Deep learning analysis of eye fundus images to support medical diagnosis

Machine learning techniques have been successfully applied to support medical decision making of cancer, heart diseases and degenerative diseases of the brain. In particular, deep learning methods have been used for early detection of abnormalities in the eye that could improve the diagnosis of different ocular diseases, especially in developing countries, where there are major limitations to access to specialized medical treatment. However, the early detection of clinical signs such as blood vessel, optic disc alterations, exudates, hemorrhages, drusen, and microaneurysms presents three main challenges: the ocular images can be affected by noise artifact, the features of the clinical signs depend specifically on the acquisition source, and the combination of local signs and grading disease label is not an easy task. This research approaches the problem of combining local signs and global labels of different acquisition sources of medical information as a valuable tool to support medical decision making in ocular diseases. Different models for different eye diseases were developed. Four models were developed using eye fundus images: for DME, it was designed a two-stages model that uses a shallow model to predict an exudate binary mask. Then, the binary mask is stacked with the raw fundus image into a 4-channel array as an input of a deep convolutional neural network for diabetic macular edema diagnosis; for glaucoma, it was developed three deep learning models. First, it was defined a deep learning model based on three-stages that contains an initial stage for automatically segment two binary masks containing optic disc and physiological cup segmentation, followed by an automatic morphometric features extraction stage from previous segmentations, and a final classification stage that supports the glaucoma diagnosis with intermediate medical information. Two late-data-fusion methods that fused morphometric features from cartesian and polar segmentation of the optic disc and physiological cup with features extracted from raw eye fundus images. On the other hand, two models were defined using optical coherence tomography. First, a customized convolutional neural network termed as OCT-NET to extract features from OCT volumes to classify DME, DR-DME and AMD conditions. In addition, this model generates images with highlighted local information about the clinical signs, and it estimates the number of slides inside a volume with local abnormalities. Finally, a 3D-Deep learning model that uses OCT volumes as an input to estimate the retinal thickness map useful to grade AMD. The methods were systematically evaluated using ten free public datasets. The methods were compared and validated against other state-of-the-art algorithms and the results were also qualitatively evaluated by ophthalmology experts from Fundación Oftalmológica Nacional. In addition, the proposed methods were tested as a diagnosis support tool of diabetic macular edema, glaucoma, diabetic retinopathy and age-related macular degeneration using two different ocular imaging representations. Thus, we consider that this research could be potentially a big step in building telemedicine tools that could support medical personnel for detecting ocular diseases using eye fundus images and optical coherence tomography.Las técnicas de aprendizaje automático se han aplicado con éxito para apoyar la toma de decisiones médicas sobre el cáncer, las enfermedades cardíacas y las enfermedades degenerativas del cerebro. En particular, se han utilizado métodos de aprendizaje profundo para la detección temprana de anormalidades en el ojo que podrían mejorar el diagnóstico de diferentes enfermedades oculares, especialmente en países en desarrollo, donde existen grandes limitaciones para acceder a tratamiento médico especializado. Sin embargo, la detección temprana de signos clínicos como vasos sanguíneos, alteraciones del disco óptico, exudados, hemorragias, drusas y microaneurismas presenta tres desafíos principales: las imágenes oculares pueden verse afectadas por artefactos de ruido, las características de los signos clínicos dependen específicamente de fuente de adquisición, y la combinación de signos locales y clasificación de la enfermedad no es una tarea fácil. Esta investigación aborda el problema de combinar signos locales y etiquetas globales de diferentes fuentes de adquisición de información médica como una herramienta valiosa para apoyar la toma de decisiones médicas en enfermedades oculares. Se desarrollaron diferentes modelos para diferentes enfermedades oculares. Se desarrollaron cuatro modelos utilizando imágenes de fondo de ojo: para DME, se diseñó un modelo de dos etapas que utiliza un modelo superficial para predecir una máscara binaria de exudados. Luego, la máscara binaria se apila con la imagen de fondo de ojo original en una matriz de 4 canales como entrada de una red neuronal convolucional profunda para el diagnóstico de edema macular diabético; para el glaucoma, se desarrollaron tres modelos de aprendizaje profundo. Primero, se definió un modelo de aprendizaje profundo basado en tres etapas que contiene una etapa inicial para segmentar automáticamente dos máscaras binarias que contienen disco óptico y segmentación fisiológica de la copa, seguido de una etapa de extracción de características morfométricas automáticas de segmentaciones anteriores y una etapa de clasificación final que respalda el diagnóstico de glaucoma con información médica intermedia. Dos métodos de fusión de datos tardíos que fusionaron características morfométricas de la segmentación cartesiana y polar del disco óptico y la copa fisiológica con características extraídas de imágenes de fondo de ojo crudo. Por otro lado, se definieron dos modelos mediante tomografía de coherencia óptica. Primero, una red neuronal convolucional personalizada denominada OCT-NET para extraer características de los volúmenes OCT para clasificar las condiciones DME, DR-DME y AMD. Además, este modelo genera imágenes con información local resaltada sobre los signos clínicos, y estima el número de diapositivas dentro de un volumen con anomalías locales. Finalmente, un modelo de aprendizaje 3D-Deep que utiliza volúmenes OCT como entrada para estimar el mapa de espesor retiniano útil para calificar AMD. Los métodos se evaluaron sistemáticamente utilizando diez conjuntos de datos públicos gratuitos. Los métodos se compararon y validaron con otros algoritmos de vanguardia y los resultados también fueron evaluados cualitativamente por expertos en oftalmología de la Fundación Oftalmológica Nacional. Además, los métodos propuestos se probaron como una herramienta de diagnóstico de edema macular diabético, glaucoma, retinopatía diabética y degeneración macular relacionada con la edad utilizando dos representaciones de imágenes oculares diferentes. Por lo tanto, consideramos que esta investigación podría ser potencialmente un gran paso en la construcción de herramientas de telemedicina que podrían ayudar al personal médico a detectar enfermedades oculares utilizando imágenes de fondo de ojo y tomografía de coherencia óptica.Doctorad

Automatic Detection of Exudate in Diabetic Retinopathy Using K-Clustering Algorithm

Diabetic Retinopathy is an eye disease where in which veins may swell and release liquid or new irregular veins develop on retina and piece the light touchy part, this will prompt vision misfortune. It is one of the primary drivers of visual impairment on the planet. Variety in retinal vein thickness, discharge of Exudates which is a protein spillage in the retina, Hemorrhages are a portion of the side effects of Diabetic Retinopathy. Shading fundus pictures will be utilized by ophthalmologists to study eye infections like diabetic retinopathy. Since Optic Disk shows up as a splendid spot in the retinal picture, which takes after exudates, it must be expelled from the picture. Subsequently recognition of Optic Disk is a vital parameter in retinal investigation. On the other hand, in our nation individuals experiencing this disease are all the more in number and therefore oblige more number of ophthalmologists and gigantic time to dissect and analyze the illness. In India, there are insufficient assets, regarding time and accessible master ophthalmologists. In this paper, a programmed and proficient strategy to distinguish Optic Disk and exudates are proposed. The retinal pictures are preprocessed utilizing the method of LAB shading space picture. The preprocessed shading retinal pictures are portioned utilizing Fuzzy C Means grouping method keeping in mind the end goal to distinguish Optic Disk furthermore division is done utilizing Line Operator procedure. Among the over two techniques, best one is recognized. The exudates are removed utilizing K means bunching and finally the grouping is done utilizing SVM. With the characterization accomplished, the Exudates and Non Exudates pictures are separated. DOI: 10.17762/ijritcc2321-8169.15058

Automatic segmentation of exudates in colour retinal fundus images

This work aims at the development of an algorithm that allows the automatic detection of exudates in retinal fundus images. The detection of exudates allows diabetic retinopathy (DR) to be diagnosed, consequently it is an important task for the control and the treatment of people suffering DR. In addition, an increase of 35\% of people suffering from diabetes is predicted and, therefore, of people who will suffer from DR in the coming years. As a result, an important burden for ophthalmologists will be expected. For all this, it's highly needed the development of an automatic system for the detection of exudates. Two different algorithms are proposed. Background subtraction to deal with uneven illumination and mathematical morphology operators are used for exudate location. Finally, dynamic thresholding is applied for exudate segmentation. In the first algorithm dynamic thresholding is combined with the Kirsch edge detector. In the second one, a template and morphological operators are used to differentiate bright elements from exudates is used. The methods have been validated in three public datasets named e-ophta-EX, HEI-MED and DiaretDB1. The first two datasets have been used to validated the algorithms both at lesion level and image-level. However, DiaretDB1 was only used to validate the algorithms at image-level due to its ground truth does not mark exact boundaries of exudates. The results for the image-level validation are better for the second algorithm obtaining an AUC of 0.84, 0.75 and 0.84 for e-ophta-EX, HEI-MED and DiaretDB1, respectively. The results obtained with the evaluation at lesion-level are the same for the two methods and are quantified in terms of sensitivity and PPV. We have achieved values of sensitivity and PPV of 0.54 and 0.52, respectively, in e-ophta-EX and, 0.52 and 0.52, respectively, in HEI-MED for method 1. For method 2, we have obtained values for sensitivity and PPV of 0.5 and 0.57, respectively, for e-ophta-EX and 0.42 and 0.76, respectively, for HEI-MED.Outgoin

Una revisión sistemática de métodos de aprendizaje profundo aplicados a imágenes oculares

Artificial intelligence is having an important effect on different areas of medicine, and ophthalmology has not been the exception. In particular, deep learning methods have been applied successfully to the detection of clinical signs and the classification of ocular diseases. This represents a great potential to increase the number of people correctly diagnosed. In ophthalmology, deep learning methods have primarily been applied to eye fundus images and optical coherence tomography. On the one hand, these methods have achieved an outstanding performance in the detection of ocular diseases such as: diabetic retinopathy, glaucoma, diabetic macular degeneration and age-related macular degeneration.  On the other hand, several worldwide challenges have shared big eye imaging datasets with segmentation of part of the eyes, clinical signs and the ocular diagnostic performed by experts. In addition, these methods are breaking the stigma of black-box models, with the delivering of interpretable clinically information. This review provides an overview of the state-of-the-art deep learning methods used in ophthalmic images, databases and potential challenges for ocular diagnosisLa inteligencia artificial está teniendo un importante impacto en diversas áreas de la medicina y a la oftalmología no ha sido la excepción. En particular, los métodos de aprendizaje profundo han sido aplicados con éxito en la detección de signos clínicos y la clasificación de enfermedades oculares. Esto representa un potencial impacto en el incremento de pacientes correctamente y oportunamente diagnosticados. En oftalmología, los métodos de aprendizaje profundo se han aplicado principalmente a imágenes de fondo de ojo y tomografía de coherencia óptica. Por un lado, estos métodos han logrado un rendimiento sobresaliente en la detección de enfermedades oculares tales como: retinopatía diabética, glaucoma, degeneración macular diabética y degeneración macular relacionada con la edad. Por otro lado, varios desafíos mundiales han compartido grandes conjuntos de datos con segmentación de parte de los ojos, signos clínicos y el diagnóstico ocular realizado por expertos. Adicionalmente, estos métodos están rompiendo el estigma de los modelos de caja negra, con la entrega de información clínica interpretable. Esta revisión proporciona una visión general de los métodos de aprendizaje profundo de última generación utilizados en imágenes oftálmicas, bases de datos y posibles desafíos para los diagnósticos oculare

Image Processing Technique for Hard Exudates Detection for diagnosis of Diabetic Retinopathy

Diabetic Retinopathy(DR) is a diabetic eye diseases which is referred as combination of various eye problems. These Problems are faced as a complication of diabetes by people, who are suffering from it. Prolongation of DR may result in permanent blindness. To avoid this, Detection of DR in an automated way at early stage is recommended. Hard Exudates are one of the primary abnormalities that can be seen in DR. In this paper, we have given various Image Processing Techniques that can be used for automated detection of Hard Exudates. We have evaluated the outcomes by using ground truth of the test images and the use of image databases in the particular digital algorithm for detection of Hard Exudates. Accuracy, sensitivity and Specificity are few of the parameters which are used for the concluding the better method for digital Processing DOI: 10.17762/ijritcc2321-8169.16047

Structure analysis and lesion detection from retinal fundus images

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.Ocular pathology is one of the main health problems worldwide. The number of people with retinopathy symptoms has increased considerably in recent years. Early adequate treatment has demonstrated to be effective to avoid the loss of the vision. The analysis of fundus images is a non intrusive option for periodical retinal screening. Different models designed for the analysis of retinal images are based on supervised methods, which require of hand labelled images and processing time as part of the training stage. On the other hand most of the methods have been designed under the basis of specific characteristics of the retinal images (e.g. field of view, resolution). This compromises its performance to a reduce group of retinal image with similar features. For these reasons an unsupervised model for the analysis of retinal image is required, a model that can work without human supervision or interaction. And that is able to perform on retinal images with different characteristics. In this research, we have worked on the development of this type of model. The system locates the eye structures (e.g. optic disc and blood vessels) as first step. Later, these structures are masked out from the retinal image in order to create a clear field to perform the lesion detection. We have selected the Graph Cut technique as a base to design the retinal structures segmentation methods. This selection allows incorporating prior knowledge to constraint the searching for the optimal segmentation. Different link weight assignments were formulated in order to attend the specific needs of the retinal structures (e.g. shape). This research project has put to work together the fields of image processing and ophthalmology to create a novel system that contribute significantly to the state of the art in medical image analysis. This new knowledge provides a new alternative to address the analysis of medical images and opens a new panorama for researchers exploring this research area.Mexican National Council of Science and Technolog

Dual-Branch U-Net Architecture for Retinal Lesions Segmentation on Fundus Image

Deep learning has found widespread application in diabetic retinopathy (DR) screening, primarily for lesion detection. However, this approach encounters challenges such as information loss due to convolutional operations, shape uncertainty, and the high similarity between different lesions types. These factors collectively hinder the accurate segmentation of lesions. In this research paper, we introduce a novel dual-branch U-Net architecture, referred to as Dual-Branch (DB)-U-Net, tailored to address the intricacies of small-scale lesion segmentation. Our approach involves two branches: one employs a U-Net to capture the shared characteristics of lesions, while the other utilizes a modified U-Net, known as U2Net, equipped with two decoders that share a common encoder. U2Net is responsible for generating probability maps for lesion segmentation as well as corresponding boundary segmentation. DB U-Net combines the outputs of U2Net and U-Net as a dual branch, concatenating their segmentation maps to produce the final result. To mitigate the challenge of imbalanced data, we employ the Dice loss as a loss function. We evaluate the effectiveness of our approach on publicly available datasets, including DDR, IDRiD, and E-Ophtha. Our results demonstrate that DB U-Net achieves AUPR values of 0.5254 and 0.7297 for Microaneurysms and soft exudates segmentation, respectively, on the IDRiD dataset. These results outperform other models, highlighting the potential clinical utility of our method in identifying retinal lesions from retinal fundus images

A new deep learning approach for the retinal hard exudates detection based on superpixel multi-feature extraction and patch-based CNN

Diabetic Retinopathy (DR) is a severe complication of chronic diabetes causing significant visual deterioration and may lead to blindness with delay of being treated. Exudative diabetic maculopathy, a form of macular edema where hard exudates (HE) develop, is a frequent cause of visual deterioration in DR. The detection of HE comprises a significant role in the DR diagnosis. In this paper, an automatic exudates detection method based on superpixel multi-feature extraction and patch-based deep convolutional neural network is proposed. Firstly, superpixels, regarded as candidates, are generated on each resized image using the superpixel segmentation algorithm called Simple Linear Iterative Clustering (SLIC). Then, 25 features extracted from resized images and patches are generated on each feature. Patches are subsequently used to train a deep convolutional neural network, which distinguishes the hard exudates from the background. Experiments conducted on three publicly available datasets (DiaretDB1, e-ophtha EX and IDRiD) demonstrate that our proposed methodology achieved superior HE detection when compared with current state-of-art algorithms