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Deep learning-based detection and classification of geographic atrophy using a deep convolutional neural network classifier

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript



To automatically detect and classify geographic atrophy (GA) in fundus autofluorescence (FAF) images using a deep learning algorithm.


In this study, FAF images of patients with GA, a healthy comparable group and a comparable group with other retinal diseases (ORDs) were used to train a multi-layer deep convolutional neural network (DCNN) (1) to detect GA and (2) to differentiate in GA between a diffuse-trickling pattern (dt-GA) and other GA FAF patterns (ndt-GA) in FAF images.

  1. 1.

    For the automated detection of GA in FAF images, two classifiers were built (GA vs. healthy/GA vs. ORD). The DCNN was trained and validated with 400 FAF images in each case (GA 200, healthy 200, or ORD 200). For the subsequent testing, the built classifiers were then tested with 60 untrained FAF images in each case (AMD 30, healthy 30, or ORD 30). Hereby, both classifiers automatically determined a GA probability score and a normal FAF probability score or an ORD probability score.

  2. 2.

    To automatically differentiate between dt-GA and ndt-GA, the DCNN was trained and validated with 200 FAF images (dt-GA 72; ndt-GA 138). Afterwards, the built classifier was tested with 20 untrained FAF images (dt-GA 10; ndt-GA 10) and a dt-GA probability score and an ndt-GA probability score was calculated.

For both classifiers, the performance of the training and validation procedure after 500 training steps was measured by determining training accuracy, validation accuracy, and cross entropy.


For the GA classifiers (GA vs. healthy/GA vs. ORD), the achieved training accuracy was 99/98%, the validation accuracy 96/91%, and the cross entropy 0.062/0.100. For the dt-GA classifier, the training accuracy was 99%, the validation accuracy 77%, and the cross entropy 0.166.

The mean GA probability score was 0.981 ± 0.048 (GA vs. healthy)/0.972 ± 0.439 (GA vs. ORD) in the GA image group and 0.01 ± 0.016 (healthy)/0.061 ± 0.072 (ORD) in the comparison groups (p < 0.001). The mean dt-GA probability score was 0.807 ± 0.116 in the dt-GA image group and 0.180 ± 0.100 in the ndt-GA image group (p < 0.001).


For the first time, this study describes the use of a deep learning-based algorithm to automatically detect and classify GA in FAF. Hereby, the created classifiers showed excellent results. With further developments, this model may be a tool to predict the individual progression risk of GA and give relevant information for future therapeutic approaches.

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Correspondence to Maximilian Treder.

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All authors certify that they have no affiliations with/or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements) or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Financial disclosure

M. Treder: Allergan, Novartis; J.L. Lauermann: Bayer, Novartis; N. Eter: Allergan, Alimera, Bausch and Lomb, Bayer, Heidelberg Engineering, Novartis, Roche.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Treder, M., Lauermann, J.L. & Eter, N. Deep learning-based detection and classification of geographic atrophy using a deep convolutional neural network classifier. Graefes Arch Clin Exp Ophthalmol 256, 2053–2060 (2018).

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