Identifying Mouse Autoimmune Uveitis from Fundus Photographs Using Deep Learning

Purpose: To develop a deep learning model for objective evaluation of experimental autoimmune uveitis (EAU), the animal model of posterior uveitis that reveals its essential pathological features via fundus photographs. Methods: We developed a deep learning construct to identify uveitis using reference mouse fundus images and further categorized the severity levels of disease into mild and severe EAU. We evaluated the performance of the model using the area under the receiver operating characteristic curve (AUC) and confusion matrices. We further assessed the clinical relevance of the model by visualizing the principal components of features at different layers and through the use of gradient-weighted class activation maps, which presented retinal regions having the most significant influence on the model. Results: Our model was trained, validated, and tested on 1500 fundus images (training, 1200; validation, 150; testing, 150) and achieved an average AUC of 0.98 for identifying the normal, trace (small and local lesions), and disease classes (large and spreading lesions). The AUCs of the model using an independent subset with 180 images were 1.00 (95% confidence interval [CI], 0.99-1.00), 0.97 (95% CI, 0.94-0.99), and 0.96 (95% CI, 0.90-1.00) for the normal, trace and disease classes, respectively. Conclusions: The proposed deep learning model is able to identify three severity levels of EAU with high accuracy. The model also achieved high accuracy on independent validation subsets, reflecting a substantial degree of generalizability. Translational Relevance: The proposed model represents an important new tool for use in animal medical research and provides a step toward clinical uveitis identification in clinical practice.