Evidence map›Paper›PMID 34541004›Full record

ArticleJournal of diabetes research2021

Automated Grading of Diabetic Retinopathy with Ultra-Widefield Fluorescein Angiography and Deep Learning.

Xiaoling Wang, Zexuan Ji, Xiao Ma, Ziyue Zhang, Zuohuizi Yi, Hongmei Zheng, Wen Fan, Changzheng Chen

Abstract read
In one paragraph

Article in Journal of diabetes research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

13 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Applications of generative adversarial networks in the diagnosis, prognosis, and treatment of ophthalmic diseases.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2025
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  5. Artificial intelligence virtual assistants in primary eye care practice.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2025
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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

8 authors.

Xiaoling WangEye Center, Renmin Hospital of Wuhan University, Wuhan, China.ORCID https://orcid.org/0000-0003-2785-7066
Zexuan JiSchool of Computer Science and Engineering, Nanjing University of Science and Technology, Nanjing, China.ORCID https://orcid.org/0000-0003-1665-0270
Xiao MaSchool of Computer Science and Engineering, Nanjing University of Science and Technology, Nanjing, China.ORCID https://orcid.org/0000-0002-1842-5029
Ziyue ZhangSchool of Computer Science and Engineering, Nanjing University of Science and Technology, Nanjing, China.ORCID https://orcid.org/0000-0002-4556-573X
Zuohuizi YiEye Center, Renmin Hospital of Wuhan University, Wuhan, China.ORCID https://orcid.org/0000-0002-1601-9457
Hongmei ZhengEye Center, Renmin Hospital of Wuhan University, Wuhan, China.ORCID https://orcid.org/0000-0003-4354-1651
Wen FanDepartment of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.ORCID https://orcid.org/0000-0001-5224-6895
Changzheng ChenEye Center, Renmin Hospital of Wuhan University, Wuhan, China.ORCID https://orcid.org/0000-0002-7281-552X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe objective of this study was to establish diagnostic technology to automatically grade the severity of diabetic retinopathy (DR) according to the ischemic index and leakage index with ultra-widefield fluorescein angiography (UWFA) and the Early Treatment Diabetic Retinopathy Study (ETDRS) 7-standard field (7-SF).

methodsThis is a cross-sectional study. UWFA samples from 280 diabetic patients and 119 normal patients were used to train and test an artificial intelligence model to differentiate PDR and NPDR based on the ischemic index and leakage index with UWFA. A panel of retinal specialists determined the ground truth for our data set before experimentation. A confusion matrix as a metric was used to measure the precision of our algorithm, and a simple linear regression function was implemented to explore the discrimination of indexes on the DR grades. In addition, the model was tested with simulated 7-SF.

resultsThe model classification of DR in the original UWFA images achieved 88.50% accuracy and 73.68% accuracy in the simulated 7-SF images. A simple linear regression function demonstrated that there is a significant relationship between the ischemic index and leakage index and the severity of DR. These two thresholds were set to classify the grade of DR, which achieved 76.8% accuracy.

conclusionsThe optimization of the cycle generative adversarial network (CycleGAN) and convolutional neural network (CNN) model classifier achieved DR grading based on the ischemic index and leakage index with UWFA and simulated 7-SF and provided accurate inference results. The classification accuracy with UWFA is slightly higher than that of simulated 7-SF.

Indexed as

Deep LearningFluorescein AngiographyChinaCross-Sectional StudiesDiabetic RetinopathyHumansIschemia

Identifiers

PMID34541004
PMCPMC8445732

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