Superpixel-Based Optic Nerve Head Segmentation Method of Fundus Images for Glaucoma Assessment

Glaucoma disease is the second leading cause of blindness in the world. This progressive ocular neuropathy is mainly caused by uncontrolled high intraocular pressure. Although there is still no cure, early detection and appropriate treatment can stop the disease progression to low vision and blindness. In the clinical practice, the gold standard used by ophthalmologists for glaucoma diagnosis is fundus retinal imaging, in particular optic nerve head (ONH) subjective/manual examination. In this work, we propose an unsupervised superpixel-based method for the optic nerve head (ONH) segmentation. An automatic algorithm based on linear iterative clustering is used to compute an ellipse fitting for the automatic detection of the ONH contour. The tool has been tested using a public retinal fundus images dataset with medical expert ground truths of the ONH contour and validated with a classified (control vs. glaucoma eyes) database. Results showed that the automatic segmentation method provides similar results in ellipse fitting of the ONH that those obtained from the ground truth experts within the statistical range of inter-observation variability. Our method is a user-friendly available program that provides fast and reliable results for clinicians working on glaucoma screening using retinal fundus images

Machine Learning for Glaucoma Assessment using Fundus Images

[ES] Las imágenes de fondo de ojo son muy utilizadas por los oftalmólogos para la evaluación de la retina y la detección de glaucoma. Esta patología es la segunda causa de ceguera en el mundo, según estudios de la Organización Mundial de la Salud (OMS). En esta tesis doctoral, se estudian algoritmos de aprendizaje automático (machine learning) para la evaluación automática del glaucoma usando imágenes de fondo de ojo. En primer lugar, se proponen dos métodos para la segmentación automática. El primer método utiliza la transformación Watershed Estocástica para segmentar la copa óptica y posteriormente medir características clínicas como la relación Copa/Disco y la regla ISNT. El segundo método es una arquitectura U-Net que se usa específicamente para la segmentación del disco óptico y la copa óptica. A continuación, se presentan sistemas automáticos de evaluación del glaucoma basados en redes neuronales convolucionales (CNN por sus siglas en inglés). En este enfoque se utilizan diferentes modelos entrenados en ImageNet como clasificadores automáticos de glaucoma, usando fine-tuning. Esta nueva técnica permite detectar el glaucoma sin segmentación previa o extracción de características. Además, este enfoque presenta una mejora considerable del rendimiento comparado con otros trabajos del estado del arte. En tercer lugar, dada la dificultad de obtener grandes cantidades de imágenes etiquetadas (glaucoma/no glaucoma), esta tesis también aborda el problema de la síntesis de imágenes de la retina. En concreto se analizaron dos arquitecturas diferentes para la síntesis de imágenes, las arquitecturas Variational Autoencoder (VAE) y la Generative Adversarial Networks (GAN). Con estas arquitecturas se generaron imágenes sintéticas que se analizaron cualitativa y cuantitativamente, obteniendo un rendimiento similar a otros trabajos en la literatura. Finalmente, en esta tesis se plantea la utilización de un tipo de GAN (DCGAN) como alternativa a los sistemas automáticos de evaluación del glaucoma presentados anteriormente. Para alcanzar este objetivo se implementó un algoritmo de aprendizaje semi-supervisado.[CA] Les imatges de fons d'ull són molt utilitzades pels oftalmòlegs per a l'avaluació de la retina i la detecció de glaucoma. Aquesta patologia és la segona causa de ceguesa al món, segons estudis de l'Organització Mundial de la Salut (OMS). En aquesta tesi doctoral, s'estudien algoritmes d'aprenentatge automàtic (machine learning) per a l'avaluació automàtica del glaucoma usant imatges de fons d'ull. En primer lloc, es proposen dos mètodes per a la segmentació automàtica. El primer mètode utilitza la transformació Watershed Estocàstica per segmentar la copa òptica i després mesurar característiques clíniques com la relació Copa / Disc i la regla ISNT. El segon mètode és una arquitectura U-Net que s'usa específicament per a la segmentació del disc òptic i la copa òptica. A continuació, es presenten sistemes automàtics d'avaluació del glaucoma basats en xarxes neuronals convolucionals (CNN per les sigles en anglès). En aquest enfocament s'utilitzen diferents models entrenats en ImageNet com classificadors automàtics de glaucoma, usant fine-tuning. Aquesta nova tècnica permet detectar el glaucoma sense segmentació prèvia o extracció de característiques. A més, aquest enfocament presenta una millora considerable del rendiment comparat amb altres treballs de l'estat de l'art. En tercer lloc, donada la dificultat d'obtenir grans quantitats d'imatges etiquetades (glaucoma / no glaucoma), aquesta tesi també aborda el problema de la síntesi d'imatges de la retina. En concret es van analitzar dues arquitectures diferents per a la síntesi d'imatges, les arquitectures Variational Autoencoder (VAE) i la Generative adversarial Networks (GAN). Amb aquestes arquitectures es van generar imatges sintètiques que es van analitzar qualitativament i quantitativament, obtenint un rendiment similar a altres treballs a la literatura. Finalment, en aquesta tesi es planteja la utilització d'un tipus de GAN (DCGAN) com a alternativa als sistemes automàtics d'avaluació del glaucoma presentats anteriorment. Per assolir aquest objectiu es va implementar un algoritme d'aprenentatge semi-supervisat.[EN] Fundus images are widely used by ophthalmologists to assess the retina and detect glaucoma, which is, according to studies from the World Health Organization (WHO), the second cause of blindness worldwide. In this thesis, machine learning algorithms for automatic glaucoma assessment using fundus images are studied. First, two methods for automatic segmentation are proposed. The first method uses the Stochastic Watershed transformation to segment the optic cup and measures clinical features such as the Cup/Disc ratio and ISNT rule. The second method is a U-Net architecture focused on the optic disc and optic cup segmentation task. Secondly, automated glaucoma assessment systems using convolutional neural networks (CNNs) are presented. In this approach, different ImageNet-trained models are fine-tuned and used as automatic glaucoma classifiers. These new techniques allow detecting glaucoma without previous segmentation or feature extraction. Moreover, it improves the performance of other state-of-art works. Thirdly, given the difficulty of getting large amounts of glaucoma-labelled images, this thesis addresses the problem of retinal image synthesis. Two different architectures for image synthesis, the Variational Autoencoder (VAE) and Generative Adversarial Networks (GAN) architectures, were analysed. Using these models, synthetic images that were qualitative and quantitative analysed, reporting state-of-the-art performance, were generated. Finally, an adversarial model is used to create an alternative automatic glaucoma assessment system. In this part, a semi-supervised learning algorithm was implemented to reach this goal.The research derived from this doctoral thesis has been supported by the Generalitat Valenciana under the scholarship Santiago Grisolía [GRISOLIA/2015/027].Díaz Pinto, AY. (2019). Machine Learning for Glaucoma Assessment using Fundus Images [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/124351TESI

Accurate and reliable segmentation of the optic disc in digital fundus images

We describe a complete pipeline for the detection and accurate automatic segmentation of the optic disc in digital fundus images. This procedure provides separation of vascular information and accurate inpainting of vessel-removed images, symmetry-based optic disc localization, and fitting of incrementally complex contour models at increasing resolutions using information related to inpainted images and vessel masks. Validation experiments, performed on a large dataset of images of healthy and pathological eyes, annotated by experts and partially graded with a quality label, demonstrate the good performances of the proposed approach. The method is able to detect the optic disc and trace its contours better than the other systems presented in the literature and tested on the same data. The average error in the obtained contour masks is reasonably close to the interoperator errors and suitable for practical applications. The optic disc segmentation pipeline is currently integrated in a complete software suite for the semiautomatic quantification of retinal vessel properties from fundus camera images (VAMPIRE)

Automatic extraction of retinal features from colour retinal images for glaucoma diagnosis: a review

Glaucoma is a group of eye diseases that have common traits such as, high eye pressure, damage to the Optic Nerve Head and gradual vision loss. It affects peripheral vision and eventually leads to blindness if left untreated. The current common methods of pre-diagnosis of Glaucoma include measurement of Intra-Ocular Pressure (IOP) using Tonometer, Pachymetry, Gonioscopy; which are performed manually by the clinicians. These tests are usually followed by Optic Nerve Head (ONH) Appearance examination for the confirmed diagnosis of Glaucoma. The diagnoses require regular monitoring, which is costly and time consuming. The accuracy and reliability of diagnosis is limited by the domain knowledge of different ophthalmologists. Therefore automatic diagnosis of Glaucoma attracts a lot of attention.This paper surveys the state-of-the-art of automatic extraction of anatomical features from retinal images to assist early diagnosis of the Glaucoma. We have conducted critical evaluation of the existing automatic extraction methods based on features including Optic Cup to Disc Ratio (CDR), Retinal Nerve Fibre Layer (RNFL), Peripapillary Atrophy (PPA), Neuroretinal Rim Notching, Vasculature Shift, etc., which adds value on efficient feature extraction related to Glaucoma diagnosis. © 2013 Elsevier Ltd