Optical coherence tomography-based short-term effect prediction of anti-vascular endothelial growth factor treatment in neovascular age-related macular degeneration using sensitive structure guided network.

purposeTo predict short-term anti-vascular endothelial growth factor (anti-VEGF) treatment responder/non-responder for neovascular age-related macular degeneration (nAMD) patients based on optical coherence tomography (OCT) images.

methodsA total of 4944 OCT scans from 206 patients with nAMD were involved to develop and evaluate a responder/non-responder prediction method for the short-term effect of anti-VEGF therapy. A deep learning architecture named sensitive structure guided network (SSG-Net) was proposed to make the prediction leveraging a sensitive structure guidance module trained from pre- and post-treatment images. To verify its clinical efficiency, other 2 deep learning methods and 4 experienced ophthalmologists were involved to evaluate the performance of the developed model.

resultsFor the testing dataset, SSG-Net could predict the response by an accuracy of 84.6% and an area under the receiver curve (AUC) of 0.83, with a sensitivity of 0.692 and specificity of 1. In contrast, the 2 compared deep learning methods achieved an accuracy of 65.4% with a sensitivity of 0.461 and specificity of 0.846, and an accuracy of 73.1% with a sensitivity of 0.692 and specificity of 0.846, respectively. The predicted accuracy for 4 experienced ophthalmologists was 53.8 to 76.9%, with sensitivity of 0.538 to 0.923 and specificity of 0.385 to 0.846, respectively.

conclusionOur proposed SSG-Net shows effective prediction on the short-term efficacy of anti-VEGF treatment for nAMD patients. This technique could potentially help clinicians explain the necessity of anti-VEGF treatment to the potential responder and avoid unnecessary treatment for the non-responder.