External Validation of Deep Learning Models for Classifying Etiology of Retinal Hemorrhage Using Diverse Fundus Photography Datasets

Retinal hemorrhage (RH) is a significant clinical finding with various etiologies, necessitating accurate classification for effective management. This study aims to externally validate deep learning (DL) models, specifically FastVit_SA12 and ResNet18, for distinguishing between traumatic and medica...

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Main Authors: Pooya Khosravi, Nolan A. Huck, Kourosh Shahraki, Elina Ghafari, Reza Azimi, So Young Kim, Eric Crouch, Xiaohui Xie, Donny W. Suh
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Bioengineering
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Online Access:https://www.mdpi.com/2306-5354/12/1/20
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author Pooya Khosravi
Nolan A. Huck
Kourosh Shahraki
Elina Ghafari
Reza Azimi
So Young Kim
Eric Crouch
Xiaohui Xie
Donny W. Suh
author_facet Pooya Khosravi
Nolan A. Huck
Kourosh Shahraki
Elina Ghafari
Reza Azimi
So Young Kim
Eric Crouch
Xiaohui Xie
Donny W. Suh
author_sort Pooya Khosravi
collection DOAJ
description Retinal hemorrhage (RH) is a significant clinical finding with various etiologies, necessitating accurate classification for effective management. This study aims to externally validate deep learning (DL) models, specifically FastVit_SA12 and ResNet18, for distinguishing between traumatic and medical causes of RH using diverse fundus photography datasets. A comprehensive dataset was compiled, including private collections from South Korea and Virginia, alongside publicly available datasets such as RFMiD, BRSET, and DeepEyeNet. The models were evaluated on a total of 2661 images, achieving high performance metrics. FastVit_SA12 demonstrated an overall accuracy of 96.99%, with a precision of 0.9935 and recall of 0.9723 for medical cases, while ResNet18 achieved a 94.66% accuracy with a precision of 0.9893. A Grad-CAM analysis revealed that ResNet18 emphasized global vascular patterns, such as arcuate vessels, while FastVit_SA12 focused on clinically relevant areas, including the optic disk and hemorrhagic regions. Medical cases showed localized activations, whereas trauma-related images displayed diffuse patterns across the fundus. Both models exhibited strong sensitivity and specificity, indicating their potential utility in clinical settings for accurate RH diagnosis. This study underscores the importance of external validation in enhancing the reliability and applicability of AI models in ophthalmology, paving the way for improved patient care and outcomes.
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spelling doaj-art-d21fa339dabb4299abad6af1f25520e72025-01-24T13:22:59ZengMDPI AGBioengineering2306-53542024-12-011212010.3390/bioengineering12010020External Validation of Deep Learning Models for Classifying Etiology of Retinal Hemorrhage Using Diverse Fundus Photography DatasetsPooya Khosravi0Nolan A. Huck1Kourosh Shahraki2Elina Ghafari3Reza Azimi4So Young Kim5Eric Crouch6Xiaohui Xie7Donny W. Suh8Department of Ophthalmology, School of Medicine, University of California, Irvine, CA 92697, USADepartment of Ophthalmology, School of Medicine, University of California, Irvine, CA 92697, USADepartment of Ophthalmology, School of Medicine, University of California, Irvine, CA 92697, USADepartment of Ophthalmology, School of Medicine, University of California, Irvine, CA 92697, USADepartment of Ophthalmology, School of Medicine, University of California, Irvine, CA 92697, USADepartment of Ophthalmology, Soonchunhyang University College of Medicine, Cheonan, 31151, Republic of KoreaDepartment of Ophthalmology, Eastern Virginia Medical School, Norfolk, VA 23507, USADonald Bren School of Information and Computer Sciences, University of California, Irvine, CA 92697, USADepartment of Ophthalmology, School of Medicine, University of California, Irvine, CA 92697, USARetinal hemorrhage (RH) is a significant clinical finding with various etiologies, necessitating accurate classification for effective management. This study aims to externally validate deep learning (DL) models, specifically FastVit_SA12 and ResNet18, for distinguishing between traumatic and medical causes of RH using diverse fundus photography datasets. A comprehensive dataset was compiled, including private collections from South Korea and Virginia, alongside publicly available datasets such as RFMiD, BRSET, and DeepEyeNet. The models were evaluated on a total of 2661 images, achieving high performance metrics. FastVit_SA12 demonstrated an overall accuracy of 96.99%, with a precision of 0.9935 and recall of 0.9723 for medical cases, while ResNet18 achieved a 94.66% accuracy with a precision of 0.9893. A Grad-CAM analysis revealed that ResNet18 emphasized global vascular patterns, such as arcuate vessels, while FastVit_SA12 focused on clinically relevant areas, including the optic disk and hemorrhagic regions. Medical cases showed localized activations, whereas trauma-related images displayed diffuse patterns across the fundus. Both models exhibited strong sensitivity and specificity, indicating their potential utility in clinical settings for accurate RH diagnosis. This study underscores the importance of external validation in enhancing the reliability and applicability of AI models in ophthalmology, paving the way for improved patient care and outcomes.https://www.mdpi.com/2306-5354/12/1/20retinal hemorrhage (RH)deep learning (DL)fundus photographyexternal validation
spellingShingle Pooya Khosravi
Nolan A. Huck
Kourosh Shahraki
Elina Ghafari
Reza Azimi
So Young Kim
Eric Crouch
Xiaohui Xie
Donny W. Suh
External Validation of Deep Learning Models for Classifying Etiology of Retinal Hemorrhage Using Diverse Fundus Photography Datasets
Bioengineering
retinal hemorrhage (RH)
deep learning (DL)
fundus photography
external validation
title External Validation of Deep Learning Models for Classifying Etiology of Retinal Hemorrhage Using Diverse Fundus Photography Datasets
title_full External Validation of Deep Learning Models for Classifying Etiology of Retinal Hemorrhage Using Diverse Fundus Photography Datasets
title_fullStr External Validation of Deep Learning Models for Classifying Etiology of Retinal Hemorrhage Using Diverse Fundus Photography Datasets
title_full_unstemmed External Validation of Deep Learning Models for Classifying Etiology of Retinal Hemorrhage Using Diverse Fundus Photography Datasets
title_short External Validation of Deep Learning Models for Classifying Etiology of Retinal Hemorrhage Using Diverse Fundus Photography Datasets
title_sort external validation of deep learning models for classifying etiology of retinal hemorrhage using diverse fundus photography datasets
topic retinal hemorrhage (RH)
deep learning (DL)
fundus photography
external validation
url https://www.mdpi.com/2306-5354/12/1/20
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