{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:35:06Z","timestamp":1760060106690,"version":"build-2065373602"},"reference-count":24,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Information"],"abstract":"<jats:p>Background: Retinal diseases are becoming an important public health issue, with early diagnosis and timely intervention playing a key role in preventing vision loss. Optical coherence tomography (OCT) remains the leading non-invasive imaging technique for identifying retinal conditions. However, distinguishing between diabetic macular edema (DME) and macular edema resulting from retinal vein occlusion (RVO) can be particularly challenging, especially for clinicians without specialized training in retinal disorders, as both conditions manifest through increased retinal thickness. Due to the limited research exploring the application of deep learning methods, particularly for RVO detection using OCT scans, this study proposes a novel diagnostic approach based on stacked convolutional neural networks. This architecture aims to enhance classification accuracy by integrating multiple neural network layers, enabling more robust feature extraction and improved differentiation between retinal pathologies. Methods: The VGG-16, VGG-19, and ResNet50 models were fine-tuned using the Kermany dataset to classify the OCT images and afterwards were trained using a private OCT dataset. Four stacked models were then developed using these models: a model using the VGG-16 and VGG-19 networks, a model using the VGG-16 and ResNet50 networks, a model using the VGG-19 and ResNet50 models, and finally a model using all three networks. The performance metrics of the model includes accuracy, precision, recall, F2-score, and area under of the receiver operating characteristic curve (AUROC). Results: The stacked neural network using all three models achieved the best results, having an accuracy of 90.7%, precision of 99.2%, a recall of 90.7%, and an F2-score of 92.3%. Conclusions: This study presents a novel method for distinguishing retinal disease by using stacked neural networks. This research aims to provide a reliable tool for ophthalmologists to improve diagnosis accuracy and speed.<\/jats:p>","DOI":"10.3390\/info16080649","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T10:55:37Z","timestamp":1753872937000},"page":"649","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development of Stacked Neural Networks for Application with OCT Data, to Improve Diabetic Retinal Health Care Management"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-5304-7503","authenticated-orcid":false,"given":"Pedro","family":"Rebolo","sequence":"first","affiliation":[{"name":"INEGI\u2014Institute of Science and Innovation in Mechanical and Industrial Engineering, 4200-465 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5001-5539","authenticated-orcid":false,"given":"Guilherme","family":"Barbosa","sequence":"additional","affiliation":[{"name":"INEGI\u2014Institute of Science and Innovation in Mechanical and Industrial Engineering, 4200-465 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0729-7008","authenticated-orcid":false,"given":"Eduardo","family":"Carvalho","sequence":"additional","affiliation":[{"name":"INEGI\u2014Institute of Science and Innovation in Mechanical and Industrial Engineering, 4200-465 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9583-3571","authenticated-orcid":false,"given":"Bruno","family":"Areias","sequence":"additional","affiliation":[{"name":"INEGI\u2014Institute of Science and Innovation in Mechanical and Industrial Engineering, 4200-465 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3979-0874","authenticated-orcid":false,"given":"Ana","family":"Guerra","sequence":"additional","affiliation":[{"name":"INEGI\u2014Institute of Science and Innovation in Mechanical and Industrial Engineering, 4200-465 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7079-9554","authenticated-orcid":false,"given":"S\u00f3nia","family":"Torres-Costa","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Centro Hospitalar e Universit\u00e1rio S\u00e3o Jo\u00e3o, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4633-8600","authenticated-orcid":false,"given":"Nilza","family":"Rami\u00e3o","sequence":"additional","affiliation":[{"name":"INEGI\u2014Institute of Science and Innovation in Mechanical and Industrial Engineering, 4200-465 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4718-0910","authenticated-orcid":false,"given":"Manuel","family":"Falc\u00e3o","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Centro Hospitalar e Universit\u00e1rio S\u00e3o Jo\u00e3o, 4200-319 Porto, Portugal"},{"name":"Department of Surgery and Physiology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3326-6345","authenticated-orcid":false,"given":"Marco","family":"Parente","sequence":"additional","affiliation":[{"name":"INEGI\u2014Institute of Science and Innovation in Mechanical and Industrial Engineering, 4200-465 Porto, Portugal"},{"name":"DEMec, Faculty of Engineering, University of Porto, 4200-319 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1038\/s41433-022-02007-4","article-title":"Retinal vein occlusion (RVO) guideline: Executive summary","volume":"36","author":"Nicholson","year":"2022","journal-title":"Eye"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.ophtha.2009.07.017","article-title":"The prevalence of retinal vein occlusion: Pooled data from population studies from the United States, Europe, Asia, and Australia","volume":"117","author":"Rogers","year":"2010","journal-title":"Ophthalmology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1016\/j.survophthal.2018.04.005","article-title":"Ischemic retinal vein occlusion: Characterizing the more severe spectrum of retinal vein occlusion","volume":"63","author":"Khayat","year":"2018","journal-title":"Surv. 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