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Purpose  To develop an artificial intelligence (AI) system that can predict optical coherence tomography (OCT)-derived high myopia grades based on fundus photographs.    Methods  In this retrospective study, 1,853 qualified fundus photographs obtained from the Zhongshan Ophthalmic Center (ZOC) were selected to develop an AI system. Three retinal specialists assessed corresponding OCT images to label the fundus photographs. We developed a novel deep learning model to detect and predict myopic maculopathy according to the atrophy (A), traction (T), and neovascularisation (N) classification and grading system. Furthermore, we compared the performance of our model with that of ophthalmologists.    Results  When evaluated on the test set, the deep learning model showed an area under the receiver operating characteristic curve (AUC) of 0.969 for category A, 0.895 for category T, and 0.936 for category N. The average accuracy of each category was 92.38% (A), 85.34% (T), and 94.21% (N). Moreover, the performance of our AI system was superior to that of attending ophthalmologists and comparable to that of retinal specialists.    Conclusion  Our AI system achieved performance comparable to that of retinal specialists in predicting vision-threatening conditions in high myopia via simple fundus photographs instead of fundus and OCT images. The application of this system can save the cost of patients' follow-up, and is more suitable for applications in less developed areas that only have fundus photography.

Predicting Optical Coherence Tomography-Derived High Myopia Grades From Fundus Photographs Using Deep Learning