A Depth Based Approach to Glaucoma Detection Using Retinal Fundus Images

Qualitative evaluation of stereo retinal fundus images by experts is a widely accepted method for optic nerve head evaluation (ONH) in glaucoma. The quantitative evaluation using stereo involves depth estimation of the ONH and thresholding of depth to extract optic cup. In this paper, we attempt the reverse, by estimating the disc depth using supervised and unsupervised techniques on a single optic disc image. Our depth estimation approach is evaluated on the INSPIRE-stereo dataset by using single images from the stereo pairs, and is compared with the OCT based depth ground truths. We extract spatial and intensity features from the depth maps, and perform classification of images into glaucomatous and normal. Our approach is evaluated on a dataset of 100 images and achieves an AUC of 0.888 with a sensitivity of 83% at specificity 83%. Experiments indicate that our approach can reliably estimate depth, and provide valuable information for glaucoma detection and for monitoring its progression

Segmentation of Optic Disc and Optic Cup in Retinal Fundus Images Using Coupled Shape Regression

Accurate segmentation of optic cup and disc in retinal fundus images is required to derive the cup-to-disc ratio (CDR) parameter which is the main indicator for Glaucoma assessment. In this paper, we propose a coupled regression method for accurate segmentation of optic cup and disc in retinal colour fundus image. The proposed coupled regression framework consists of a parameter regressor which directly predicts CDR from a given image, as well as an ensemble shape regressor which iteratively estimates the OD-OC boundary by taking into account the CDR estimated by the parameter regressor. The parameter regressor and the shape regressor are then coupled together within a feedback loop so that estimation of one reinforces the other. Both parameter regressor and the ensemble shape regressor are modeled using Boosted Regression Trees. The proposed optic cup and disc segmentation method is applied on an image set of 50 patients and demonstrates high segmentation accuracy. A comparative study shows that our proposed method outperforms state of the art methods for cup segmentation

Computer-aided Glaucoma Diagnosis using Stochastic Watershed Transformation on Single Fundus Images

[EN] Glaucoma is a chronic eye disease and one of the major causes of permanent blindness. Since it does not show initial symptoms, early diagnosis is important to limit its progression. This paper presents an automatic optic nerve characterization algorithm for glaucoma diagnosis based only on retinal fundus images. For optic cup segmentation, we used a new method based on the stochastic watershed transformation applied on the YIQ colour space to extract clinical indicators such as the Cup/Disc ratio, the area Cup/Disc ratio and the ISNT rule. Afterwards, an assessment between normal and glaucomatous fundus images is performed. The proposed algorithm was evaluated on 6 different (private and public) databases containing 723 images (377 normal and 346 glaucomatous images) which achieved a specificity and sensitivity of 0.674 and 0.675, respectively. Moreover, an F-score of 0.770 was obtained when evaluating this method on the publicly available database Drishti-GS1. A comparison of the proposed work with other state-of-the-art methods demonstrates the robustness of the proposed algorithm; because it was tested using images from different databases with high variability, which is a common issue in this area. Additional comparisons with existing works for cup segmentation, that use the publicly available database Drishti-GS1, are also presented in this paper.The authors would like to thank K. Narasimhan from SASTRA University for facilitating access to their database and gratefully acknowledge the support of NVIDIA Corporation with the donation of the Titan V GPU used for this research. This work was supported by the Project GALAHAD [H2020-ICT-2016-2017, 732613]. In particular, the work of Andres Diaz-Pinto has been supported by the Generalitat Valenciana under the scholarship Santiago Grisolia [GRISOLIA/2015/027].Díaz-Pinto, AY.; Morales, S.; Naranjo Ornedo, V.; Navea, A. (2019). Computer-aided Glaucoma Diagnosis using Stochastic Watershed Transformation on Single Fundus Images. Journal of Medical Imaging and Health Informatics (Online). 9(6):1057-1065. https://doi.org/10.1166/jmihi.2019.2721S105710659

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

Retinal vessel segmentation using textons

Segmenting vessels from retinal images, like segmentation in many other medical image domains, is a challenging task, as there is no unified way that can be adopted to extract the vessels accurately. However, it is the most critical stage in automatic assessment of various forms of diseases (e.g. Glaucoma, Age-related macular degeneration, diabetic retinopathy and cardiovascular diseases etc.). Our research aims to investigate retinal image segmentation approaches based on textons as they provide a compact description of texture that can be learnt from a training set. This thesis presents a brief review of those diseases and also includes their current situations, future trends and techniques used for their automatic diagnosis in routine clinical applications. The importance of retinal vessel segmentation is particularly emphasized in such applications. An extensive review of previous work on retinal vessel segmentation and salient texture analysis methods is presented. Five automatic retinal vessel segmentation methods are proposed in this thesis. The first method focuses on addressing the problem of removing pathological anomalies (Drusen, exudates) for retinal vessel segmentation, which have been identified by other researchers as a problem and a common source of error. The results show that the modified method shows some improvement compared to a previously published method. The second novel supervised segmentation method employs textons. We propose a new filter bank (MR11) that includes bar detectors for vascular feature extraction and other kernels to detect edges and photometric variations in the image. The k-means clustering algorithm is adopted for texton generation based on the vessel and non-vessel elements which are identified by ground truth. The third improved supervised method is developed based on the second one, in which textons are generated by k-means clustering and texton maps representing vessels are derived by back projecting pixel clusters onto hand labelled ground truth. A further step is implemented to ensure that the best combinations of textons are represented in the map and subsequently used to identify vessels in the test set. The experimental results on two benchmark datasets show that our proposed method performs well compared to other published work and the results of human experts. A further test of our system on an independent set of optical fundus images verified its consistent performance. The statistical analysis on experimental results also reveals that it is possible to train unified textons for retinal vessel segmentation. In the fourth method a novel scheme using Gabor filter bank for vessel feature extraction is proposed. The ii method is inspired by the human visual system. Machine learning is used to optimize the Gabor filter parameters. The experimental results demonstrate that our method significantly enhances the true positive rate while maintaining a level of specificity that is comparable with other approaches. Finally, we proposed a new unsupervised texton based retinal vessel segmentation method using derivative of SIFT and multi-scale Gabor filers. The lack of sufficient quantities of hand labelled ground truth and the high level of variability in ground truth labels amongst experts provides the motivation for this approach. The evaluation results reveal that our unsupervised segmentation method is comparable with the best other supervised methods and other best state of the art methods