Supervised machine learning statistical models for visual outcome prediction in macular hole surgery: a single-surgeon, standardized surgery study
Abstract Purpose To evaluate the predictive accuracy of various machine learning (ML) statistical models in forecasting postoperative visual acuity (VA) outcomes following macular hole (MH) surgery using preoperative optical coherence tomography (OCT) parameters. Methods This retrospective study inc...
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BMC
2025-01-01
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| Series: | International Journal of Retina and Vitreous |
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| Online Access: | https://doi.org/10.1186/s40942-025-00630-3 |
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| author | Kanika Godani Vishma Prabhu Priyanka Gandhi Ayushi Choudhary Shubham Darade Rupal Kathare Prathiba Hande Ramesh Venkatesh |
| author_facet | Kanika Godani Vishma Prabhu Priyanka Gandhi Ayushi Choudhary Shubham Darade Rupal Kathare Prathiba Hande Ramesh Venkatesh |
| author_sort | Kanika Godani |
| collection | DOAJ |
| description | Abstract Purpose To evaluate the predictive accuracy of various machine learning (ML) statistical models in forecasting postoperative visual acuity (VA) outcomes following macular hole (MH) surgery using preoperative optical coherence tomography (OCT) parameters. Methods This retrospective study included 158 eyes (151 patients) with full-thickness MHs treated between 2017 and 2023 by the same surgeon and using the same intraoperative surgical technique. Data from electronic medical records and OCT scans were extracted, with OCT-derived qualitative and quantitative MH characteristics recorded. Six supervised ML models—ANCOVA, Random Forest (RF) regression, K-Nearest Neighbor, Support Vector Machine, Extreme Gradient Boosting, and Lasso regression—were trained using an 80:20 training-to-testing split. Model performance was evaluated on an independent testing dataset using the XLSTAT software. In total, the ML statistical models were trained and tested on 14,652 OCT data points from 1332 OCT images. Results Overall, 91% achieved MH closure post-surgery, with a median VA gain of -0.3 logMAR units. The RF regression model outperformed other ML models, achieving the lowest mean square error (MSE = 0.038) on internal validation. The most significant predictors of VA were postoperative MH closure status (variable importance = 43.078) and MH area index (21.328). The model accurately predicted the post-operative VA within 0.1, 0.2 and 0.3 logMAR units in 61%, 78%, and 87% of OCT images, respectively. Conclusion The RF regression model demonstrated superior predictive accuracy for forecasting postoperative VA, suggesting ML-driven approaches may improve surgical planning and patient counselling by providing reliable insights into expected visual outcomes based on pre-operative OCT features. Clinical trial registration number Not applicable. |
| format | Article |
| id | doaj-art-4dffcc2aed2e440fba42b2f7efeb5a24 |
| institution | Kabale University |
| issn | 2056-9920 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Retina and Vitreous |
| spelling | doaj-art-4dffcc2aed2e440fba42b2f7efeb5a242025-01-19T12:34:17ZengBMCInternational Journal of Retina and Vitreous2056-99202025-01-011111810.1186/s40942-025-00630-3Supervised machine learning statistical models for visual outcome prediction in macular hole surgery: a single-surgeon, standardized surgery studyKanika Godani0Vishma Prabhu1Priyanka Gandhi2Ayushi Choudhary3Shubham Darade4Rupal Kathare5Prathiba Hande6Ramesh Venkatesh7Department of Retina and VitreousDepartment of Retina and VitreousDepartment of Retina and VitreousDepartment of Retina and VitreousDepartment of Retina and VitreousDepartment of Retina and VitreousDepartment of Retina and VitreousDepartment of Retina and VitreousAbstract Purpose To evaluate the predictive accuracy of various machine learning (ML) statistical models in forecasting postoperative visual acuity (VA) outcomes following macular hole (MH) surgery using preoperative optical coherence tomography (OCT) parameters. Methods This retrospective study included 158 eyes (151 patients) with full-thickness MHs treated between 2017 and 2023 by the same surgeon and using the same intraoperative surgical technique. Data from electronic medical records and OCT scans were extracted, with OCT-derived qualitative and quantitative MH characteristics recorded. Six supervised ML models—ANCOVA, Random Forest (RF) regression, K-Nearest Neighbor, Support Vector Machine, Extreme Gradient Boosting, and Lasso regression—were trained using an 80:20 training-to-testing split. Model performance was evaluated on an independent testing dataset using the XLSTAT software. In total, the ML statistical models were trained and tested on 14,652 OCT data points from 1332 OCT images. Results Overall, 91% achieved MH closure post-surgery, with a median VA gain of -0.3 logMAR units. The RF regression model outperformed other ML models, achieving the lowest mean square error (MSE = 0.038) on internal validation. The most significant predictors of VA were postoperative MH closure status (variable importance = 43.078) and MH area index (21.328). The model accurately predicted the post-operative VA within 0.1, 0.2 and 0.3 logMAR units in 61%, 78%, and 87% of OCT images, respectively. Conclusion The RF regression model demonstrated superior predictive accuracy for forecasting postoperative VA, suggesting ML-driven approaches may improve surgical planning and patient counselling by providing reliable insights into expected visual outcomes based on pre-operative OCT features. Clinical trial registration number Not applicable.https://doi.org/10.1186/s40942-025-00630-3Macular holeOutcomesMachine learningStatistical modelsPrediction |
| spellingShingle | Kanika Godani Vishma Prabhu Priyanka Gandhi Ayushi Choudhary Shubham Darade Rupal Kathare Prathiba Hande Ramesh Venkatesh Supervised machine learning statistical models for visual outcome prediction in macular hole surgery: a single-surgeon, standardized surgery study International Journal of Retina and Vitreous Macular hole Outcomes Machine learning Statistical models Prediction |
| title | Supervised machine learning statistical models for visual outcome prediction in macular hole surgery: a single-surgeon, standardized surgery study |
| title_full | Supervised machine learning statistical models for visual outcome prediction in macular hole surgery: a single-surgeon, standardized surgery study |
| title_fullStr | Supervised machine learning statistical models for visual outcome prediction in macular hole surgery: a single-surgeon, standardized surgery study |
| title_full_unstemmed | Supervised machine learning statistical models for visual outcome prediction in macular hole surgery: a single-surgeon, standardized surgery study |
| title_short | Supervised machine learning statistical models for visual outcome prediction in macular hole surgery: a single-surgeon, standardized surgery study |
| title_sort | supervised machine learning statistical models for visual outcome prediction in macular hole surgery a single surgeon standardized surgery study |
| topic | Macular hole Outcomes Machine learning Statistical models Prediction |
| url | https://doi.org/10.1186/s40942-025-00630-3 |
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