In this work, we propose an advanced AI based grading system for OCT images. The proposed system is a very deep fully convolutional attentive classification network trained with end to end advanced transfer learning with online random augmentation. It uses quasi random augmentation that outputs confidence values for diseases prevalence during inference. Its a fully automated retinal OCT analysis AI system capable of pathological lesions understanding without any offline preprocessing postprocessing step or manual feature extraction. We present a state of the art performance on the publicly available Mendeley OCT dataset.
@cite_18: The volume and complexity of diagnostic imaging is increasing at a pace faster than the availability of human expertise to interpret it. Artificial intelligence has shown great promise in classifying two-dimensional photographs of some common diseases and typically relies on databases of millions of annotated images. Until now, the challenge of reaching the performance of expert clinicians in a real-world clinical pathway with three-dimensional diagnostic scans has remained unsolved. Here, we apply a novel deep learning architecture to a clinically heterogeneous set of three-dimensional optical coherence tomography scans from patients referred to a major eye hospital. We demonstrate performance in making a referral recommendation that reaches or exceeds that of experts on a range of sight-threatening retinal diseases after training on only 14,884 scans. Moreover, we demonstrate that the tissue segmentations produced by our architecture act as a device-independent representation; referral accuracy is maintained when using tissue segmentations from a different type of device. Our work removes previous barriers to wider clinical use without prohibitive training data requirements across multiple pathologies in a real-world setting.
@cite_7: 
@cite_12: Our objective is to evaluate the efficacy of methods that use deep learning (DL) for the automatic fine-grained segmentation of optical coherence tomography (OCT) images of the retina. OCT images from 10 patients with mild non-proliferative diabetic retinopathy were used from a public (U. of Miami) dataset. For each patient, five images were available: one image of the fovea center, two images of the perifovea, and two images of the parafovea. For each image, two expert graders each manually annotated five retinal surfaces (i.e. boundaries between pairs of retinal layers). The first grader's annotations were used as ground truth and the second grader's annotations to compute inter-operator agreement. The proposed automated approach segments images using fully convolutional networks (FCNs) together with Gaussian process (GP)-based regression as a post-processing step to improve the quality of the estimates. Using 10-fold cross validation, the performance of the algorithms is determined by computing the per-pixel unsigned error (distance) between the automated estimates and the ground truth annotations generated by the first manual grader. We compare the proposed method against five state of the art automatic segmentation techniques. The results show that the proposed methods compare favorably with state of the art techniques, resulting in the smallest mean unsigned error values and associated standard deviations, and performance is comparable with human annotation of retinal layers from OCT when there is only mild retinopathy. The results suggest that semantic segmentation using FCNs, coupled with regression-based post-processing, can effectively solve the OCT segmentation problem on par with human capabilities with mild retinopathy.
Deep learning is also widely used in OCT image analysis task. A deep learning based OCT image segmentation method @cite_12 proposed pathological lesions segmentation using a fully convolutional method. Intraretinal cystoid fluid and subretinal fluid detection deep learning method @cite_7 using OCT was successfully tested with high accuracy. In case patient referral recommendation for sight-threatening retinal diseases using OCT images @cite_18 , this deep learning method outperforms expert ophthalmologist.