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    Detection and characterisation of vessels in retinal images.

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    Doctor of Philosophy in Mathematics, Statistics & Computer Science. University of KwaZulu-Natal, Durban 2015.As retinopathies such as diabetic retinopathy (DR) and retinopathy of prematurity (ROP) continue to be the major causes of blindness globally, regular retinal examinations of patients can assist in the early detection of the retinopathies. The manual detection of retinal vessels is a very tedious and time consuming task as it requires about two hours to manually detect vessels in each retinal image. Automatic vessel segmentation has been helpful in achieving speed, improved diagnosis and progress monitoring of these diseases but has been challenging due to complexities such as the varying width of the retinal vessels from very large to very small, low contrast of thin vessels with respect to background and noise due to nonhomogeneous illumination in the retinal images. Although several supervised and unsupervised segmentation methods have been proposed in the literature, the segmentation of thinner vessels, connectivity loss of the vessels and time complexity remain the major challenges. In order to address these problems, this research work investigated di erent unsupervised segmentation approaches to be used in the robust detection of large and thin retinal vessels in a timely e cient manner. Firstly, this thesis conducted a study on the use of di erent global thresholding techniques combined with di erent pre-processing and post-processing techniques. Two histogram-based global thresholding techniques namely, Otsu and Isodata were able to detect large retinal vessels but fail to segment the thin vessels because these thin vessels have very low contrast and are di cult to distinguish from the background tissues using the histogram of the retinal images. Two new multi-scale approaches of computing global threshold based on inverse di erence moment and sum-entropy combined with phase congruence are investigated to improve the detection of vessels. One of the findings of this study is that the multi-scale approaches of computing global threshold combined with phase congruence based techniques improved on the detection of large vessels and some of the thin vessels. They, however, failed to maintain the width of the detected vessels. The reduction in the width of the detected large and thin vessels results in low sensitivity rates while relatively good accuracy rates were maintained. Another study on the use of fuzzy c-means and GLCM sum entropy combined on phase congruence for vessel segmentation showed that fuzzy c-means combined with phase congruence achieved a higher average accuracy rates of 0.9431 and 0.9346 but a longer running time of 27.1 seconds when compared with the multi-scale based sum entropy thresholding combined with phase congruence with the average accuracy rates of 0.9416 and 0.9318 with a running time of 10.3 seconds. The longer running time of the fuzzy c-means over the sum entropy thresholding is, however, attributed to the iterative nature of fuzzy c-means. When compared with the literature, both methods achieved considerable faster running time. This thesis investigated two novel local adaptive thresholding techniques for the segmentation of large and thin retinal vessels. The two novel local adaptive thresholding techniques applied two di erent Haralick texture features namely, local homogeneity and energy. Although these two texture features have been applied for supervised image segmentation in the literature, their novelty in this thesis lies in that they are applied using an unsupervised image segmentation approach. Each of these local adaptive thresholding techniques locally applies a multi-scale approach on each of the texture information considering the pixel of interest in relationship with its spacial neighbourhood to compute the local adaptive threshold. The localised multi-scale approach of computing the thresholds handled the challenge of the vessels' width variation. Experiments showed significant improvements in the average accuracy and average sensitivity rates of these techniques when compared with the previously discussed global thresholding methods and state of the art. The two novel local adaptive thresholding techniques achieved a higher reduction of false vessels around the border of the optic disc when compared with some of the previous techniques in the literature. These techniques also achieved a highly improved computational time of 1.9 to 3.9 seconds to segment the vessels in each retinal image when compared with the state of the art. Hence, these two novel local adaptive thresholding techniques are proposed for the segmentation of the vessels in the retinal images. This thesis further investigated the combination of di erence image and kmeans clustering technique for the segmentation of large and thin vessels in retinal images. The pre-processing phase computed a di erence image and k-means clustering technique was used for the vessel detection. While investigating this vessel segmentation method, this thesis established the need for a difference image that preserves the vessel details of the retinal image. Investigating the di erent low pass filters, median filter yielded the best di erence image required by k-means clustering for the segmentation of the retinal vessels. Experiments showed that the median filter based di erence images combined with k-means clustering technique achieved higher average accuracy and average sensitivity rates when compared with the previously discussed global thresholding methods and the state of the art. The median filter based di erence images combined with k-means clustering technique (that is, DIMDF) also achieved a higher reduction of false vessels around the border of the optic disc when compared with some previous techniques in the literature. These methods also achieved a highly improved computational time of 3.4 to 4 seconds when compared with the literature. Hence, the median filter based di erence images combined with k-means clustering technique are proposed for the segmentation of the vessels in retinal images. The characterisation of the detected vessels using tortuosity measure was also investigated in this research. Although several vessel tortuosity methods have been discussed in the literature, there is still need for an improved method that e ciently detects vessel tortuosity. The experimental study conducted in this research showed that the detection of the stationary points helps in detecting the change of direction and twists in the vessels. The combination of the vessel twist frequency obtained using the stationary points and distance metric for the computation of normalised and nonnormalised tortuosity index (TI) measure was investigated. Experimental results showed that the non-normalised TI measure had a stronger correlation with the expert's ground truth when compared with the distance metric and normalised TI measures. Hence, a non-normalised TI measure that combines the vessel twist frequency based on the stationary points and distance metric is proposed for the measurement of vessel tortuosity
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