Automatic Detection of Horner Syndrome by Using Facial Images.

Horner syndrome is a clinical constellation that presents with miosis, ptosis, and facial anhidrosis. It is important as a warning sign of the damaged oculosympathetic chain, potentially with serious causes. However, the diagnosis of Horner syndrome is operator dependent and subjective. This study aims to present an objective method that can recognize Horner sign from facial photos and verify its accuracy. A total of 173 images were collected, annotated, and divided into training and testing groups. Two types of classifiers were trained (two-stage classifier and one-stage classifier). The two-stage method utilized the MediaPipe face mesh to estimate the coordinates of landmarks and generate facial geometric features accordingly. Then, ten machine learning classifiers were trained based on this. The one-stage classifier was trained based on one of the latest algorithms, YOLO v5. The performance of the classifier was evaluated by the diagnosis accuracy, sensitivity, and specificity. For the two-stage model, the MediaPipe successfully detected 92.2% of images in the testing group, and the Decision Tree Classifier presented the highest accuracy (0.790). The sensitivity and specificity of this classifier were 0.432 and 0.970, respectively. As for the one-stage classifier, the accuracy, sensitivity, and specificity were 0.65, 0.51, and 0.84, respectively. The results of this study proved the possibility of automatic detection of Horner syndrome from images. This tool could work as a second advisor for neurologists by reducing subjectivity and increasing accuracy in diagnosing Horner syndrome.