Abstract
INTRODUCTION: The aim of this work is to develop a deep learning (DL) system for rapidly and accurately screening for intraocular tumor (IOT), retinal detachment (RD), vitreous hemorrhage (VH), and posterior scleral staphyloma (PSS) using ocular B-scan ultrasound images. METHODS: Ultrasound images from five clinically confirmed categories, including vitreous hemorrhage, retinal detachment, intraocular tumor, posterior scleral staphyloma, and normal eyes, were used to develop and evaluate a fine-grained classification system (the Dual-Path Lesion Attention Network, DPLA-Net). Images were derived from five centers scanned by different sonographers and divided into training, validation, and test sets in a ratio of 7:1:2. Two senior ophthalmologists and four junior ophthalmologists were recruited to evaluate the system's performance. RESULTS: This multi-center cross-sectional study was conducted in six hospitals in China. A total of 6054 ultrasound images were collected; 4758 images were used for the training and validation of the system, and 1296 images were used as a testing set. DPLA-Net achieved a mean accuracy of 0.943 in the testing set, and the area under the curve was 0.988 for IOT, 0.997 for RD, 0.994 for PSS, 0.988 for VH, and 0.993 for normal. With the help of DPLA-Net, the accuracy of the four junior ophthalmologists improved from 0.696 (95% confidence interval [CI] 0.684-0.707) to 0.919 (95% CI 0.912-0.926, p < 0.001), and the time used for classifying each image reduced from 16.84 ± 2.34 s to 10.09 ± 1.79 s. CONCLUSIONS: The proposed DPLA-Net showed high accuracy for screening and classifying multiple ophthalmic diseases using B-scan ultrasound images across mutiple centers. Moreover, the system can promote the efficiency of classification by ophthalmologists.