ObjectiveTo evaluate the diagnostic accuracy of keratoconus using deep learning of the colour-coded maps measured with the swept-source anterior segment optical coherence tomography (AS-OCT).DesignA diagnostic accuracy study.SettingA single-centre study.ParticipantsA total of 304 keratoconic eyes (grade 1 (108 eyes), 2 (75 eyes), 3 (42 eyes) and 4 (79 eyes)) according to the Amsler-Krumeich classification, and 239 age-matched healthy eyes.Main outcome measuresThe diagnostic accuracy of keratoconus using deep learning of six colour-coded maps (anterior elevation, anterior curvature, posterior elevation, posterior curvature, total refractive power and pachymetry map).ResultsDeep learning of the arithmetical mean output data of these six maps showed an accuracy of 0.991 in discriminating between normal and keratoconic eyes. For single map analysis, posterior elevation map (0.993) showed the highest accuracy, followed by posterior curvature map (0.991), anterior elevation map (0.983), corneal pachymetry map (0.982), total refractive power map (0.978) and anterior curvature map (0.976), in discriminating between normal and keratoconic eyes. This deep learning also showed an accuracy of 0.874 in classifying the stage of the disease. Posterior curvature map (0.869) showed the highest accuracy, followed by corneal pachymetry map (0.845), anterior curvature map (0.836), total refractive power map (0.836), posterior elevation map (0.829) and anterior elevation map (0.820), in classifying the stage.ConclusionsDeep learning using the colour-coded maps obtained by the AS-OCT effectively discriminates keratoconus from normal corneas, and furthermore classifies the grade of the disease. It is suggested that this will become an aid for improving the diagnostic accuracy of keratoconus in daily practice.Clinical trial registration number000034587.
Deep Learning for Anterior Segment Optical Coherence Tomography to Predict the Presence of Plateau Iris