Machine learning (ML) has an impressive capacity to learn and analyze a large volume of data. This study aimed to train different algorithms to discriminate between healthy and pathologic corneal images by evaluating digitally processed spectral-domain optical coherence tomography (SD-OCT) corneal images. A set of 22 SD-OCT images belonging to a random set of corneal pathologies was compared to 71 healthy corneas (control group). A binary classification method was applied where three approaches of ML were explored. Once all images were analyzed, representative areas from every digital image were also extracted, processed and analyzed for a statistical feature comparison between healthy and pathologic corneas. The best performance was obtained from transfer learning—support vector machine (TL-SVM) (AUC = 0.94, SPE 88%, SEN 100%) and transfer learning—random forest (TL- RF) method (AUC = 0.92, SPE 84%, SEN 100%), followed by convolutional neural network (CNN) (AUC = 0.84, SPE 77%, SEN 91%) and random forest (AUC = 0.77, SPE 60%, SEN 95%). The highest diagnostic accuracy in classifying corneal images was achieved with the TL-SVM and the TL-RF models. In image classification, CNN was a strong predictor. This pilot experimental study developed a systematic mechanized system to discern pathologic from healthy corneas using a small sample.
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