Deep learning-based prediction of refractive error using photorefraction images captured by a smartphone: Model development and validation study

Abstract

Background: Accurately predicting refractive error in children is crucial for detecting amblyopia, which can lead to permanent visual impairment, but is potentially curable if detected early. Various tools have been adopted to more easily screen a large number of patients for amblyopia risk. Objective: For efficient screening, easy access to screening tools and an accurate prediction algorithm are the most important factors. In this study, we developed an automated deep learning-based system to predict the range of refractive error in children (mean age 4.32 years, SD 1.87 years) using 305 eccentric photorefraction images captured with a smartphone. Methods: Photorefraction images were divided into seven classes according to their spherical values as measured by cycloplegic refraction. Results: The trained deep learning model had an overall accuracy of 81.6%, with the following accuracies for each refractive error class: 80.0% for ≤−5.0 diopters (D), 77.8% for >−5.0 D and ≤−3.0 D, 82.0% for >−3.0 D and ≤−0.5 D, 83.3% for >−0.5 D and