*Article* **Discriminating Healthy Optic Discs and Visible Optic Disc Drusen on Fundus Autofluorescence and Color Fundus Photography Using Deep Learning—A Pilot Study**

**Raphael Diener \*, Jost Lennart Lauermann, Nicole Eter and Maximilian Treder**

Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany **\*** Correspondence: raphael.diener@ukmuenster.de; Tel.: +49-251-835-6001

**Abstract:** The aim of this study was to use deep learning based on a deep convolutional neural network (DCNN) for automated image classification of healthy optic discs (OD) and visible optic disc drusen (ODD) on fundus autofluorescence (FAF) and color fundus photography (CFP). In this study, a total of 400 FAF and CFP images of patients with ODD and healthy controls were used. A pre-trained multi-layer Deep Convolutional Neural Network (DCNN) was trained and validated independently on FAF and CFP images. Training and validation accuracy and cross-entropy were recorded. Both generated DCNN classifiers were tested with 40 FAF and CFP images (20 ODD and 20 controls). After the repetition of 1000 training cycles, the training accuracy was 100%, the validation accuracy was 92% (CFP) and 96% (FAF), respectively. The cross-entropy was 0.04 (CFP) and 0.15 (FAF). The sensitivity, specificity, and accuracy of the DCNN for classification of FAF images was 100%. For the DCNN used to identify ODD on color fundus photographs, sensitivity was 85%, specificity 100%, and accuracy 92.5%. Differentiation between healthy controls and ODD on CFP and FAF images was possible with high specificity and sensitivity using a deep learning approach.

**Keywords:** deep learning; artificial intelligence; optic disc drusen; visible optic disc drusen; optic disc drusen; deep convolutional neural network; DCNN; inceptionv3
