Evidence map›Paper›PMID 34352302›Full record

ArticleOphthalmology2022

Differentiation of Active Corneal Infections from Healed Scars Using Deep Learning.

Mo Tiwari, Chris Piech, Medina Baitemirova, Namperumalsamy V Prajna, Muthiah Srinivasan, Prajna Lalitha, Natacha Villegas, Niranjan Balachandar, Janice T Chua, Travis Redd and 3 more

Open access · greenAbstract read
In one paragraph

Article in Ophthalmology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 1 pooled it
6.0field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Review
  5. Review
  6. Article
  7. Review
  8. Artificial intelligence in corneal diseases: A narrative review.Contact lens & anterior eye : the journal of the British Contact Lens Association · 2024
    Review
  9. Article
  10. Article
  11. Article
  12. Article
  13. Review
  14. Diagnosis ofDiagnostics (Basel, Switzerland) · 2023
    Review
  15. Review
  16. Article
  17. Artificial intelligence-assisted diagnosis of ocular surface diseases.Frontiers in cell and developmental biology · 2023
    Review
  18. Review
  19. Artificial intelligence and corneal diseases.Current opinion in ophthalmology · 2022
    Review
  20. Infectious keratitis: A review.Clinical & experimental ophthalmology · 2022
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 5 institutions in 2 countries.

Mo TiwariDepartment of Computer Science, Stanford University, Stanford, California.
Chris PiechDepartment of Computer Science, Stanford University, Stanford, California.
Medina BaitemirovaDepartment of Biomedical Informatics, Stanford University, Stanford, California.
Namperumalsamy V PrajnaAravind Eye Hospital, Madurai, India.
Muthiah SrinivasanAravind Eye Hospital, Madurai, India.
Prajna LalithaAravind Eye Hospital, Madurai, India.
Natacha VillegasByers Eye Institute, Stanford University, Stanford, California.
Niranjan BalachandarDepartment of Computer Science, Stanford University, Stanford, California.
Janice T ChuaSchool of Medicine, University of California, Irvine, Irvine, California.
Travis ReddDepartment of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, Portland, Oregon.
Thomas M LietmanFrancis I. Proctor Foundation, University of California San Francisco, San Francisco, California.
Sebastian ThrunDepartment of Computer Science, Stanford University, Stanford, California.
Charles C LinByers Eye Institute, Stanford University, Stanford, California. Electronic address: lincc@stanford.edu.
Stanford University · USAravind Eye Hospital · INOregon Health & Science University · USUniversity of California, Irvine · USUniversity of California, San Francisco · US

Funding

Proteomics CoreP30EY010572 · NEI · OREGON HEALTH & SCIENCE UNIVERSITY · PI Kate E Keller · 1995 to 2026
$19.4M
Stanford Vision Research CoreP30EY026877 · NEI · STANFORD UNIVERSITY · PI Jeffrey L Goldberg · 2017 to 2026
$8.0M
Myocotic Ulcer Treatment TrialU10EY018573 · NEI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI LIETMAN, THOMAS M · 2009 to 2014
$3.7M
The Steroids for Cornea Ulcers TrialU10EY015114 · NEI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI LIETMAN, THOMAS M · 2005 to 2009
$2.4M
Mentored Vision Clinician-Scientist Program at OHSUK12EY027720 · NEI · OREGON HEALTH & SCIENCE UNIVERSITY · PI David Huang · 2018 to 2026
$2.2M
NEI NIH HHS K12 EY027720NEI NIH HHS P30 EY010572NEI NIH HHS P30 EY026877NEI NIH HHS U10 EY015114NEI NIH HHS U10 EY018573
6 · The paper itself

Abstract

purposeTo develop and evaluate an automated, portable algorithm to differentiate active corneal ulcers from healed scars using only external photographs.

designA convolutional neural network was trained and tested using photographs of corneal ulcers and scars.

participantsDe-identified photographs of corneal ulcers were obtained from the Steroids for Corneal Ulcers Trial (SCUT), Mycotic Ulcer Treatment Trial (MUTT), and Byers Eye Institute at Stanford University.

methodsPhotographs of corneal ulcers (n = 1313) and scars (n = 1132) from the SCUT and MUTT were used to train a convolutional neural network (CNN). The CNN was tested on 2 different patient populations from eye clinics in India (n = 200) and the Byers Eye Institute at Stanford University (n = 101). Accuracy was evaluated against gold standard clinical classifications. Feature importances for the trained model were visualized using gradient-weighted class activation mapping.

main outcome measuresAccuracy of the CNN was assessed via F

resultsThe CNN correctly classified 115 of 123 active ulcers and 65 of 77 scars in patients with corneal ulcer from India (F

conclusionsThe CNN classified corneal ulcers and scars with high accuracy and generalized to patient populations outside of its training data. The CNN focused on clinically relevant features when it made a diagnosis. The CNN demonstrated potential as an inexpensive diagnostic approach that may aid triage in communities with limited access to eye care.

Indexed as

Deep LearningPhotographyAlgorithmsArea Under CurveCicatrixCorneal UlcerEye Infections, BacterialEye Infections, FungalFalse Positive ReactionsHumansPredictive Value of TestsRetrospective StudiesROC CurveSensitivity and SpecificitySlit Lamp MicroscopyWound HealingArtificial intelligenceCorneal scarCorneal ulcerDeep learningInfectious keratitis

Identifiers

PMID34352302
PMCPMC8792172
OpenAlexW3187960382

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.