Background: The purpose of this study was to implement and evaluate a deep learning (DL) approach for automatically detecting shallow anterior chamber depth (ACD) from two-dimensional (2D) overview anterior segment photographs.Methods: We trained a DL model using a dataset of anterior segment photographs collected from Shanghai Aier Eye Hospital from June 2018 to December 2019. A Pentacam HR system was used to capture a 2D overview eye image and measure the ACD. Shallow ACD was defined as ACD

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... ss than 2.4 mm. The DL model was evaluated by a five-fold cross-validation test in a hold-out testing dataset. We also evaluated the DL model by testing it against two glaucoma specialists. The performance of the DL model was calculated by metrics, including accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC).Results: A total of 4,322 photographs (2,054 shallow AC and 2,268 deep AC images) were assigned to the training dataset, and 482 photographs (229 shallow AC and 253 deep AC images) were held out for internal testing dataset. In detecting shallow ACD in the internal hold-out testing dataset, the DL model achieved an AUC of 0.91 (95% CI, 0.88–0.94) with 82% sensitivity and 84% specificity. In the same testing dataset, the DL model also achieved better performance than the two glaucoma specialists (accuracy of 80% vs. accuracy of 74% and 69%).Conclusions: We proposed a high-performing DL model to automatically detect shallow ACD from overview anterior segment photographs. Our DL model has potential applications in detecting and monitoring shallow ACD in the real world. Trial registration:http://clinicaltrials.gov, NCT04340635, retrospectively registered on 29 March 2020.