Evidence map›Paper›PMID 40449950›Full record

ArticleBMJ open2025

Development and validation of a 3-D deep learning system for diabetic macular oedema classification on optical coherence tomography images.

Huishan Zhu, Jie Ji, Jian-Wei Lin, Ji Wang, Yi Zheng, Peiwen Xie, Cui Liu, Tsz Kin Ng, Jinqu Huang, Yongqun Xiong and 4 more

Abstract readValidation StudyMulticenter Study
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Article
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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

14 authors.

Huishan Zhu *Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China.ORCID http://orcid.org/0009-0000-4394-240X
Jie Ji *Shantou University Medical College, Shantou, China.
Jian-Wei Lin *Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China.
Ji WangJoint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China.
Yi ZhengJoint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China.
Peiwen XieJoint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China.
Cui LiuJoint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China.
Tsz Kin NgJoint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China.ORCID http://orcid.org/0000-0001-7863-7229
Jinqu HuangJoint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China.
Yongqun XiongJoint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China.
Hanfu WuJoint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China.
Leixian LinJoint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China.
Mingzhi ZhangThe Chinese University of Hong Kong, Hong Kong, China.ORCID http://orcid.org/0000-0001-9032-7274
Guihua ZhangJoint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China zgh@jsiec.org.ORCID http://orcid.org/0000-0002-3298-7220

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo develop and validate an automated diabetic macular oedema (DME) classification system based on the images from different three-dimensional optical coherence tomography (3-D OCT) devices.

designA multicentre, platform-based development study using retrospective and cross-sectional data. Data were subjected to a two-level grading system by trained graders and a retina specialist, and categorised into three types: no DME, non-centre-involved DME and centre-involved DME (CI-DME). The 3-D convolutional neural networks algorithm was used for DME classification system development. The deep learning (DL) performance was compared with the diabetic retinopathy experts.

settingData were collected from Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Chaozhou People's Hospital and The Second Affiliated Hospital of Shantou University Medical College from January 2010 to December 2023.

participants7790 volumes of 7146 eyes from 4254 patients were annotated, of which 6281 images were used as the development set and 1509 images were used as the external validation set, split based on the centres. MAIN OUTCOMES: Accuracy, F1-score, sensitivity, specificity, area under receiver operating characteristic curve (AUROC) and Cohen's kappa were calculated to evaluate the performance of the DL algorithm.

resultsIn classifying DME with non-DME, our model achieved an AUROCs of 0.990 (95% CI 0.983 to 0.996) and 0.916 (95% CI 0.902 to 0.930) for hold-out testing dataset and external validation dataset, respectively. To distinguish CI-DME from non-centre-involved-DME, our model achieved AUROCs of 0.859 (95% CI 0.812 to 0.906) and 0.881 (95% CI 0.859 to 0.902), respectively. In addition, our system showed comparable performance (Cohen's κ: 0.85 and 0.75) to the retina experts (Cohen's κ: 0.58-0.92 and 0.70-0.71).

conclusionsOur DL system achieved high accuracy in multiclassification tasks on DME classification with 3-D OCT images, which can be applied to population-based DME screening.

Indexed as

Deep LearningDiabetic RetinopathyImaging, Three-DimensionalMacular EdemaTomography, Optical CoherenceAgedCross-Sectional StudiesFemaleHumansMaleMiddle AgedRetrospective StudiesDiabetic retinopathyDiagnostic ImagingVetreoretinal

Identifiers

PMID40449950
PMCPMC12128415

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Registered trials

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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.