Microaneurysms Segmentation in Retinal Images for Early Detection of Diabetic Retinopathy

Microaneurysms (MAs) are the tiny aneurysms which show the earliest sign of diabetic retinopathy (DR). MAs might progress and harm human eyes if not treated. This paper presents an automatic method for segmentation of MAs in order to control the progression of DR. MESSIDOR database of 40 random images were utilised for further processing. The proposed approach covered pre-processing steps, contrast enhancement, filtration and segmentation by h-maxima transform and multilevel thresholding. Some post-processing techniques also involved in this approach using morphological operation. The detected MAs determined the grade of disease severity. The result showed that the percentage of severity disease detected was 60%

Automated retinal analysis

Diabetes is a chronic disease affecting over 2% of the population in the UK [1]. Long-term complications of diabetes can affect many different systems of the body including the retina of the eye. In the retina, diabetes can lead to a disease called diabetic retinopathy, one of the leading causes of blindness in the working population of industrialised countries. The risk of visual loss from diabetic retinopathy can be reduced if treatment is given at the onset of sight-threatening retinopathy. To detect early indicators of the disease, the UK National Screening Committee have recommended that diabetic patients should receive annual screening by digital colour fundal photography [2]. Manually grading retinal images is a subjective and costly process requiring highly skilled staff. This thesis describes an automated diagnostic system based oil image processing and neural network techniques, which analyses digital fundus images so that early signs of sight threatening retinopathy can be identified. Within retinal analysis this research has concentrated on the development of four algorithms: optic nerve head segmentation, lesion segmentation, image quality assessment and vessel width measurements. This research amalgamated these four algorithms with two existing techniques to form an integrated diagnostic system. The diagnostic system when used as a 'pre-filtering' tool successfully reduced the number of images requiring human grading by 74.3%: this was achieved by identifying and excluding images without sight threatening maculopathy from manual screening

Retinal Fundus Image Analysis for Diagnosis of Glaucoma: A Comprehensive Survey

© 2016 IEEE. The rapid development of digital imaging and computer vision has increased the potential of using the image processing technologies in ophthalmology. Image processing systems are used in standard clinical practices with the development of medical diagnostic systems. The retinal images provide vital information about the health of the sensory part of the visual system. Retinal diseases, such as glaucoma, diabetic retinopathy, age-related macular degeneration, Stargardt's disease, and retinopathy of prematurity, can lead to blindness manifest as artifacts in the retinal image. An automated system can be used for offering standardized large-scale screening at a lower cost, which may reduce human errors, provide services to remote areas, as well as free from observer bias and fatigue. Treatment for retinal diseases is available; the challenge lies in finding a cost-effective approach with high sensitivity and specificity that can be applied to large populations in a timely manner to identify those who are at risk at the early stages of the disease. The progress of the glaucoma disease is very often quiet in the early stages. The number of people affected has been increasing and patients are seldom aware of the disease, which can cause delay in the treatment. A review of how computer-aided approaches may be applied in the diagnosis and staging of glaucoma is discussed here. The current status of the computer technology is reviewed, covering localization and segmentation of the optic nerve head, pixel level glaucomatic changes, diagonosis using 3-D data sets, and artificial neural networks for detecting the progression of the glaucoma disease

Automatic analysis of retinal images to aid in the diagnosis and grading of diabetic retinopathy

Diabetic retinopathy (DR) is the most common complication of diabetes mellitus and one of the leading causes of preventable blindness in the adult working population. Visual loss can be prevented from the early stages of DR, when the treatments are effective. Therefore, early diagnosis is paramount. However, DR may be clinically asymptomatic until the advanced stage, when vision is already affected and treatment may become difficult. For this reason, diabetic patients should undergo regular eye examinations through screening programs. Traditionally, DR screening programs are run by trained specialists through visual inspection of the retinal images. However, this manual analysis is time consuming and expensive. With the increasing incidence of diabetes and the limited number of clinicians and sanitary resources, the early detection of DR becomes non-viable. For this reason, computed-aided diagnosis (CAD) systems are required to assist specialists for a fast, reliable diagnosis, allowing to reduce the workload and the associated costs. We hypothesize that the application of novel, automatic algorithms for fundus image analysis could contribute to the early diagnosis of DR. Consequently, the main objective of the present Doctoral Thesis is to study, design and develop novel methods based on the automatic analysis of fundus images to aid in the screening, diagnosis, and treatment of DR. In order to achieve the main goal, we built a private database and used five retinal public databases: DRIMDB, DIARETDB1, DRIVE, Messidor and Kaggle. The stages of fundus image processing covered in this Thesis are: retinal image quality assessment (RIQA), the location of the optic disc (OD) and the fovea, the segmentation of RLs and EXs, and the DR severity grading. RIQA was studied with two different approaches. The first approach was based on the combination of novel, global features. Results achieved 91.46% accuracy, 92.04% sensitivity, and 87.92% specificity using the private database. We developed a second approach aimed at RIQA based on deep learning. We achieved 95.29% accuracy with the private database and 99.48% accuracy with the DRIMDB database. The location of the OD and the fovea was performed using a combination of saliency maps. The proposed methods were evaluated over the private database and the public databases DRIVE, DIARETDB1 and Messidor. For the OD, we achieved 100% accuracy for all databases except Messidor (99.50%). As for the fovea location, we also reached 100% accuracy for all databases except Messidor (99.67%). The joint segmentation of RLs and EXs was accomplished by decomposing the fundus image into layers. Results were computed per pixel and per image. Using the private database, 88.34% per-image accuracy (ACCi) was reached for the RL detection and 95.41% ACCi for EX detection. An additional method was proposed for the segmentation of RLs based on superpixels. Evaluating this method with the private database, we obtained 84.45% ACCi. Results were validated using the DIARETDB1 database. Finally, we proposed a deep learning framework for the automatic DR severity grading. The method was based on a novel attention mechanism which performs a separate attention of the dark and the bright structures of the retina. The Kaggle DR detection dataset was used for development and validation. The International Clinical DR Scale was considered, which is made up of 5 DR severity levels. Classification results for all classes achieved 83.70% accuracy and a Quadratic Weighted Kappa of 0.78. The methods proposed in this Doctoral Thesis form a complete, automatic DR screening system, contributing to aid in the early detection of DR. In this way, diabetic patients could receive better attention for their ocular health avoiding vision loss. In addition, the workload of specialists could be relieved while healthcare costs are reduced.La retinopatía diabética (RD) es la complicación más común de la diabetes mellitus y una de las principales causas de ceguera prevenible en la población activa adulta. El diagnóstico precoz es primordial para prevenir la pérdida visual. Sin embargo, la RD es clínicamente asintomática hasta etapas avanzadas, cuando la visión ya está afectada. Por eso, los pacientes diabéticos deben someterse a exámenes oftalmológicos periódicos a través de programas de cribado. Tradicionalmente, estos programas están a cargo de especialistas y se basan de la inspección visual de retinografías. Sin embargo, este análisis manual requiere mucho tiempo y es costoso. Con la creciente incidencia de la diabetes y la escasez de recursos sanitarios, la detección precoz de la RD se hace inviable. Por esta razón, se necesitan sistemas de diagnóstico asistido por ordenador (CAD) que ayuden a los especialistas a realizar un diagnóstico rápido y fiable, que permita reducir la carga de trabajo y los costes asociados. El objetivo principal de la presente Tesis Doctoral es estudiar, diseñar y desarrollar nuevos métodos basados en el análisis automático de retinografías para ayudar en el cribado, diagnóstico y tratamiento de la RD. Las etapas estudiadas fueron: la evaluación de la calidad de la imagen retiniana (RIQA), la localización del disco óptico (OD) y la fóvea, la segmentación de RL y EX y la graduación de la severidad de la RD. RIQA se estudió con dos enfoques diferentes. El primer enfoque se basó en la combinación de características globales. Los resultados lograron una precisión del 91,46% utilizando la base de datos privada. El segundo enfoque se basó en aprendizaje profundo. Logramos un 95,29% de precisión con la base de datos privada y un 99,48% con la base de datos DRIMDB. La localización del OD y la fóvea se realizó mediante una combinación de mapas de saliencia. Los métodos propuestos fueron evaluados sobre la base de datos privada y las bases de datos públicas DRIVE, DIARETDB1 y Messidor. Para el OD, logramos una precisión del 100% para todas las bases de datos excepto Messidor (99,50%). En cuanto a la ubicación de la fóvea, también alcanzamos un 100% de precisión para todas las bases de datos excepto Messidor (99,67%). La segmentación conjunta de RL y EX se logró descomponiendo la imagen del fondo de ojo en capas. Utilizando la base de datos privada, se alcanzó un 88,34% de precisión por imagen (ACCi) para la detección de RL y un 95,41% de ACCi para la detección de EX. Se propuso un método adicional para la segmentación de RL basado en superpíxeles. Evaluando este método con la base de datos privada, obtuvimos 84.45% ACCi. Los resultados se validaron utilizando la base de datos DIARETDB1. Finalmente, propusimos un método de aprendizaje profundo para la graduación automática de la gravedad de la DR. El método se basó en un mecanismo de atención. Se utilizó la base de datos Kaggle y la Escala Clínica Internacional de RD (5 niveles de severidad). Los resultados de clasificación para todas las clases alcanzaron una precisión del 83,70% y un Kappa ponderado cuadrático de 0,78. Los métodos propuestos en esta Tesis Doctoral forman un sistema completo y automático de cribado de RD, contribuyendo a ayudar en la detección precoz de la RD. De esta forma, los pacientes diabéticos podrían recibir una mejor atención para su salud ocular evitando la pérdida de visión. Además, se podría aliviar la carga de trabajo de los especialistas al mismo tiempo que se reducen los costes sanitarios.Escuela de DoctoradoDoctorado en Tecnologías de la Información y las Telecomunicacione

Comprehensive retinal image analysis: image processing and feature extraction techniques oriented to the clinical task

Medical digital imaging has become a key element of modern health care procedures. It provides a visual documentation, a permanent record for the patients, and most importantly the ability to extract information about many diseases. Ophthalmology is a field that is heavily dependent on the analysis of digital images because they can aid in establishing an early diagnosis even before the first symptoms appear. This dissertation contributes to the digital analysis of such images and the problems that arise along the imaging pipeline, a field that is commonly referred to as retinal image analysis. We have dealt with and proposed solutions to problems that arise in retinal image acquisition and longitudinal monitoring of retinal disease evolution. Specifically, non-uniform illumination, poor image quality, automated focusing, and multichannel analysis. However, there are many unavoidable situations in which images of poor quality, like blurred retinal images because of aberrations in the eye, are acquired. To address this problem we have proposed two approaches for blind deconvolution of blurred retinal images. In the first approach, we consider the blur to be space-invariant and later in the second approach we extend the work and propose a more general space-variant scheme. For the development of the algorithms we have built preprocessing solutions that have enabled the extraction of retinal features of medical relevancy, like the segmentation of the optic disc and the detection and visualization of longitudinal structural changes in the retina. Encouraging experimental results carried out on real retinal images coming from the clinical setting demonstrate the applicability of our proposed solutions

A novel automated approach of multi-modality retinal image registration and fusion

Biomedical image registration and fusion are usually scene dependent, and require intensive computational effort. A novel automated approach of feature-based control point detection and area-based registration and fusion of retinal images has been successfully designed and developed. The new algorithm, which is reliable and time-efficient, has an automatic adaptation from frame to frame with few tunable threshold parameters. The reference and the to-be-registered images are from two different modalities, i.e. angiogram grayscale images and fundus color images. The relative study of retinal images enhances the information on the fundus image by superimposing information contained in the angiogram image. Through the thesis research, two new contributions have been made to the biomedical image registration and fusion area. The first contribution is the automatic control point detection at the global direction change pixels using adaptive exploratory algorithm. Shape similarity criteria are employed to match the control points. The second contribution is the heuristic optimization algorithm that maximizes Mutual-Pixel-Count (MPC) objective function. The initially selected control points are adjusted during the optimization at the sub-pixel level. A global maxima equivalent result is achieved by calculating MPC local maxima with an efficient computation cost. The iteration stops either when MPC reaches the maximum value, or when the maximum allowable loop count is reached. To our knowledge, it is the first time that the MPC concept has been introduced into biomedical image fusion area as the measurement criteria for fusion accuracy. The fusion image is generated based on the current control point coordinates when the iteration stops. The comparative study of the presented automatic registration and fusion scheme against Centerline Control Point Detection Algorithm, Genetic Algorithm, RMSE objective function, and other existing data fusion approaches has shown the advantage of the new approach in terms of accuracy, efficiency, and novelty

Computer analysis for registration and change detection of retinal images

The current system of retinal screening is manual; It requires repetitive examination of a large number of retinal images by professional optometrists who try to identify the presence of abnormalities. As a result of the manual and repetitive nature of such examination, there is a possibility for error in diagnosis, in particular in the case when the progression of disease is slight. As the sight is an extremely important sense, any tools which can improve the probability of detecting disease could be considered beneficial. Moreover, the early detection of ophthalmic anomalies can prevent the impairment or loss of vision. The study reported in this Thesis investigates computer vision and image processing techniques to analyse retinal images automatically, in particular for diabetic retinopathy disease which causes blindness. This analysis aims to automate registration to detect differences between a pair of images taken at different times. These differences could be the result of disease progression or, occasionally, simply the presence of artefacts. The resulting methods from this study, will be therefore used to build a software tool to aid the diagnosis process undertaken by ophthalmologists. The research also presents a number of algorithms for the enhancement and visualisation of information present within the retinal images, which under normal situations would be invisible to the viewer; For instance, in the case of slight disease progression or in the case of similar levels of contrast between images, making it difficult for the human eye to see or to distinguish any variations. This study also presents a number of developed methods for computer analysis of retinal images. These methods include a colour distance measurement algorithm, detection of bifurcations and their cross points in retina, image registration, and change detection. The overall analysis in this study can be classified to four stages: image enhancement, landmarks detection, registration, and change detection. The study has showed that the methods developed can achieve automatic, efficient, accurate, and robust implementation