Detection of pathological myopia by PAMELA with texture-based features through an SVM approach

10.1260/2040-2295.1.1.1Journal of Healthcare Engineering111-1

ACHIKO-M Database for high myopia analysis and its evaluation

Myopia is the leading public health concern with high prevalence in developed countries. In this paper, we present the ACHIKO-M fundus image database with both myopic and emmetropic cases for high myopia study. The database contains 705 myopic subjects and 151 normal subjects with both left eye and right eye images for each subject. In addition, various clinical data is also available, allowing correlation study of different risk factors. We evaluated two state-of-the-art automated myopia detection algorithms on this database to show how it can be used. Both methods achieve more than 90% accuracy for myopia diagnosis. We will also discuss how ACHIKO-M can be a good database for both scientific and clinical research of myopia

Efficient Pyramid Channel Attention Network for Pathological Myopia Detection

Pathological myopia (PM) is the leading ocular disease for impaired vision and blindness worldwide. The key to detecting PM as early as possible is to detect informative features in global and local lesion regions, such as fundus tessellation, atrophy and maculopathy. However, applying classical convolutional neural networks (CNNs) to efficiently highlight global and local lesion context information in feature maps is quite challenging. To tackle this issue, we aim to fully leverage the potential of global and local lesion information with attention module design. Based on this, we propose an efficient pyramid channel attention (EPCA) module, which dynamically explores the relative importance of global and local lesion context information in feature maps. Then we combine the EPCA module with the backbone network to construct EPCA-Net for automatic PM detection based on fundus images. In addition, we construct a PM dataset termed PM-fundus by collecting fundus images of PM from publicly available datasets (e.g., the PALM dataset and ODIR dataset). The comprehensive experiments are conducted on three datasets, demonstrating that our EPCA-Net outperforms state-of-the-art methods in detecting PM. Furthermore, motivated by the recent pretraining-and-finetuning paradigm, we attempt to adapt pre-trained natural image models for PM detection by freezing them and treating the EPCA module and other attention modules as the adapters. The results show that our method with the pretraining-and-finetuning paradigm achieves competitive performance through comparisons to part of methods with traditional fine-tuning methods with fewer tunable parameters.Comment: 12 page

Automatic Diagnosis of Pathological Myopia from Heterogeneous Biomedical Data

10.1371/journal.pone.0065736PLoS ONE86

Retinal imaging tool for assessment of the parapapillary atrophy and the optic disc

Ophthalmic diseases such as glaucoma are associated with progressive changes in the structure of the optic disc (OD) and parapapillary atrophy (PPA). These structural changes may therefore have relevance to other systemic diseases. The size and location of OD and PPA can be used as registration landmarks for monitoring changes in features of the fundus of the eye. Retinal vessel evaluation, for example, can be used as a biomarker for the effects of multiple systemic diseases, or co-morbidities. This thesis presents the first computer-aided measuring tool that detects and quantifies the progression of PPA automatically on a 2D retinal fundus image in the presence of image noise. An automated segmentation system is described that can detect features of the optic nerve. Three novel approaches are explored that extract the PPA and OD region approximately from a 2D fundus image. The OD region is segmented using (i) a combination of active contour and morphological operations, (ii) a modified Chan-Vese algorithm and (iii) a combination of edge detection and ellipse fitting methods. The PPA region is identified from the presence of bright pixels in the temporal zone of the OD, and segmented using a sequence of techniques, including a modified Chan-Vese approach, thresholding, scanning filter and multi-seed region growing methods. The work demonstrates for the first time how the OD and PPA regions can be identified and quantified from 2D fundus images using a standard fundus camera

A foundation model for generalizable disease detection from retinal images

Medical artificial intelligence (AI) offers great potential for recognizing signs of health conditions in retinal images and expediting the diagnosis of eye diseases and systemic disorders1. However, the development of AI models requires substantial annotation and models are usually task-specific with limited generalizability to different clinical applications2. Here, we present RETFound, a foundation model for retinal images that learns generalizable representations from unlabelled retinal images and provides a basis for label-efficient model adaptation in several applications. Specifically, RETFound is trained on 1.6 million unlabelled retinal images by means of self-supervised learning and then adapted to disease detection tasks with explicit labels. We show that adapted RETFound consistently outperforms several comparison models in the diagnosis and prognosis of sight-threatening eye diseases, as well as incident prediction of complex systemic disorders such as heart failure and myocardial infarction with fewer labelled data. RETFound provides a generalizable solution to improve model performance and alleviate the annotation workload of experts to enable broad clinical AI applications from retinal imaging

A foundation model for generalizable disease detection from retinal images

Medical artificial intelligence (AI) offers great potential for recognizing signs of health conditions in retinal images and expediting the diagnosis of eye diseases and systemic disorders 1. However, the development of AI models requires substantial annotation and models are usually task-specific with limited generalizability to different clinical applications 2. Here, we present RETFound, a foundation model for retinal images that learns generalizable representations from unlabelled retinal images and provides a basis for label-efficient model adaptation in several applications. Specifically, RETFound is trained on 1.6 million unlabelled retinal images by means of self-supervised learning and then adapted to disease detection tasks with explicit labels. We show that adapted RETFound consistently outperforms several comparison models in the diagnosis and prognosis of sight-threatening eye diseases, as well as incident prediction of complex systemic disorders such as heart failure and myocardial infarction with fewer labelled data. RETFound provides a generalizable solution to improve model performance and alleviate the annotation workload of experts to enable broad clinical AI applications from retinal imaging.</p

Advanced Representation Learning for Dense Prediction Tasks in Medical Image Analysis

Machine learning is a rapidly growing field of artificial intelligence that allows computers to learn and make predictions using human labels. However, traditional machine learning methods have many drawbacks, such as being time-consuming, inefficient, task-specific biased, and requiring a large amount of domain knowledge. A subfield of machine learning, representation learning, focuses on learning meaningful and useful features or representations from input data. It aims to automatically learn relevant features from raw data, saving time, increasing efficiency and generalization, and reducing reliance on expert knowledge. Recently, deep learning has further accelerated the development of representation learning. It leverages deep architectures to extract complex and abstract representations, resulting in significant outperformance in many areas. In the field of computer vision, deep learning has made remarkable progress, particularly in high-level and real-world computer vision tasks. Since deep learning methods do not require handcrafted features and have the ability to understand complex visual information, they facilitate researchers to design automated systems that make accurate diagnoses and interpretations, especially in the field of medical image analysis. Deep learning has achieved state-of-the-art performance in many medical image analysis tasks, such as medical image regression/classification, generation and segmentation tasks. Compared to regression/classification tasks, medical image generation and segmentation tasks are more complex dense prediction tasks that understand semantic representations and generate pixel-level predictions. This thesis focuses on designing representation learning methods to improve the performance of dense prediction tasks in the field of medical image analysis. With advances in imaging technology, more complex medical images become available for use in this field. In contrast to traditional machine learning algorithms, current deep learning-based representation learning methods provide an end-to-end approach to automatically extract representations without the need for manual feature engineering from the complex data. In the field of medical image analysis, there are three unique challenges requiring the design of advanced representation learning architectures, \ie, limited labeled medical images, overfitting with limited data, and lack of interpretability. To address these challenges, we aim to design robust representation learning architectures for the two main directions of dense prediction tasks, namely medical image generation and segmentation. For medical image generation, the specific topic that we focus on is chromosome straightening. This task involves generating a straightened chromosome image from a curved chromosome input. In addition, the challenges of this task include insufficient training images and corresponding ground truth, as well as the non-rigid nature of chromosomes, leading to distorted details and shapes after straightening. We first propose a study for the chromosome straightening task. We introduce a novel framework using image-to-image translation and demonstrate its efficacy and robustness in generating straightened chromosomes. The framework addresses the challenges of limited training data and outperforms existing studies. We then present a subsequent study to address the limitations of our previous framework, resulting in new state-of-the-art performance and better interpretability and generalization capability. We propose a new robust chromosome straightening framework, named Vit-Patch GAN, which instead learns the motion representation of chromosomes for straightening while retaining more details of shape and banding patterns. For medical image segmentation, we focus on the fovea localization task, which is transferred from localization to small region segmentation. Accurate segmentation of the fovea region is crucial for monitoring and analyzing retinal diseases to prevent irreversible vision loss. This task also requires the incorporation of global features to effectively identify the fovea region and overcome hard cases associated with retinal diseases and non-standard fovea locations. We first propose a novel two-branch architecture, Bilateral-ViT, for fovea localization in retina image segmentation. This vision-transformer-based architecture incorporates global image context and blood vessel structure. It surpasses existing methods and achieves state-of-the-art results on two public datasets. We then propose a subsequent method to further improve the performance of fovea localization. We design a novel dual-stream deep learning architecture called Bilateral-Fuser. In contrast to our previous Bilateral-ViT, Bilateral-Fuser globally incorporates long-range connections from multiple cues, including fundus and vessel distribution. Moreover, with the newly designed Bilateral Token Incorporation module, Bilateral-Fuser learns anatomical-aware tokens, significantly reducing computational costs while achieving new state-of-the-art performance. Our comprehensive experiments also demonstrate that Bilateral-Fuser achieves better accuracy and robustness on both normal and diseased retina images, with excellent generalization capability