arXiv:2506.17262cs.LGcs.AI2025-06被引 2

用AI分析视神经头受力变化,找出青光眼视野缺损的关键区域。

AI to Identify Strain-sensitive Regions of the Optic Nerve Head Linked to Functional Loss in Glaucoma

  • 通过力学模拟与深度学习,结合视神经头应变数据预测视野缺损模式。
  • 模型AUC达0.77-0.88,优于仅依赖结构信息的预测。
  • 发现视神经盘下部和下方颞侧区域对缺损预测最敏感,随病情加重而扩大。

目的:(1) 评估视神经头(ONH)生物力学是否能提升对青光眼三种进展性视野缺损模式的预测能力;(2) 利用可解释AI识别导致这些预测的关键应变敏感区域。方法:招募237例青光眼患者,对单眼在两种条件下成像:(1) 正常注视位,(2) 眼压通过眼动动力测量法升高至约35 mmHg。由专家根据特定视野缺损将受试者分为四类:(1) 上鼻侧阶梯(N=26),(2) 上部分弧形缺损(N=62),(3) 上半场缺损(N=25),(4) 其他/非特异性缺损(N=124)。采用自动组织分割与数字体积相关法计算眼压诱导的神经组织及筛板(LC)应变。将生物力学与结构特征输入几何深度学习模型,执行三项分类任务:(1) 上鼻侧阶梯,(2) 上部分弧形缺损,(3) 上半场缺损。数据按80%训练、20%测试划分,使用曲线下面积(AUC)评估性能。应用可解释AI技术突出各分类任务中关键的视神经头区域。结果:模型取得0.77–0.88的高AUC,表明视神经头应变可提升视野缺损预测能力,超越单纯形态学分析。关键应变敏感区域为下部和下颞侧视神经盘边缘,其贡献度随疾病进展而增强。结论与意义:视神经头应变有助于预测青光眼视野缺损模式。神经视网膜盘比筛板是模型预测中最关键的区域。

原文摘要 · Abstract (English)

Objective: (1) To assess whether ONH biomechanics improves prediction of three progressive visual field loss patterns in glaucoma; (2) to use explainable AI to identify strain-sensitive ONH regions contributing to these predictions. Methods: We recruited 237 glaucoma subjects. The ONH of one eye was imaged under two conditions: (1) primary gaze and (2) primary gaze with IOP elevated to ~35 mmHg via ophthalmo-dynamometry. Glaucoma experts classified the subjects into four categories based on the presence of specific visual field defects: (1) superior nasal step (N=26), (2) superior partial arcuate (N=62), (3) full superior hemifield defect (N=25), and (4) other/non-specific defects (N=124). Automatic ONH tissue segmentation and digital volume correlation were used to compute IOP-induced neural tissue and lamina cribrosa (LC) strains. Biomechanical and structural features were input to a Geometric Deep Learning model. Three classification tasks were performed to detect: (1) superior nasal step, (2) superior partial arcuate, (3) full superior hemifield defect. For each task, the data were split into 80% training and 20% testing sets. Area under the curve (AUC) was used to assess performance. Explainable AI techniques were employed to highlight the ONH regions most critical to each classification. Results: Models achieved high AUCs of 0.77-0.88, showing that ONH strain improved VF loss prediction beyond morphology alone. The inferior and inferotemporal rim were identified as key strain-sensitive regions, contributing most to visual field loss prediction and showing progressive expansion with increasing disease severity. Conclusion and Relevance: ONH strain enhances prediction of glaucomatous VF loss patterns. Neuroretinal rim, rather than the LC, was the most critical region contributing to model predictions.

青光眼视神经可解释AI生物力学

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