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

EDDense-Net: Fully Dense Encoder Decoder Network for Joint Segmentation of Optic Cup and Disc

Glaucoma is an eye disease that causes damage to the optic nerve, which can lead to visual loss and permanent blindness. Early glaucoma detection is therefore critical in order to avoid permanent blindness. The estimation of the cup-to-disc ratio (CDR) during an examination of the optical disc (OD) is used for the diagnosis of glaucoma. In this paper, we present the EDDense-Net segmentation network for the joint segmentation of OC and OD. The encoder and decoder in this network are made up of dense blocks with a grouped convolutional layer in each block, allowing the network to acquire and convey spatial information from the image while simultaneously reducing the network's complexity. To reduce spatial information loss, the optimal number of filters in all convolution layers were utilised. In semantic segmentation, dice pixel classification is employed in the decoder to alleviate the problem of class imbalance. The proposed network was evaluated on two publicly available datasets where it outperformed existing state-of-the-art methods in terms of accuracy and efficiency. For the diagnosis and analysis of glaucoma, this method can be used as a second opinion system to assist medical ophthalmologists

Retinal Fundus Image Analysis for Diagnosis of Glaucoma: A Comprehensive Survey

© 2016 IEEE. The rapid development of digital imaging and computer vision has increased the potential of using the image processing technologies in ophthalmology. Image processing systems are used in standard clinical practices with the development of medical diagnostic systems. The retinal images provide vital information about the health of the sensory part of the visual system. Retinal diseases, such as glaucoma, diabetic retinopathy, age-related macular degeneration, Stargardt's disease, and retinopathy of prematurity, can lead to blindness manifest as artifacts in the retinal image. An automated system can be used for offering standardized large-scale screening at a lower cost, which may reduce human errors, provide services to remote areas, as well as free from observer bias and fatigue. Treatment for retinal diseases is available; the challenge lies in finding a cost-effective approach with high sensitivity and specificity that can be applied to large populations in a timely manner to identify those who are at risk at the early stages of the disease. The progress of the glaucoma disease is very often quiet in the early stages. The number of people affected has been increasing and patients are seldom aware of the disease, which can cause delay in the treatment. A review of how computer-aided approaches may be applied in the diagnosis and staging of glaucoma is discussed here. The current status of the computer technology is reviewed, covering localization and segmentation of the optic nerve head, pixel level glaucomatic changes, diagonosis using 3-D data sets, and artificial neural networks for detecting the progression of the glaucoma disease

Automatic extraction of retinal features to assist diagnosis of glaucoma disease

Glaucoma is a group of eye diseases that have common traits such as high eye pressure, damage to the Optic Nerve Head (ONH) and gradual vision loss. It affects the peripheral vision and eventually leads to blindness if left untreated. The current common methods of diagnosis of glaucoma are performed manually by the clinicians. Clinicians perform manual image operations such as change of contrast, zooming in zooming out etc to observe glaucoma related clinical indications. This type of diagnostic process is time consuming and subjective. With the advancement of image and vision computing, by automating steps in the diagnostic process, more patients can be screened and early treatment can be provided to prevent any or further loss of vision. The aim of this work is to develop a system called Glaucoma Detection Framework (GDF), which can automatically determine changes in retinal structures and imagebased pattern associated with glaucoma so as to assist the eye clinicians for glaucoma diagnosis in a timely and effective manner. In this work, several major contributions have been made towards the development of the automatic GDF consisting of the stages of preprocessing, optic disc and cup segmentation and regional image feature methods for classification between glaucoma and normal images. Firstly, in the preprocessing step, a retinal area detector based on superpixel classification model has been developed in order to automatically determine true retinal area from a Scanning Laser Ophthalmoscope (SLO) image. The retinal area detector can automatically extract artefacts out from the SLO image while preserving the computational effciency and avoiding over-segmentation of the artefacts. Localization of the ONH is one of the important steps towards the glaucoma analysis. A new weighted feature map approach has been proposed, which can enhance the region of ONH for accurate localization. For determining vasculature shift, which is one of glaucoma indications, we proposed the ONH cropped image based vasculature classification model to segment out the vasculature from the ONH cropped image. The ONH cropped image based vasculature classification model is developed in order to avoid misidentification of optic disc boundary and Peripapillary Atrophy (PPA) around the ONH of being a part of the vasculature area. Secondly, for automatic determination of optic disc and optic cup boundaries, a Point Edge Model (PEM), a Weighted Point Edge Model (WPEM) and a Region Classification Model (RCM) have been proposed. The RCM initially determines the optic disc region using the set of feature maps most suitable for the region classification whereas the PEM updates the contour using the force field of the feature maps with strong edge profile. The combination of PEM and RCM entitled Point Edge and Region Classification Model (PERCM) has significantly increased the accuracy of optic disc segmentation with respect to clinical annotations around optic disc. On the other hand, the WPEM determines the force field using the weighted feature maps calculated by the RCM for optic cup in order to enhance the optic cup region compared to rim area in the ONH. The combination of WPEM and RCM entitled Weighted Point Edge and Region Classification Model (WPERCM) can significantly enhance the accuracy of optic cup segmentation. Thirdly, this work proposes a Regional Image Features Model (RIFM) which can automatically perform classification between normal and glaucoma images on the basis of regional information. Different from the existing methods focusing on global features information only, our approach after optic disc localization and segmentation can automatically divide an image into five regions (i.e. optic disc or Optic Nerve Head (ONH) area, inferior (I), superior(S), nasal(N) and temporal(T)). These regions are usually used for diagnosis of glaucoma by clinicians through visual observation only. It then extracts image-based information such as textural, spatial and frequency based information so as to distinguish between normal and glaucoma images. The method provides a new way to identify glaucoma symptoms without determining any geometrical measurement associated with clinical indications glaucoma. Finally, we have accommodated clinical indications of glaucoma including the CDR, vasculature shift and neuroretinal rim loss with the RIFM classification and performed automatic classification between normal and glaucoma images. Since based on the clinical literature, no geometrical measurement is the guaranteed sign of glaucoma, the accommodation of the RIFM classification results with clinical indications of glaucoma can lead to more accurate classification between normal and glaucoma images. The proposed methods in this work have been tested against retinal image databases of 208 fundus images and 102 Scanning Laser Ophthalmoscope (SLO) images. These databases have been annotated by the clinicians around different anatomical structures associated with glaucoma as well as annotated with healthy or glaucomatous images. In fundus images, ONH cropped images have resolution varying from 300 to 900 whereas in SLO images, the resolution is 341 x 341. The accuracy of classification between normal and glaucoma images on fundus images and the SLO images is 94.93% and 98.03% respectively

Machine Learning Techniques, Detection and Prediction of Glaucoma– A Systematic Review

Globally, glaucoma is the most common factor in both permanent blindness and impairment. However, the majority of patients are unaware they have the condition, and clinical practise continues to face difficulties in detecting glaucoma progression using current technology. An expert ophthalmologist examines the retinal portion of the eye to see how the glaucoma is progressing. This method is quite time-consuming, and doing it manually takes more time. Therefore, using deep learning and machine learning techniques, this problem can be resolved by automatically diagnosing glaucoma. This systematic review involved a comprehensive analysis of various automated glaucoma prediction and detection techniques. More than 100 articles on Machine learning (ML) techniques with understandable graph and tabular column are reviewed considering summery, method, objective, performance, advantages and disadvantages. In the ML techniques such as support vector machine (SVM), and K-means. Fuzzy c-means clustering algorithm are widely used in glaucoma detection and prediction. Through the systematic review, the most accurate technique to detect and predict glaucoma can be determined which can be utilized for future betterment

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

Optic disc and cup segmentation through fuzzy broad learning system for glaucoma screening

Glaucoma is an ocular disease that causes permanent blindness if not cured at an early stage. Cup-to-disc ratio (CDR), obtained by dividing the height of optic cup (OC) with the height of optic disc (OD), is a widely adopted metric used for glaucoma screening. Therefore, accurately segmenting OD and OC is crucial for calculating a CDR. Most methods have employed deep learning methods for the segmentation of OD and OC. However, these methods are very time-consuming. We present a new fuzzy broad learning system-based technique for OD and OC segmentation with glaucoma screening. We comprehensively integrated extracting a region of interest (ROI) from RGB images, data augmentation, extracting red and green channel images, and inputting them to the two separate fuzzy broad learning system-based neural networks for segmenting the OD and OC, respectively, and then calculated CDR. Experiments show that our fuzzy broad learning system-based technique outperforms many state-of-the-art methods

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