Automated Identification of Clinically Relevant Regions in Glaucoma OCT Reports Using Expert Eye Tracking Data and Deep Learning.

Purpose: To propose a deep learning-based approach for predicting the most-fixated regions on optical coherence tomography (OCT) reports using eye tracking data of ophthalmologists, assisting them in finding medically salient image regions.

Methods: We collected eye tracking data of ophthalmology residents, fellows, and faculty as they viewed OCT reports to detect glaucoma. We used a U-Net model as the deep learning backbone and quantized eye tracking coordinates by dividing the input report into an 11 × 11 grid. The model was trained to predict the grids on which fixations would land in unseen OCT reports. We investigated the contribution of different variables, including the viewer's level of expertise, model architecture, and number of eye gaze patterns included in training.

Results: Our approach predicted most-fixated regions in OCT reports with precision of 0.723, recall of 0.562, and f1-score of 0.609. We found that using a grid-based eye tracking structure enabled efficient training and using a U-Net backbone led to the best performance.

Conclusions: Our approach has the potential to assist ophthalmologists in diagnosing glaucoma by predicting the most medically salient regions on OCT reports. Our study suggests the value of eye tracking in guiding deep learning algorithms toward informative regions when experts may not be accessible.

Translational Relevance: By suggesting important OCT report regions for a glaucoma diagnosis, our model could aid in medical education and serve as a precursor for self-supervised deep learning approaches to expedite early detection of irreversible vision loss owing to glaucoma.