Predicting Axial Length From Choroidal Thickness on Optical Coherence Tomography Images With Machine Learning Based Algorithms

Hao Chun Lu, Hsin Yi Chen, Chien Jung Huang, Pao Hsien Chu, Lung Sheng Wu, Chia Ying Tsai*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Purpose: We formulated and tested ensemble learning models to classify axial length (AXL) from choroidal thickness (CT) as indicated on fovea-centered, 2D single optical coherence tomography (OCT) images. Design: Retrospective cross-sectional study. Participants: We analyzed 710 OCT images from 355 eyes of 188 patients. Each eye had 2 OCT images. Methods: The CT was estimated from 3 points of each image. We used five machine-learning base algorithms to construct the classifiers. This study trained and validated the models to classify the AXLs eyes based on binary (AXL < or > 26 mm) and multiclass (AXL < 22 mm, between 22 and 26 mm, and > 26 mm) classifications. Results: No features were redundant or duplicated after an analysis using Pearson’s correlation coefficient, LASSO-Pattern search algorithm, and variance inflation factors. Among the positions, CT at the nasal side had the highest correlation with AXL followed by the central area. In binary classification, our classifiers obtained high accuracy, as indicated by accuracy, recall, positive predictive value (PPV), negative predictive value (NPV), F1 score, and area under ROC curve (AUC) values of 94.37, 100, 90.91, 100, 86.67, and 95.61%, respectively. In multiclass classification, our classifiers were also highly accurate, as indicated by accuracy, weighted recall, weighted PPV, weighted NPV, weighted F1 score, and macro AUC of 88.73, 88.73, 91.21, 85.83, 87.42, and 93.42%, respectively. Conclusions: Our binary and multiclass classifiers classify AXL well from CT, as indicated on OCT images. We demonstrated the effectiveness of the proposed classifiers and provided an assistance tool for physicians.

Original languageEnglish
Article number850284
JournalFrontiers in Medicine
StatePublished - 28 Jun 2022


  • axial length
  • choroidal thickness
  • ensemble learning
  • high myopia
  • machine learning
  • optical coherence tomography (OCT)


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