Automated Fovea Detection Based on Unsupervised Retinal Vessel Segmentation Method

The Computer Assisted Diagnosis systems could save workloads and give objective diagnostic to ophthalmologists. At first level of automated screening of systems feature extraction is the fundamental step. One of these retinal features is the fovea. The fovea is a small fossa on the fundus, which is represented by a deep-red or red-brown color in color retinal images. By observing retinal images, it appears that the main vessels diverge from the optic nerve head and follow a specific course that can be geometrically modeled as a parabola, with a common vertex inside the optic nerve head and the fovea located along the apex of this parabola curve. Therefore, based on this assumption, the main retinal blood vessels are segmented and fitted to a parabolic model. With respect to the core vascular structure, we can thus detect fovea in the fundus images. For the vessel segmentation, our algorithm addresses the image locally where homogeneity of features is more likely to occur. The algorithm is composed of 4 steps: multi-overlapping windows, local Radon transform, vessel validation, and parabolic fitting. In order to extract blood vessels, sub-vessels should be extracted in local windows. The high contrast between blood vessels and image background in the images cause the vessels to be associated with peaks in the Radon space. The largest vessels, using a high threshold of the Radon transform, determines the main course or overall configuration of the blood vessels which when fitted to a parabola, leads to the future localization of the fovea. In effect, with an accurate fit, the fovea normally lies along the slope joining the vertex and the focus. The darkest region along this line is the indicative of the fovea. To evaluate our method, we used 220 fundus images from a rural database (MUMS-DB) and one public one (DRIVE). The results show that, among 20 images of the first public database (DRIVE) we detected fovea in 85% of them. Also for the MUMS-DB database among 200 images we detect fovea correctly in 83% on them

Quantitative assessment of the conjunctival microcirculation using a smartphone and slit-lamp biomicroscope

Purpose: The conjunctival microcirculation is a readily-accessible vascular bed for quantitative haemodynamic assessment and has been studied previously using a digital charge-coupled device (CCD). Smartphone video imaging of the conjunctiva, and haemodynamic parameter quantification, represents a novel approach. We report the feasibility of smartphone video acquisition and subsequent haemodynamic measure quantification via semi-automated means. Methods: Using an Apple iPhone 6 s and a Topcon SL-D4 slit-lamp biomicroscope, we obtained videos of the conjunctival microcirculation in 4 fields of view per patient, for 17 low cardiovascular risk patients. After image registration and processing, we quantified the diameter, mean axial velocity, mean blood volume flow, and wall shear rate for each vessel studied. Vessels were grouped into quartiles based on their diameter i.e. group 1 (&lt;11 μm), 2 (11–16 μm), 3 (16–22 μm) and 4 (&gt;22 μm). Results: From the 17 healthy controls (mean QRISK3 6.6%), we obtained quantifiable haemodynamics from 626 vessel segments. The mean diameter of microvessels, across all sites, was 21.1μm (range 5.8–58 μm). Mean axial velocity was 0.50mm/s (range 0.11–1mm/s) and there was a modestly positive correlation (r 0.322) seen with increasing diameter, best appreciated when comparing group 4 to the remaining groups (p &lt; .0001). Blood volume flow (mean 145.61pl/s, range 7.05–1178.81pl/s) was strongly correlated with increasing diameter (r 0.943, p &lt; .0001) and wall shear rate (mean 157.31 s − 1, range 37.37–841.66 s − 1) negatively correlated with increasing diameter (r − 0.703, p &lt; .0001). Conclusions: We, for the first time, report the successful assessment and quantification of the conjunctival microcirculatory haemodynamics using a smartphone-based system. </p

Quantitative Analysis of Conjunctival Vasculature

The purpose of this project was to investigate the utility of an automated means of quantifying the conjunctival bed. To simplify the task of any image processing system, it is important that the original image capture stage is optimised, this is an aspect that is often overlooked on the assumption that sophisticated computational techniques can be used to enhance the image. Hence, the concept of exposure density was used to achieve optimal images of bulbar conjunctival vessels using a digital camera (Kodak DCS 100 camera). A database of filters predicted a 6.5 times increase in vessel contrast when recording on the green channel of the charge coupled device (CCD) camera with a Wratten 99 (green) filter over the illumination optics, compared to recording without a filter. With knowledge of the optical transfer characteristics of the imaging system a vascular model was derived. The tubular model, corrected for optical distortions, was fitted to densitometric profiles across conjunctival vessels repetitively imaged under different optical configurations. Although vessel contrast did not increase by the predicted amount, a -30% increase in the amplitude was observed in comparison to images recorded on the green CCD alone. Hence, this became the method of choice when imaging vessels of the conjunctiva. Often automated methods of image segmentation are used without quantification of what is actually being measured, however, this is complicated when no accepted gold standard of measurement exists. Manual methods of determining widths using electronic callipers from projected digitally created photographs were used as the gold standard as they demonstrated a good intra session repeatability and range of measurement when 101 sample vessel widths were measured (95% confidence interval from +10.12 to -9.29pm, ranging from 14.4 to 140.0pm). To best agree with the automated measure of width, the algorithm was run at sigma (a) = 3, to give a 95% confidence interval of inter method repeatability of +9.41 to -8.48|im. However, it was acknowledged that this algorithm overestimates small vessel widths, and underestimates larger widths. The use of an automated approach of vessel recognition results in a vast amount of data concerning vessel axis and vessel edge locations. Five indices were derived to describe the vascular bed including mean vessel width, width variance, tortuosity, tortuosity variance and density, for vessels as a whole and for sub-groups of vessels classified on the basis of size. These indices were a novel way of describing the conjunctival vascular complex. The inter session repeatabilities of these indices were investigated on 31 normal patients and were acceptable in all cases. Also the diurnal variation in these indices on this population showed negligible changes. The angiopathic consequence of diabetes are well known in a variety of organs. However, these have never been adequately quantified in conjunctival vasculature. Seventeen Type I (TI) diabetics, 36 Type II (Til) diabetics, and 60 normals were analysed. Although several indices showed a difference between normals and diabetics for all vessels and sub-categories of vessels, by far the most remarkable was the dramatic change in density at a capillary level (vessels less that 25pm in diameter). A -57.12% (95% confidence interval from -71.96 to -36.76%, PcO.0001) reduction in capillary density was found in TI diabetics compared to normals and a reduction of - 17.5% (95% confidence interval from -41.02 to 16.64%) in Til diabetics compared to normals, however this was not statistically significant (P=0.273). A similar phenomenon was found in venular density (vessel 25 to less than 40|im in diameter). Hence, diabetes principally exerts its affect on the microvasculature of the conjunctival bed. In addition a statistically significant association between mean arterial pressure and vascular density was found, even though our sample did not contain anyone diagnosed with hypertension. A -13.82% (95% confidence interval from -23.71 to -2.65%, P=0.017) reduction in capillary density per lOmmHg rise in mean arterial pressure was established. Hence raised mean arterial pressure exerts an effect on smaller vessels of the conjunctiva

Development of Novel Techniques for Measuring Bulbar Conjunctival Red Blood Cell Velocity, Oximetry and Redness

Introduction The ocular surface provides a unique opportunity to study hemodynamics since the vessels can be visualized directly, without treatment and non-invasively. The availability of instruments to measure various hemodynamic parameters on the ocular surface in an objective manner are lacking. The quantification of red blood cell velocity, blood oxygen saturation and conjunctival redness on the ocular surface using novel, validated techniques has the potential of providing useful information about vascular physiology. The specific aims of each chapter are as follows: Chapter 3: The objective was to design, develop and validate a system that would non-invasively quantify the red blood cell velocity in the conjunctival vessels. A tool was developed to automatically analyze video sequences of conjunctival vessels, digitally imaged with high enough magnification to resolve movement of the blood within the vessel. Chapter 4: The objective was to: a) design and develop a method in order to non-invasively quantify the changes in blood oxygen saturation (SO2) in the conjunctival vessels and demonstrate reliability of the measures and, b) demonstrate the application of the method by showing a response to an isocapnic hyperoxic provocation and compare those values to the results from a valid instrument. Chapter 5: The aim of this experiment was to examine variations in ocular redness levels, red blood cell velocities and oxygen saturation levels over time in clinically healthy participants and also to compare differences between two age groups. Chapter 6: The aim of this experiment was to examine the ocular redness levels, red blood cell velocities and oxygen saturation levels in clinically healthy participants when a topical ophthalmic decongestant was instilled onto the eye and to demonstrate the validity of the use of two novel techniques. Chapter 7: The aim of this experiment was to examine ocular redness, red blood cell velocity and oxygen saturation in participants who were habitual soft contact lens wearers (study) compared to those that did not (control) and also to compare differences in silicone (SH) and non-silicone hydrogel wearers. Methods Chapter 3: Simulations representing moving RBCs within a vessel and the random variation of each cell in terms of speed, shape and intensity were created in order to evaluate the performance of the algorithm. For each vessel, a signal that correlated to blood cell position was extracted from each frame, and the inter-frame displacement was estimated through a modified dynamic time warping (DTW) algorithm. This provided the red blood cell velocity over time in each point of the vessels. Thus, from these estimates, the mean red blood cell velocity for each vessel was easily evaluated. The true mean velocity from the simulation with the one estimated by the algorithm was compared and the system accuracy was determined. Chapter 4: a) Conjunctival vessels were imaged with two narrow-band interference filters with O2-sensitive and O2-insensitive peak transmissions using a Zeiss slit lamp at 32x magnification. Optical densities were calculated from vascular segments using the average reflected intensities inside and outside the vessels. Optical density ratios were used to calculate relative oxygen saturation values. Video images of the bulbar conjunctiva were recorded at three times of the day. Measurement repeatability was assessed over location at each time and across consecutive frames. b) Subjects initially breathed air for 10 minutes followed by pure oxygen (O2) for 20 minutes, and then air for a final 10 minute period using a sequential re-breathing circuit. Simultaneously, SO2 values measured with a pulse oximeter ear clip and finger clip were recorded. The validity of the dual wavelength method was demonstrated by comparing the values to those from the ear clip pulse oximeter. Chapter 5: Participants attended eight separate visits over the course of a day. Levels of bulbar conjunctival redness, red blood cell velocity and blood oxygen saturation were measured on a vessel of interest. Chapter 6: Participants attended three separate visits during an allotted 60 minute session. Bulbar conjunctival redness, red blood cell velocity and blood oxygen saturation were measured on a vessel of interest, pre-insertion, just after insertion and, 10 minutes after insertion of a topical ocular decongestant. Significant differences between the three measures were assessed and correlations between the three parameters were reported. Chapter 7: Participants were measured 8 times over the course of a day with their contact lenses in place. Bulbar conjunctival redness, red blood cell velocity and blood oxygen saturation were measured. Results Chapter 3: Results for the simulated videos demonstrated a very good concordance between the estimated and actual velocities supporting its validity. The mean relative error for the modified Dynamic Time Warping (DTW) method is 6%. Chapter 4: The intraclass correlations (ICCs) between the three locations at each time point were 0.93, 0.56 and 0.86 respectively. Measurements across 5 consecutive frames showed no significant difference for all subjects (ICC = 0.96). The ICCs between the two methods at each time point were 0.45, 0.10 and 0.11 respectively. a) There was no significant difference in SO2 between the three locations measured using the dual wavelength method for all subjects. There was also no significant difference between the three locations at any of the time points for the dual wavelength method. b) In response to isocapnic hyperoxic provocation using the dual wavelength method, blood oxygen saturation was increased from control values and subsequently recovered after withdrawal of hyperoxia. Blood oxygen saturation values recorded from the ear clip and finger clip of the pulse oximeter also showed an increase from control values and subsequently recovered after withdrawal of hyperoxia. SO2 comparison between the dual wavelength method and the ear-clip pulse oximeter method did not show a significant difference. The interaction between the two methods and time on SO2 was not significant. Chapter 5: From baseline, the group mean redness and oxygen saturation did not change significantly over time. There was a significant difference in the group mean red blood cell velocity values over time. There was no significant difference between age strata for all three measures. Chapter 6: After drop instillation redness values decreased significantly. There was no change in red blood cell velocity and oxygen saturation over time. There was a moderate significant correlation between SO2 and red blood cell velocity just after drop insertion. Chapter 7: When comparing the study and control groups, no significant difference in redness or SO2 over time was found. RBC velocity over time was found to be significantly different between groups. When comparing the two study groups (SH vs. hydrogel) no significant difference across either measure over time was found. Conclusions Chapter 3: Signal displacement estimation through the DTW algorithm can be used to estimate mean red blood cell velocity. Successful application of the algorithm in the estimation of RBC velocity in conjunctival vessels was demonstrated. Chapter 4: The application of the dual wavelength method was demonstrated and optical density ratios can be used in a reliable manner for relative oxygen saturation measurements. This valid method promises to enable the study of conjunctival O2 saturation under various experimental and physiological conditions. Chapter 5: The results of this study support the theory of metabolic regulation. The lack of any significant change across time for redness and oxygen saturation along with significant changes in red blood cell velocity substantiates this notion. Chapter 6: This study supports the literature regarding metabolic regulation of the microvasculature during the use of various stimuli. The results demonstrated that oxygen saturation levels remain stable even when a significant decrease in ocular redness is measured. The novel techniques used in this experiment demonstrated the expected action of the decongestant further contributing to their application and validity. Chapter 7: In summary, the participants in the study group were habitual contact lens wearers that had lower RBC velocities when compared to the control group supporting the notion that contact lenses initiate a hypoxic response. The lack of change in SO2 in either group supports the theory of metabolic regulation

PhDAY 2020 -FOO (Facultad de Óptica y Optometría)

Por cuarto año consecutivo los doctorandos de la Facultad de Óptica y Optometría de la Universidad Complutense de Madrid cuentan con un congreso propio organizado por y para ellos, el 4º PhDAY- FOO. Se trata de un congreso gratuito abierto en la que estos jóvenes científicos podrán presentar sus investigaciones al resto de sus compañeros predoctorales y a toda la comunidad universitaria que quiera disfrutar de este evento. Apunta en tu agenda: el 15 de octubre de 2020. En esta ocasión será un Congreso On-line para evitar que la incertidumbre asociada a la pandemia Covid-19 pudiera condicionar su celebración