Saki Noma1, Takehiro Yamashita2, Ryo Asaoka3,4,5,6, Hiroto Terasaki2, Naoya Yoshihara2, Naoko Kakiuchi2, Taiji Sakamoto2. 1. Department of Ophthalmology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu, Shizuoka, Japan. 2. Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan. 3. Department of Ophthalmology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu, Shizuoka, Japan. rasaoka-tky@umin.ac.jp. 4. Seirei Christopher University, Hamamatsu, Shizuoka, Japan. rasaoka-tky@umin.ac.jp. 5. Department of Ophthalmology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan. rasaoka-tky@umin.ac.jp. 6. Department of Ophthalmology, The University of Tokyo, Tokyo, Japan. rasaoka-tky@umin.ac.jp.
Abstract
PURPOSES: Recently, artificial intelligence has been used to determine sex using fundus photographs alone. We had earlier reported that sex can be distinguished using known factors obtained from color fundus photography (CFP) in adult eyes. However, it is not clear when the sex difference in fundus parameters begins. Therefore, we conducted this study to investigate sex determination based on fundus parameters using binominal logistic regression in elementary school students. METHODS: This prospective observational cross-sectional study was conducted on 119 right eyes of elementary school students (aged 8 or 9 years, 59 boys and 60 girls). Through CFP, the tessellation fundus index was calculated as R/(R + G + B) using the mean value of red-green-blue intensity in the eight locations around the optic disc. Optic disc ovality ratio, papillomacular angle, retinal artery trajectory, and retinal vessel were quantified based on our earlier reports. Regularized binomial logistic regression was applied to these variables to select the decisive factors. Furthermore, its discriminative performance was evaluated using the leave-one-out cross-validation method. Sex difference in the parameters was assessed using the Mann-Whitney U test. RESULTS: The optimal model yielded by the Ridge binomial logistic regression suggested that the ovality ratio of girls was significantly smaller, whereas their nasal green and blue intensities were significantly higher, than those of boys. Using this approach, the area under the receiver-operating characteristic curve was 63.2%. CONCLUSIONS: Although sex can be distinguished using CFP even in elementary school students, the discrimination accuracy was relatively low. Some sex difference in the ocular fundus may begin after the age of 10 years.
PURPOSES: Recently, artificial intelligence has been used to determine sex using fundus photographs alone. We had earlier reported that sex can be distinguished using known factors obtained from color fundus photography (CFP) in adult eyes. However, it is not clear when the sex difference in fundus parameters begins. Therefore, we conducted this study to investigate sex determination based on fundus parameters using binominal logistic regression in elementary school students. METHODS: This prospective observational cross-sectional study was conducted on 119 right eyes of elementary school students (aged 8 or 9 years, 59 boys and 60 girls). Through CFP, the tessellation fundus index was calculated as R/(R + G + B) using the mean value of red-green-blue intensity in the eight locations around the optic disc. Optic disc ovality ratio, papillomacular angle, retinal artery trajectory, and retinal vessel were quantified based on our earlier reports. Regularized binomial logistic regression was applied to these variables to select the decisive factors. Furthermore, its discriminative performance was evaluated using the leave-one-out cross-validation method. Sex difference in the parameters was assessed using the Mann-Whitney U test. RESULTS: The optimal model yielded by the Ridge binomial logistic regression suggested that the ovality ratio of girls was significantly smaller, whereas their nasal green and blue intensities were significantly higher, than those of boys. Using this approach, the area under the receiver-operating characteristic curve was 63.2%. CONCLUSIONS: Although sex can be distinguished using CFP even in elementary school students, the discrimination accuracy was relatively low. Some sex difference in the ocular fundus may begin after the age of 10 years.
Entities:
Keywords:
Children; Fundus photography; Sex differences; Sex identification
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