Distributed machine learning cloud teleophthalmology IoT for predicting AMD disease progression

Arun Das, Paul Rad, Kim-Kwang Raymond Choo, Babak Nouhi, Jonathan Lish, James Martel

Age-Related Macular Degeneration (AMD) Research using AREDS dataset provided by National Institute of Health (NIH).

Research Question: Developing Deep Learning algorithms for grading AMD into four severity categories.

Picture Ref: JAMA

Ref: ncbi.nlm.nih.gov

Each eye has:

• No drusen or small, nonextensive drusen
• No intermediate drusen
• No large drusen
• No pigment abnormalities
• No advanced AMD
• A visual acuity score of 74 letters or more
• No disqualifying lesions.

At least one eye has one or more intermediate drusen, extensive small drusen, or pigment abnormalities associated with AMD, and neither eye has:

• Large drusen
• Advanced AMD
• A visual acuity score of 73 or less
• A disqualifying lesion.

There are two types of AMD Category 3 participants.

1. At least one eye has one or more of the following:

• One or more large drusen
• Intermediate drusen, with total drusen area
  • At least that of Circle I-2 (i.e., about 20 average-size intermediate drusen) if soft indistinct drusen are present or
  • At least that of Circle O-2 (i.e., about 1/5 disc area, or about 65 average-size intermediate drusen) if soft indistinct drusen are absent
• Definite geographic atrophy not involving the center of the macula, and neither eye has any of the following:
  • Advanced AMD
  • A visual acuity score of 73 letters or less
  • A disqualifying lesion. or

2. Only one eye meets the criteria specified above in part

• and the fellow eye has either of the following:
  • A visual acuity score of 73 or less not attributable to AMD, or
  • A disqualifying lesion (listed in Section 3.1.3.2) considered to be uniocular.

There are two types of AMD Category 4 participants.

1. One eye has advanced AMD with or without visual acuity score of 73 or less, and with or without a disqualifying lesion considered to be uniocular, and the fellow eye has:

• A visual acuity score of 74 or more
• No evidence of advanced AMD
• No disqualifying lesion. or

2. One eye has reduced vision (< 74 letters) due to AMD, but no evidence of advanced AMD, and the fellow eye has:

• A visual acuity score of 74 or more
• No evidence of advanced AMD
• No disqualifying lesion.

Ref: ncbi.nlm.nih.gov

• Large Drusen: Large drusen (≥ 125 microns in diameter) in at least one eye at the last study visit and in at least one other study visit (in the same eye).
• Large Drusen Questionable 1: Large drusen in at least one eye at 2 or more visits (other than the last visit).
• Large Drusen Questionable 2: Large drusen in at least one eye only at the last study visit. This includes participants who only have a baseline visit if one or both eyes have large drusen.
• Large Drusen Questionable 3: Large drusen in at least one eye at just one study visit (other than the last visit).
• Control: AMD Category 1 (no drusen or small [< 63 microns in diameter] non-extensive drusen) in both eyes at all visits. This includes participants who only have a baseline visit if both eyes were graded as AMD Category 1.
• Control Questionable 1: AMD Category 1 in both eyes at last visit and at all previous visits, except that one eye is AMD Category 2 (non-extensive intermediate [(≥ 63 microns to < 125 microns in diameter] drusen or extensive small drusen) at one visit.
• Control Questionable 2: AMD Category 1 in both eyes at last visit and at all previous visits, except that each eye is AMD Category 2 at one visit.
• Control Questionable 3: AMD Category 1 in both eyes at last visit, no worse than AMD Category 2 in either eye at all other visits, at least one eye is Category 2 at 2 or more visits prior to last visit.
• Control Questionable 4: AMD Category 1 in one eye at last visit and AMD Category 2 in fellow eye at last visit; AMD Category 1 at all other visits. Participant must have at least one visit postbaseline.
• Other, Non-control: Does not meet any of the criteria of categories noted above.