DeepDrRVO: A GAN-auxiliary two-step masked transformer framework benefits early recognition and differential diagnosis of retinal vascular occlusion from color fundus photographs.

Retinal vascular occlusion (RVO) are common causes of visual impairment. Accurate recognition and differential diagnosis of RVO are unmet medical needs for determining appropriate treatments and health care to properly manage the ocular condition and minimize the damaging effects. To leverage deep learning as a potential solution to detect RVO reliably, we developed a deep learning model on color fundus photographs (CFPs) using a two-step masked SwinTransformer with a Few-Sample Generator (FSG)-auxiliary training framework (called DeepDrRVO) for early and differential RVO diagnosis. The DeepDrRVO was trained on the training set from the in-house cohort and achieved consistently high performance in early recognition and differential diagnosis of RVO in the validation set from the in-house cohort with an accuracy of 86.3%, and other three independent multi-center cohorts with the accuracy of 92.6%, 90.8%, and 100%. Further comparative analysis showed that the proposed DeepDrRVO outperforms conventional state-of-the-art classification models, such as ResNet18, ResNet50d, MobileNetv3, and EfficientNetb1. These results highlight the potential benefits of the deep learning model in automatic early RVO detection and differential diagnosis for improving clinical outcomes and providing insights into diagnosing other ocular diseases with a few-shot learning challenge. The DeepDrRVO is publicly available on https://github.com/ZhouSunLab-Workshops/DeepDrRVO.