Artificial Intelligence for Optical Coherence Tomography in Glaucoma.

Purpose: The integration of artificial intelligence (AI), particularly deep learning (DL), with optical coherence tomography (OCT) offers significant opportunities in the diagnosis and management of glaucoma. This article explores the application of various DL models in enhancing OCT capabilities and addresses the challenges associated with their clinical implementation. Methods: A review of articles utilizing DL models was conducted, including convolutional neural networks (CNNs), recurrent neural networks (RNNs), generative adversarial networks (GANs), autoencoders, and large language models (LLMs). Key developments and practical applications of these models in OCT image analysis were emphasized, particularly in the context of enhancing image quality, glaucoma diagnosis, and monitoring progression. Results: CNNs excel in segmenting retinal layers and detecting glaucomatous damage, whereas RNNs are effective in analyzing sequential OCT scans for disease progression. GANs enhance image quality and data augmentation, and autoencoders facilitate advanced feature extraction. LLMs show promise in integrating textual and visual data for comprehensive diagnostic assessments. Despite these advancements, challenges such as data availability, variability, potential biases, and the need for extensive validation persist. Conclusions: DL models are reshaping glaucoma management by enhancing OCT's diagnostic capabilities. However, the successful translation into clinical practice requires addressing major challenges related to data variability, biases, fairness, and model validation to ensure accurate and reliable patient care. Translational Relevance: This review bridges the gap between basic research and clinical care by demonstrating how AI, particularly DL models, can markedly enhance OCT's clinical utility in diagnosis, monitoring, and prediction, moving toward more individualized, personalized, and precise treatment strategies.