The evidence for automated grading in diabetic retinopathy screening

Peer reviewedPostprin

Weakly-supervised localization of diabetic retinopathy lesions in retinal fundus images

Convolutional neural networks (CNNs) show impressive performance for image classification and detection, extending heavily to the medical image domain. Nevertheless, medical experts are sceptical in these predictions as the nonlinear multilayer structure resulting in a classification outcome is not directly graspable. Recently, approaches have been shown which help the user to understand the discriminative regions within an image which are decisive for the CNN to conclude to a certain class. Although these approaches could help to build trust in the CNNs predictions, they are only slightly shown to work with medical image data which often poses a challenge as the decision for a class relies on different lesion areas scattered around the entire image. Using the DiaretDB1 dataset, we show that on retina images different lesion areas fundamental for diabetic retinopathy are detected on an image level with high accuracy, comparable or exceeding supervised methods. On lesion level, we achieve few false positives with high sensitivity, though, the network is solely trained on image-level labels which do not include information about existing lesions. Classifying between diseased and healthy images, we achieve an AUC of 0.954 on the DiaretDB1.Comment: Accepted in Proc. IEEE International Conference on Image Processing (ICIP), 201

A robust lesion boundary segmentation algorithm using level set methods

This paper addresses the issue of accurate lesion segmentation in retinal imagery, using level set methods and a novel stopping mechanism - an elementary features scheme. Specifically, the curve propagation is guided by a gradient map built using a combination of histogram equalization and robust statistics. The stopping mechanism uses elementary features gathered as the curve deforms over time, and then using a lesionness measure, defined herein, ’looks back in time’ to find the point at which the curve best fits the real object. We compare the proposed method against five other segmentation algorithms performed on 50 randomly selected images of exudates with a database of clinician demarcated boundaries as ground truth

Colour normalisation to reduce inter-patient and intra-patient variability in microaneurysm detection in colour retinal images

Images of the human retina vary considerably in their appearance depending on the skin pigmentation (amount of melanin) of the subject. Some form of normalisation of colour in retinal images is required for automated analysis of images if good sensitivity and specificity at detecting lesions is to be achieved in populations involving diverse races. Here we describe an approach to colour normalisation by shade-correction intra-image and histogram normalisation inter-image. The colour normalisation is assessed by its effect on the automated detection of microaneurysms in retinal images. It is shown that the Na¨ıve Bayes classifier used in microaneurysm detection benefits from the use of features measured over colour normalised images

Improving the economic value of photographic screening for optical coherence tomography-detectable macular oedema : a prospective, multicentre, UK study

Peer reviewedPublisher PD