Abstract
Background/Objectives: Retinitis pigmentosa (RP) is a progressive hereditary retinal disorder that frequently leads to vision loss, with cystoid macular edema (CME) occurring in approximately 10-50% of affected patients. Early detection of CME is crucial for timely intervention, yet most existing studies lack longitudinal data capable of capturing subtle disease progression. Methods: We propose a deep learning-based framework utilizing longitudinal optical coherence tomography (OCT) imaging for early detection of CME in patients with RP. A total of 2280 longitudinal OCT images were preprocessed using denoising and data augmentation techniques. Multiple pre-trained deep learning architectures were evaluated using a patient-wise data split to ensure robust performance assessment. Results: Among the evaluated models, ResNet-34 achieved the best performance, with an accuracy of 98.68%, specificity of 99.45%, and an F1-score of 98.36%. Conclusions: These results demonstrate the potential of longitudinal OCT-based artificial intelligence as a reliable, non-invasive screening tool for early CME detection in RP. To the best of our knowledge, this study is the first to leverage longitudinal OCT data for AI-driven CME prediction in this patient population.