Automated Detection of Vascular Leakage in Fluorescein Angiography – A Proof of Concept

Creative Commons License

Young L. H., Kim J., Yakin M., Lin H., Dao D. T., Kodati S., ...More

Translational Vision Science and Technology, vol.11, no.7, 2022 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 11 Issue: 7
  • Publication Date: 2022
  • Doi Number: 10.1167/tvst.11.7.19
  • Journal Name: Translational Vision Science and Technology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Keywords: fluorescein angiography, machine learning, uveitis
  • Lokman Hekim University Affiliated: No


Purpose: The purpose of this paper was to develop a deep learning algorithm to detect retinal vascular leakage (leakage) in fluorescein angiography (FA) of patients with uveitis and use the trained algorithm to determine clinically notable leakage changes. Methods: An algorithm was trained and tested to detect leakage on a set of 200 FA images (61 patients) and evaluated on a separate 50-image test set (21 patients). The ground truth was leakage segmentation by two clinicians. The Dice Similarity Coefficient (DSC) was used to measure concordance. Results: During training, the algorithm achieved a best average DSC of 0.572 (95% confidence interval [CI] = 0.548–0.596). The trained algorithm achieved a DSC of 0.563 (95% CI = 0.543–0.582) when tested on an additional set of 50 images. The trained algorithm was then used to detect leakage on pairs of FA images from longitudinal patient visits. Longitudinal leakage follow-up showed a >2.21% change in the visible retina area covered by leakage (as detected by the algorithm) had a sensitivity and speci-ficity of 90% (area under the curve [AUC] = 0.95) of detecting a clinically notable change compared to the gold standard, an expert clinician’s assessment. Conclusions: This deep learning algorithm showed modest concordance in identifying vascular leakage compared to ground truth but was able to aid in identifying vascular FA leakage changes over time. Translational Relevance: This is a proof-of-concept study that vascular leakage can be detected in a more standardized way and that tools can be developed to help clinicians more objectively compare vascular leakage between FAs.