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Deep learning model to identify homonymous defects on automated perimetry
  1. Aaron Hao Tan1,
  2. Laura Donaldson2,
  3. Luqmaan Moolla3,
  4. Austin Pereira4,
  5. Edward Margolin5
  1. 1Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, Ontario, Canada
  2. 2Ophthalmology and Vision Science, University of Toronto, Toronto, Ontario, Canada
  3. 3College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
  4. 4Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
  5. 5Ophthalmology, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Edward Margolin, Ophthalmology, University of Toronto, Toronto, Canada; edmargolin{at}


Background Homonymous visual field (VF) defects are usually an indicator of serious intracranial pathology but may be subtle and difficult to detect. Artificial intelligence (AI) models could play a key role in simplifying the detection of these defects. This study aimed to develop an automated deep learning AI model to accurately identify homonymous VF defects from automated perimetry.

Methods VFs performed on Humphrey field analyser (24–2 algorithm) were collected and run through an in-house optical character recognition program that extracted mean deviation data and prepared it for use in the proposed AI model. The deep learning AI model, Deep Homonymous Classifier, was developed using PyTorch framework and used convolutional neural networks to extract spatial features for binary classification. Total collected dataset underwent 7-fold cross validation for model training and evaluation. To address dataset class imbalance, data augmentation techniques and state-of-the-art loss function that uses complement cross entropy were used to train and enhance the proposed AI model.

Results The proposed model was evaluated using 7-fold cross validation and achieved an average accuracy of 87% for detecting homonymous VF defects in previously unseen VFs. Recall, which is a critical value for this model as reducing false negatives is a priority in disease detection, was found to be on average 92%. The calculated F2 score for the proposed model was 0.89 with a Cohen’s kappa value of 0.70.

Conclusion This newly developed deep learning model achieved an overall average accuracy of 87%, making it highly effective in identifying homonymous VF defects on automated perimetry.

  • field of vision
  • visual pathway

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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  • Contributors Study design: EM, LD and AHT; data collection: AP, LM, LD and AHT; data analysis: AHT; manuscript writing, and final approval of the manuscript: EM, LD, AHT, LM and AP. Guarantor: EM.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.