiography / methods
  • Fundus Oculi
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Ophthalmoscopy / methods
  • Optical Imaging / methods
  • Retina / metabolism
  • Retina / pathology
  • Retinal Pigment Epithelium / metabolism
  • Retinal Pigment Epithelium / pathology
  • Stargardt Disease / metabolism
  • Stargardt Disease / pathology*
  • Tomography, Optical Coherence / methods
  • Young Adult
  • Zinc Phosphate Cement / metabolism*

Substances

  • Flecks
  • Zinc Phosphate Cement