Current and future roles of artificial intelligence in retinopathy of prematurity

Retinopathy of prematurity (ROP) is a severe condition affecting premature infants, leading to abnormal retinal blood vessel growth, retinal detachment, and potential blindness. While semi-automated systems have been used in the past to diagnose ROP-related plus disease by quantifying retinal vessel features, traditional machine learning (ML) models face challenges like accuracy and overfitting. Recent advancements in deep learning (DL), especially convolutional neural networks (CNNs), have significantly improved ROP detection and classification. The i-ROP deep learning (i-ROP-DL) system also shows promise in detecting plus disease, offering reliable ROP diagnosis potential. This research comprehensively examines the contemporary progress and challenges associated with using retinal imaging and artificial intelligence (AI) to detect ROP, offering valuable insights that can guide further investigation in this domain. Based on 89 original studies in this field (out of 1487 studies that were comprehensively reviewed), we concluded that traditional methods for ROP diagnosis suffer from subjectivity and manual analysis, leading to inconsistent clinical decisions. AI holds great promise for improving ROP management. This review explores AI's potential in ROP detection, classification, diagnosis, and prognosis.Comment: 28 pages, 8 figures, 2 tables, 235 references, 1 supplementary tabl

PREMATURE INFANT BLOOD VESSEL SEGMENTATION OF RETINAL IMAGES BASED ON HYBRID METHOD FOR THE DETERMINATION OF TORTUOSITY

For the retinal blood vessels segmentation, we used a method, which is based on the morphological operations. The output of this process is extracted retinal binary image, where is situated main blood vessels. In this paper is used dataset of images (2800 images) from device RetCam3. Before applying the image processing, it was selected 30 images with diagnosed pre-plus diseases, and it is divided into two groups with low contrast and good contrast images. In the next part of the analysis, it was analyzing and showing blood vessels with tortuosity. Tortuosity is a symptom of ROP (retinopathy of prematurity). The clinical physicians evaluate tortuosity by visual comparison of the retinal images images. For this reason, it was suggested model which can automatically indicate the tortuosity of the retinal blood vessels by setting a threshold of the blood vessels curvature

Tram-Line filtering for retinal vessel segmentation

The segmentation of the vascular network from retinal fundal images is a fundamental step in the analysis of the retina, and may be used for a number of purposes, including diagnosis of diabetic retinopathy. However, due to the variability of retinal images segmentation is difficult, particularly with images of diseased retina which include significant distractors. This paper introduces a non-linear filter for vascular segmentation, which is particularly robust against such distractors. We demonstrate results on the publicly-available STARE dataset, superior to Stare’s performance, with 57.2% of the vascular network (by length) successfully located, with 97.2% positive predictive value measured by vessel length, compared with 57% and 92.2% for Stare. The filter is also simple and computationally efficient

Deep learning in ophthalmology: The technical and clinical considerations

The advent of computer graphic processing units, improvement in mathematical models and availability of big data has allowed artificial intelligence (AI) using machine learning (ML) and deep learning (DL) techniques to achieve robust performance for broad applications in social-media, the internet of things, the automotive industry and healthcare. DL systems in particular provide improved capability in image, speech and motion recognition as well as in natural language processing. In medicine, significant progress of AI and DL systems has been demonstrated in image-centric specialties such as radiology, dermatology, pathology and ophthalmology. New studies, including pre-registered prospective clinical trials, have shown DL systems are accurate and effective in detecting diabetic retinopathy (DR), glaucoma, age-related macular degeneration (AMD), retinopathy of prematurity, refractive error and in identifying cardiovascular risk factors and diseases, from digital fundus photographs. There is also increasing attention on the use of AI and DL systems in identifying disease features, progression and treatment response for retinal diseases such as neovascular AMD and diabetic macular edema using optical coherence tomography (OCT). Additionally, the application of ML to visual fields may be useful in detecting glaucoma progression. There are limited studies that incorporate clinical data including electronic health records, in AL and DL algorithms, and no prospective studies to demonstrate that AI and DL algorithms can predict the development of clinical eye disease. This article describes global eye disease burden, unmet needs and common conditions of public health importance for which AI and DL systems may be applicable. Technical and clinical aspects to build a DL system to address those needs, and the potential challenges for clinical adoption are discussed. AI, ML and DL will likely play a crucial role in clinical ophthalmology practice, with implications for screening, diagnosis and follow up of the major causes of vision impairment in the setting of ageing populations globally

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

Algorithms for the automatic tracking of the blood vessels network in retinal images acquired by RetCam in newborns

L’obiettivo di questo lavoro di tesi è la realizzazione di una serie di algoritmi capaci di tracciare automaticamente i vasi retinici in immagini acquisite tramite RetCam (field of view=130°) da neonati prematuri. I neonati prematuri rischiano infatti di sviluppare una patologia (Retinopatia del Prematuro) che se non correttamente trattata può portare al distacco retinico e alla cecità. L’analisi del fondo oculare è l’unico modo per determinare la condizione del paziente ma decidere se intervenire o meno in un neonato dovrebbe essere una decisione basata su dati oggettivi e su un protocollo ben definito. Il tracciamento automatico dei vasi retinici in immagini RetCam è un processo complicato data la scarsa qualità delle immagini da elaborare, soprattutto per la trasparenza della retina nei neonati e per il basso contrasto delle immagini, ma rappresenta uno step fondamentale per la successiva valutazione automatica della condizione della retina sotto esame. In questo lavoro sono state considerate 20 immagini, di cui è stato realizzato il tracciamento manuale per determinare la performance del sistema implementato. Fra le 20 immagini ne sono state scelte 6 per allenare un classificatore che , a partire dalle immagini filtrate, distingueva ogni segmento dell’immagine come appartenente o meno alla rete di vasi retinici. il risultato finale è dato dalla combinazione delle 2 classificazioni disponibili per ogni immagine ed è caratterizzato da un’immagine binaria avente i vasi retinici bianchi su sfondo ner

Retinal Image Analysis: A Review

Images of the eye ground or retina not only provide an insight to important parts of the visual system but also reflect the general state of health of the entire human body. Automated retina image analysis is becoming an important screening tool for early detection of certain risks and diseases like diabetic retinopathy, hypertensive retinopathy, age related macular degeneration, glaucoma etc. This can in turn be used to reduce human errors or to provide services to remote areas. In this review paper, we discuss some of the current techniques used to automatically detect the important clinical features of retinal image, such as the blood vessels, optic disc and macula. The quantitative analysis and measurements of these features can be used to better understand the relationship between various diseases and the retinal features

A Review of the Management of Eye Diseases Using Artificial Intelligence, Machine Learning, and Deep Learning in Conjunction with Recent Research on Eye Health Problems: Eye Microbiome

In the field of computer science, Artificial Intelligence can be considered one of the branches that study the development of algorithms that mimic certain aspects of human intelligence. Over the past few years, there has been a rapid advancement in the technology of computer-aided diagnosis (CAD). This in turn has led to an increase in the use of deep learning methods in a variety of applications. For us to be able to understand how AI can be used in order to recognize eye diseases, it is crucial that we have a deep understanding of how AI works in its core concepts. This paper aims to describe the most recent and applicable uses of artificial intelligence in the various fields of ophthalmology disease