Forecasting Future Humphrey Visual Fields Using Deep Learning

TL;DR

This study demonstrates that deep learning models can accurately forecast future Humphrey Visual Fields up to 5.5 years ahead using only a single baseline test, aiding glaucoma progression prediction.

Contribution

Introduces a deep learning approach capable of predicting future visual fields from a single baseline, advancing glaucoma progression modeling.

Findings

Best model achieved 2.47 dB MAE on test set.

Predicted visual fields correlated with actual with r=0.92 up to 5.5 years.

Model trained on over 1.7 million data points from 32,443 tests.

Abstract

Purpose: To determine if deep learning networks could be trained to forecast a future 24-2 Humphrey Visual Field (HVF). Participants: All patients who obtained a HVF 24-2 at the University of Washington. Methods: All datapoints from consecutive 24-2 HVFs from 1998 to 2018 were extracted from a University of Washington database. Ten-fold cross validation with a held out test set was used to develop the three main phases of model development: model architecture selection, dataset combination selection, and time-interval model training with transfer learning, to train a deep learning artificial neural network capable of generating a point-wise visual field prediction. Results: More than 1.7 million perimetry points were extracted to the hundredth decibel from 32,443 24-2 HVFs. The best performing model with 20 million trainable parameters, CascadeNet-5, was selected. The overall MAE for the test set was 2.47 dB (95% CI: 2.45 dB to 2.48 dB). The 100 fully trained models were able to successfully predict progressive field loss in glaucomatous eyes up to 5.5 years in the future with a correlation of 0.92 between the MD of predicted and actual future HVF (p < 2.2 x 10 -16 ) and an average difference of 0.41 dB. Conclusions: Using unfiltered real-world datasets, deep learning networks show an impressive ability to not only learn spatio-temporal HVF changes but also to generate predictions for future HVFs up to 5.5 years, given only a single HVF.