The study demonstrated the benefit of the machine learning model VGG16, which provided high sensitivity and specificity for detecting sight-threatening cytomegalovirus retinitis in HIV-positive patients. This model is a useful… Click to show full abstract
The study demonstrated the benefit of the machine learning model VGG16, which provided high sensitivity and specificity for detecting sight-threatening cytomegalovirus retinitis in HIV-positive patients. This model is a useful tool for ophthalmologists in clinical practice for preventing blindness from cytomegalovirus retinitis, especially during the COVID-19 pandemic. Propose: A screening protocol for cytomegalovirus retinitis (CMVR) by fundus photography was generated, and the diagnostic accuracy of machine learning technology for CMVR screening in HIV patients was investigated. Methods: One hundred sixty-five eyes of 90 HIV-positive patients were enrolled and evaluated for CMVR with binocular indirect ophthalmoscopy. Then, a single central field of the fundus image was recorded from each eye. All images were then interpreted by both machine learning models, generated by using the Keras application, and by a third-year ophthalmology resident. Diagnostic performance of CMVR screening using a machine learning model and the third-year ophthalmology resident were analyzed and compared. Results: Machine learning model, Keras application (VGG16), provided 68.8% (95% confidence interval [CI] = 50%–83.9%) sensitivity and 100% (95% CI = 97.2%–100%) specificity. The program provided accuracy of 93.94%. However, the sensitivity and specificity for the third-year ophthalmology grading were 67.7% (95% CI = 48.6%–83.3%) and 98.4% (95% CI = 94.5%–99.8%). The accuracy for CMVR classification was 89.70%. When considering for sight-threatening retinitis in Zone 1 and excluded Zones 2 and 3, the machine learning model provided high sensitivity of 88.2% (95% CI = 63.6%–98.5%) and high specificity of 100% (95% CI = 97.2%–100%). Conclusion: This study demonstrated the benefit of the machine learning model VGG16, which provided high sensitivity and specificity for detecting sight-threatening CMVR in HIV-positive patients. This model is a useful tool for ophthalmologists in clinical practice for preventing blindness from CMVR, especially during the Coronavrus Disease 2019 pandemic.
               
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