Application of Artificial Intelligence to Quantitative Assessment of Fundus Tessellated Density in Young Adults with Different Refractions

Abstract

Introduction: To quantitatively assess fundus tessellated density (FTD) and associated factors by artificial intelligence (AI) in young adults. Methods: A total of 1084 undergraduates (age, 17-23 years old) were enrolled in November 2021. The students were divided into three groups according to axial length (AL): Group 1 (AL<24.0 mm, n=155), Group 2 (24 mm≤AL<26 mm, n=578), and Group 3 (AL≥26 mm, n=269). FTD was calculated by extracting the fundus tessellations as the regions of interest (Circle 1, diameter of 3.0 mm; Circle 2, diameter of 6.0 mm) and then calculating the average exposed choroid area per unit area of fundus. Results: Among 1084 students, 1002 (92.5%) students' FTDs were extracted. The mean FTD was 0.06±0.06 (range, 0 to 0.40). In multivariate analysis, FTD was significantly associated with male sex, longer AL, thinner subfoveal choroid thickness (SFCT), increased choriocapillaris vessel density (VD) and decreased deeper choroidal VD (all p<0.05). In Circle 1 (diameter of 3.0 mm) and Circle 2 (diameter of 6.0 mm), analysis of variance (ANOVA) showed that the FTD of the nasal (Nas) region (p<0.05) was significantly larger than that of the superior (Sup), inferior (Inf), and temporal (Tem) regions. Conclusion: AI-based imaging processing could improve the accuracy of fundus tessellation diagnosis. FTD was significantly associated with a longer AL, thinner SFCT, increased choriocapillaris VD, and decreased deeper choroidal VD.

Fundus Tessellated Density of Pathologic Myopia

“…They further examined FTD variations in different refractive statuses and reported a negative correlation between FTD and SE (mean –2.16 ± 2.40 D), with lower SE values associated with higher FTD. Likewise, Li et al 9 conducted a study involving 1084 young adults aged 17–23 years. They quantified FTD and investigated associated factors, including subfoveal choroid thickness.…”

“…This indicated that for PM patients, the “X” method is more suitable, and the 6.0-mm diameter centered on the macular is more representative. Li et al adopt the method of “X” and found that 3.0 and 6.0 mm were associated with longer AL and thinner subfoveal choroid thickness 9 . While for the optic disc, the different methods are all suitable.…”

“…Li et al adopt the method of "X" and found that 3.0 and 6.0 mm were associated with longer AL and thinner subfoveal choroid thickness. 9 While for the optic disc, the different methods are all suitable. In clinical practice, the "X" method is predominantly utilized to quantify the width of the optic disc rim.…”

“…The advancement of artificial intelligence imaging processing technology has enabled the quantitative measurement of fundus tessellated density (FTD) using color photographs. Previous studies have primarily focused on investigating the distribution of FTD and associated factors in population-based research or specific groups such as undergraduate populations 8–10 . However, there is a lack of research that specifically quantifies and compares FTD in different categories and locations of PM.…”

“…Previous studies have primarily focused on investigating the distribution of FTD and associated factors in populationbased research or specific groups such as undergraduate populations. [8][9][10] However, there is a lack of research that specifically quantifies and compares FTD in different categories and locations of PM. Furthermore, FTD has the capability to depict alterations in the choroidal blood vessels across the entire posterior fundus pole, and it has a certain advantage compared with optical coherence tomography (OCT), which is limited to quantitatively assessing of the choroid within specific regions.…”