Predicting subretinal fluid absorption with machine learning in patients with central serous chorioretinopathy

Background Machine learning was used to predict subretinal fluid absorption (SFA) at 1, 3 and 6 months after laser treatment in patients with central serous chorioretinopathy (CSC). Methods The clinical and imaging data from 480 eyes of 461 patients with CSC were collected at Zhongshan Ophthalmic Center (ZOC) and Xiamen Eye Center (XEC). The data included clinical features from electronic medical records and measured features from fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), optical coherence tomography angiography (OCTA), and optical coherence tomography (OCT). A ZOC dataset was used for training and internal validation. An XEC dataset was used for external validation. Six machine learning algorithms and a blending algorithm were trained to predict SFA in patients with CSC after laser treatment. The SFA results predicted by machine learning were compared with the actual patient prognoses. Based on the initial detailed investigation, we constructed a simplified model using fewer clinical features and OCT features for convenient application. Results During the internal validation, random forest performed best in SFA prediction, with accuracies of 0.651±0.068, 0.753±0.065 and 0.818±0.058 at 1, 3 and 6 months, respectively. In the external validation, XGBoost performed best at SFA prediction with accuracies of 0.734, 0.727, and 0.900 at 1, 3 and 6 months, respectively. The simplified model showed a comparable level of predictive power. Conclusions Machine learning can achieve high accuracy in long-term SFA predictions and identify the features relevant to CSC patients' prognoses. Our study provides an individualized reference for ophthalmologists to treat and create a follow-up schedule for CSC patients.