Deep learning algorithms for detection of diabetic macular edema in OCT images: A systematic review and meta-analysis

Purpose Artificial intelligence (AI) can detect diabetic macular edema (DME) from optical coherence tomography (OCT) images. We aimed to evaluate the performance of deep learning neural networks in DME detection. Methods Embase, Pubmed, the Cochrane Library, and IEEE Xplore were searched up to August 14, 2021. We included studies using deep learning algorithms to detect DME from OCT images. Two reviewers extracted the data independently, and the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was applied to assess the risk of bias. The study is reported according to Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA). Results Ninteen studies involving 41005 subjects were included. The pooled sensitivity and specificity were 96.0% (95% confidence interval (CI): 93.9% to 97.3%) and 99.3% (95% CI: 98.2% to 99.7%), respectively. Subgroup analyses found that data set selection, sample size of training set and the choice of OCT devices contributed to the heterogeneity (all P < 0.05). While there was no association between the diagnostic accuracy and transfer learning adoption or image management (all P > 0.05). Conclusions Deep learning methods, particularly the convolutional neural networks (CNNs) could effectively detect clinically significant DME, which can provide referral suggestions to the patients.