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

A deep learning model to assess and enhance eye fundus image quality

Engineering aims to design, build, and implement solutions that will increase and/or improve the life quality of human beings. Likewise, from medicine, solutions are generated for the same purposes, enabling these two knowledge areas to converge for a common goal. With the thesis work “A Deep Learning Model to Assess and Enhance Eye Fundus Image Quality", a model was proposed and implement a model that allows us to evaluate and enhance the quality of fundus images, which contributes to improving the efficiency and effectiveness of a subsequent diagnosis based on these images. On the one hand, for the evaluation of these images, a model based on a lightweight convolutional neural network architecture was developed, termed as Mobile Fundus Quality Network (MFQ-Net). This model has approximately 90% fewer parameters than those of the latest generation. For its evaluation, the Kaggle public data set was used with two sets of quality annotations, binary (good and bad) and three classes (good, usable and bad) obtaining an accuracy of 0.911 and 0.856 in the binary mode and three classes respectively in the classification of the fundus image quality. On the other hand, a method was developed for eye fundus quality enhancement termed as Pix2Pix Fundus Oculi Quality Enhancement (P2P-FOQE). This method is based on three stages which are; pre-enhancement: for color adjustment, enhancement: with a Pix2Pix network (which is a Conditional Generative Adversarial Network) as the core of the method and post-enhancement: which is a CLAHE adjustment for contrast and detail enhancement. This method was evaluated on a subset of quality annotations for the Kaggle public database which was re-classified for three categories (good, usable, and poor) by a specialist from the Fundación Oftalmolóica Nacional. With this method, the quality of these images for the good class was improved by 72.33%. Likewise, the image quality improved from the bad class to the usable class, and from the bad class to the good class by 56.21% and 29.49% respectively.La ingeniería busca diseñar, construir e implementar soluciones que permitan aumentar y/o mejorar la calidad de vida de los seres humanos. Igualmente, desde la medicina son generadas soluciones con los mismos fines, posibilitando que estas dos áreas del conocimiento convergan por un bien común. Con el trabajo de tesis “A Deep Learning Model to Assess and Enhance Eye Fundus Image Quality”, se propuso e implementó un modelo que permite evaluar y mejorar la calidad de las imágenes de fondo de ojo, lo cual contribuye a mejorar la eficiencia y eficacia de un posterior diagnóstico basado en estas imágenes. Para la evaluación de estás imágenes, se desarrolló un modelo basado en una arquitectura de red neuronal convolucional ligera, la cual fue llamada Mobile Fundus Quality Network (MFQ-Net). Este modelo posee aproximadamente 90% menos parámetros que aquellos de última generación. Para su evaluación se utilizó el conjunto de datos públicos de Kaggle con dos sets de anotaciones de calidad, binario (buena y mala) y tres clases (buena, usable y mala) obteniendo en la tareas de clasificación de la calidad de la imagen de fondo de ojo una exactitud de 0.911 y 0.856 en la modalidad binaria y tres clases respectivamente. Por otra parte, se desarrolló un método el cual realiza una mejora de la calidad de imágenes de fondo de ojo llamado Pix2Pix Fundus Oculi Quality Enhacement (P2P-FOQE). Este método está basado en tres etapas las cuales son; premejora: para ajuste de color, mejora: con una red Pix2Pix (la cual es una Conditional Generative Adversarial Network) como núcleo del método y postmejora: la cual es un ajuste CLAHE para contraste y realce de detalles. Este método fue evaluado en un subconjunto de anotaciones de calidad para la base de datos pública de Kaggle el cual fue re clasificado por un especialista de la Fundación Oftalmológica Nacional para tres categorías (buena, usable y mala). Con este método fue mejorada la calidad de estas imágenes para la clase buena en un 72,33%. Así mismo, la calidad de imagen mejoró de la clase mala a la clase utilizable, y de la clase mala a clase buena en 56.21% y 29.49% respectivamente.Línea de investigación: Visión por computadora para análisis de imágenes médicasMaestrí

Detection and characterisation of vessels in retinal images.

Doctor of Philosophy in Mathematics, Statistics & Computer Science. University of KwaZulu-Natal, Durban 2015.As retinopathies such as diabetic retinopathy (DR) and retinopathy of prematurity (ROP) continue to be the major causes of blindness globally, regular retinal examinations of patients can assist in the early detection of the retinopathies. The manual detection of retinal vessels is a very tedious and time consuming task as it requires about two hours to manually detect vessels in each retinal image. Automatic vessel segmentation has been helpful in achieving speed, improved diagnosis and progress monitoring of these diseases but has been challenging due to complexities such as the varying width of the retinal vessels from very large to very small, low contrast of thin vessels with respect to background and noise due to nonhomogeneous illumination in the retinal images. Although several supervised and unsupervised segmentation methods have been proposed in the literature, the segmentation of thinner vessels, connectivity loss of the vessels and time complexity remain the major challenges. In order to address these problems, this research work investigated di erent unsupervised segmentation approaches to be used in the robust detection of large and thin retinal vessels in a timely e cient manner. Firstly, this thesis conducted a study on the use of di erent global thresholding techniques combined with di erent pre-processing and post-processing techniques. Two histogram-based global thresholding techniques namely, Otsu and Isodata were able to detect large retinal vessels but fail to segment the thin vessels because these thin vessels have very low contrast and are di cult to distinguish from the background tissues using the histogram of the retinal images. Two new multi-scale approaches of computing global threshold based on inverse di erence moment and sum-entropy combined with phase congruence are investigated to improve the detection of vessels. One of the findings of this study is that the multi-scale approaches of computing global threshold combined with phase congruence based techniques improved on the detection of large vessels and some of the thin vessels. They, however, failed to maintain the width of the detected vessels. The reduction in the width of the detected large and thin vessels results in low sensitivity rates while relatively good accuracy rates were maintained. Another study on the use of fuzzy c-means and GLCM sum entropy combined on phase congruence for vessel segmentation showed that fuzzy c-means combined with phase congruence achieved a higher average accuracy rates of 0.9431 and 0.9346 but a longer running time of 27.1 seconds when compared with the multi-scale based sum entropy thresholding combined with phase congruence with the average accuracy rates of 0.9416 and 0.9318 with a running time of 10.3 seconds. The longer running time of the fuzzy c-means over the sum entropy thresholding is, however, attributed to the iterative nature of fuzzy c-means. When compared with the literature, both methods achieved considerable faster running time. This thesis investigated two novel local adaptive thresholding techniques for the segmentation of large and thin retinal vessels. The two novel local adaptive thresholding techniques applied two di erent Haralick texture features namely, local homogeneity and energy. Although these two texture features have been applied for supervised image segmentation in the literature, their novelty in this thesis lies in that they are applied using an unsupervised image segmentation approach. Each of these local adaptive thresholding techniques locally applies a multi-scale approach on each of the texture information considering the pixel of interest in relationship with its spacial neighbourhood to compute the local adaptive threshold. The localised multi-scale approach of computing the thresholds handled the challenge of the vessels' width variation. Experiments showed significant improvements in the average accuracy and average sensitivity rates of these techniques when compared with the previously discussed global thresholding methods and state of the art. The two novel local adaptive thresholding techniques achieved a higher reduction of false vessels around the border of the optic disc when compared with some of the previous techniques in the literature. These techniques also achieved a highly improved computational time of 1.9 to 3.9 seconds to segment the vessels in each retinal image when compared with the state of the art. Hence, these two novel local adaptive thresholding techniques are proposed for the segmentation of the vessels in the retinal images. This thesis further investigated the combination of di erence image and kmeans clustering technique for the segmentation of large and thin vessels in retinal images. The pre-processing phase computed a di erence image and k-means clustering technique was used for the vessel detection. While investigating this vessel segmentation method, this thesis established the need for a difference image that preserves the vessel details of the retinal image. Investigating the di erent low pass filters, median filter yielded the best di erence image required by k-means clustering for the segmentation of the retinal vessels. Experiments showed that the median filter based di erence images combined with k-means clustering technique achieved higher average accuracy and average sensitivity rates when compared with the previously discussed global thresholding methods and the state of the art. The median filter based di erence images combined with k-means clustering technique (that is, DIMDF) also achieved a higher reduction of false vessels around the border of the optic disc when compared with some previous techniques in the literature. These methods also achieved a highly improved computational time of 3.4 to 4 seconds when compared with the literature. Hence, the median filter based di erence images combined with k-means clustering technique are proposed for the segmentation of the vessels in retinal images. The characterisation of the detected vessels using tortuosity measure was also investigated in this research. Although several vessel tortuosity methods have been discussed in the literature, there is still need for an improved method that e ciently detects vessel tortuosity. The experimental study conducted in this research showed that the detection of the stationary points helps in detecting the change of direction and twists in the vessels. The combination of the vessel twist frequency obtained using the stationary points and distance metric for the computation of normalised and nonnormalised tortuosity index (TI) measure was investigated. Experimental results showed that the non-normalised TI measure had a stronger correlation with the expert's ground truth when compared with the distance metric and normalised TI measures. Hence, a non-normalised TI measure that combines the vessel twist frequency based on the stationary points and distance metric is proposed for the measurement of vessel tortuosity

WOFEX 2021 : 19th annual workshop, Ostrava, 1th September 2021 : proceedings of papers

The workshop WOFEX 2021 (PhD workshop of Faculty of Electrical Engineer-ing and Computer Science) was held on September 1st September 2021 at the VSB – Technical University of Ostrava. The workshop offers an opportunity for students to meet and share their research experiences, to discover commonalities in research and studentship, and to foster a collaborative environment for joint problem solving. PhD students are encouraged to attend in order to ensure a broad, unconfined discussion. In that view, this workshop is intended for students and researchers of this faculty offering opportunities to meet new colleagues.Ostrav

The Retina in Health and Disease

Vision is the most important sense in higher mammals. The retina is the first step in visual processing and the window to the brain. It is not surprising that problems arising in the retina lead to moderate to severe visual impairments. We offer here a collection of reviews as well as original papers dealing with various aspects of retinal function as well as dysfunction. New approaches in retinal research are described, such as the expression and localization of the endocannabinoid system in the normal retina and the role of cannabinoid receptors that could offer new avenues of research in the development of potential treatments for retinal diseases. Moreover, new insights are offered in advancing knowledge towards the prevention and cure of visual pathologies, mainly AMD, RP, and diabetic retinopathy

Advances in Ophthalmology

This book focuses on the different aspects of ophthalmology - the medical science of diagnosis and treatment of eye disorders. Ophthalmology is divided into various clinical subspecialties, such as cornea, cataract, glaucoma, uveitis, retina, neuro-ophthalmology, pediatric ophthalmology, oncology, pathology, and oculoplastics. This book incorporates new developments as well as future perspectives in ophthalmology and is a balanced product between covering a wide range of diseases and expedited publication. It is intended to be the appetizer for other books to follow. Ophthalmologists, researchers, specialists, trainees, and general practitioners with an interest in ophthalmology will find this book interesting and useful

Imaging Sensors and Applications

In past decades, various sensor technologies have been used in all areas of our lives, thus improving our quality of life. In particular, imaging sensors have been widely applied in the development of various imaging approaches such as optical imaging, ultrasound imaging, X-ray imaging, and nuclear imaging, and contributed to achieve high sensitivity, miniaturization, and real-time imaging. These advanced image sensing technologies play an important role not only in the medical field but also in the industrial field. This Special Issue covers broad topics on imaging sensors and applications. The scope range of imaging sensors can be extended to novel imaging sensors and diverse imaging systems, including hardware and software advancements. Additionally, biomedical and nondestructive sensing applications are welcome