In this manuscript we develop a deep learning algorithm to improve estimation of rates of progression and prediction of future patterns of visual field loss in glaucoma. A generalized variational auto-encoder (VAE) was trained to learn a low-dimensional representation of standard automated perimetry (SAP) visual fields using 29,161 fields from 3,832 patients. The VAE was trained on a 90% sample of the data, with randomization at the patient level. Using the remaining 10%, rates of progression and predictions were generated, with comparisons to SAP mean deviation (MD) rates and point-wise (PW) regression predictions, respectively. The longitudinal rate of change through the VAE latent space (e.g., with eight dimensions) detected a significantly higher proportion of progression than MD at two (25% vs. 9%) and four (35% vs 15%) years from baseline. Early on, VAE improved prediction over PW, with significantly smaller mean absolute error in predicting the 4th, 6th and 8th visits from the first three (e.g., visit eight: VAE8: 5.14 dB vs. PW: 8.07 dB; P < 0.001). A deep VAE can be used for assessing both rates and trajectories of progression in glaucoma, with the additional benefit of being a generative technique capable of predicting future patterns of visual field damage.

译文

:在此手稿中,我们开发了一种深度学习算法,以改善青光眼的进展率估计和未来视野丧失模式的预测。训练了通用变分自动编码器(VAE),以使用来自3,832位患者的29,161个视野来学习标准自动视野(SAP)视野的低维表示。在90%的数据样本上对VAE进行了训练,并在患者水平上进行了随机分配。使用剩余的10%,生成进展和预测的速率,并分别与SAP平均偏差(MD)速率和逐点(PW)回归预测进行比较。在距基线两年(25%vs. 9%)和四年(35%vs 15%)的年份,通过VAE潜在空间的纵向变化率(例如,具有八个维度)检测到的进展比例明显高于MD。早期,VAE改进了PW的预测,从前三个中预测第4、6和8次访问时的平均绝对误差明显较小(例如,访问八次:VAE8:5.14 dB,而PW:8.07 dB; P <0.001)。深度VAE可用于评估青光眼的进展速度和轨迹,其另外的好处是能够预测未来视野损害模式的生成技术。

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