Automatic detection of microaneurysms in colour fundus images for diabetic retinopathy screening.

Regular eye screening is essential for the early detection and treatment of the diabetic retinopathy. This paper presents a novel automatic screening system for diabetic retinopathy that focuses on the detection of the earliest visible signs of retinopathy, which are microaneurysms. Microaneurysms are small dots on the retina, formed by ballooning out of a weak part of the capillary wall. The detection of the microaneurysms at an early stage is vital, and it is the first step in preventing the diabetic retinopathy. The paper first explores the existing systems and applications related to diabetic retinopathy screening, with a focus on the microaneurysm detection methods. The proposed decision support system consists of an automatic acquisition, screening and classification of diabetic retinopathy colour fundus images, which could assist in the detection and management of the diabetic retinopathy. Several feature extraction methods and the circular Hough transform have been employed in the proposed microaneurysm detection system, alongside the fuzzy histogram equalisation method. The latter method has been applied in the preprocessing stage of the diabetic retinopathy eye fundus images and provided improved results for detecting the microaneurysms

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

Detection and Classification of Diabetic Retinopathy Pathologies in Fundus Images

Diabetic Retinopathy (DR) is a disease that affects up to 80% of diabetics around the world. It is the second greatest cause of blindness in the Western world, and one of the leading causes of blindness in the U.S. Many studies have demonstrated that early treatment can reduce the number of sight-threatening DR cases, mitigating the medical and economic impact of the disease. Accurate, early detection of eye disease is important because of its potential to reduce rates of blindness worldwide. Retinal photography for DR has been promoted for decades for its utility in both disease screening and clinical research studies. In recent years, several research centers have presented systems to detect pathology in retinal images. However, these approaches apply specialized algorithms to detect specific types of lesion in the retina. In order to detect multiple lesions, these systems generally implement multiple algorithms. Furthermore, some of these studies evaluate their algorithms on a single dataset, thus avoiding potential problems associated with the differences in fundus imaging devices, such as camera resolution. These methodologies primarily employ bottom-up approaches, in which the accurate segmentation of all the lesions in the retina is the basis for correct determination. A disadvantage of bottom-up approaches is that they rely on the accurate segmentation of all lesions in order to measure performance. On the other hand, top-down approaches do not depend on the segmentation of specific lesions. Thus, top-down methods can potentially detect abnormalities not explicitly used in their training phase. A disadvantage of these methods is that they cannot identify specific pathologies and require large datasets to build their training models. In this dissertation, I merged the advantages of the top-down and bottom-up approaches to detect DR with high accuracy. First, I developed an algorithm based on a top-down approach to detect abnormalities in the retina due to DR. By doing so, I was able to evaluate DR pathologies other than microaneurysms and exudates, which are the main focus of most current approaches. In addition, I demonstrated good generalization capacity of this algorithm by applying it to other eye diseases, such as age-related macular degeneration. Due to the fact that high accuracy is required for sight-threatening conditions, I developed two bottom-up approaches, since it has been proven that bottom-up approaches produce more accurate results than top-down approaches for particular structures. Consequently, I developed an algorithm to detect exudates in the macula. The presence of this pathology is considered to be a surrogate for clinical significant macular edema (CSME), a sight-threatening condition of DR. The analysis of the optic disc is usually not taken into account in DR screening systems. However, there is a pathology called neovascularization that is present in advanced stages of DR, making its detection of crucial clinical importance. In order to address this problem, I developed an algorithm to detect neovascularization in the optic disc. These algorithms are based on amplitude-modulation and frequency-modulation (AM-FM) representations, morphological image processing methods, and classification algorithms. The methods were tested on a diverse set of large databases and are considered to be the state-of the art in this field

Digital ocular fundus imaging: a review

Ocular fundus imaging plays a key role in monitoring the health status of the human eye. Currently, a large number of imaging modalities allow the assessment and/or quantification of ocular changes from a healthy status. This review focuses on the main digital fundus imaging modality, color fundus photography, with a brief overview of complementary techniques, such as fluorescein angiography. While focusing on two-dimensional color fundus photography, the authors address the evolution from nondigital to digital imaging and its impact on diagnosis. They also compare several studies performed along the transitional path of this technology. Retinal image processing and analysis, automated disease detection and identification of the stage of diabetic retinopathy (DR) are addressed as well. The authors emphasize the problems of image segmentation, focusing on the major landmark structures of the ocular fundus: the vascular network, optic disk and the fovea. Several proposed approaches for the automatic detection of signs of disease onset and progression, such as microaneurysms, are surveyed. A thorough comparison is conducted among different studies with regard to the number of eyes/subjects, imaging modality, fundus camera used, field of view and image resolution to identify the large variation in characteristics from one study to another. Similarly, the main features of the proposed classifications and algorithms for the automatic detection of DR are compared, thereby addressing computer-aided diagnosis and computer-aided detection for use in screening programs.Fundação para a Ciência e TecnologiaFEDErPrograma COMPET

A Smartphone-Based Tool for Rapid, Portable, and Automated Wide-Field Retinal Imaging.

Purpose:High-quality, wide-field retinal imaging is a valuable method for screening preventable, vision-threatening diseases of the retina. Smartphone-based retinal cameras hold promise for increasing access to retinal imaging, but variable image quality and restricted field of view can limit their utility. We developed and clinically tested a smartphone-based system that addresses these challenges with automation-assisted imaging. Methods:The system was designed to improve smartphone retinal imaging by combining automated fixation guidance, photomontage, and multicolored illumination with optimized optics, user-tested ergonomics, and touch-screen interface. System performance was evaluated from images of ophthalmic patients taken by nonophthalmic personnel. Two masked ophthalmologists evaluated images for abnormalities and disease severity. Results:The system automatically generated 100° retinal photomontages from five overlapping images in under 1 minute at full resolution (52.3 pixels per retinal degree) fully on-phone, revealing numerous retinal abnormalities. Feasibility of the system for diabetic retinopathy (DR) screening using the retinal photomontages was performed in 71 diabetics by masked graders. DR grade matched perfectly with dilated clinical examination in 55.1% of eyes and within 1 severity level for 85.2% of eyes. For referral-warranted DR, average sensitivity was 93.3% and specificity 56.8%. Conclusions:Automation-assisted imaging produced high-quality, wide-field retinal images that demonstrate the potential of smartphone-based retinal cameras to be used for retinal disease screening. Translational Relevance:Enhancement of smartphone-based retinal imaging through automation and software intelligence holds great promise for increasing the accessibility of retinal screening

Automatic Screening and Classification of Diabetic Retinopathy Eye Fundus Image

Diabetic Retinopathy (DR) is a disorder of the retinal vasculature. It develops to some degree in nearly all patients with long-standing diabetes mellitus and can result in blindness. Screening of DR is essential for both early detection and early treatment. This thesis aims to investigate automatic methods for diabetic retinopathy detection and subsequently develop an effective system for the detection and screening of diabetic retinopathy. The presented diabetic retinopathy research involves three development stages. Firstly, the thesis presents the development of a preliminary classification and screening system for diabetic retinopathy using eye fundus images. The research will then focus on the detection of the earliest signs of diabetic retinopathy, which are the microaneurysms. The detection of microaneurysms at an early stage is vital and is the first step in preventing diabetic retinopathy. Finally, the thesis will present decision support systems for the detection of diabetic retinopathy and maculopathy in eye fundus images. The detection of maculopathy, which are yellow lesions near the macula, is essential as it will eventually cause the loss of vision if the affected macula is not treated in time. An accurate retinal screening, therefore, is required to assist the retinal screeners to classify the retinal images effectively. Highly efficient and accurate image processing techniques must thus be used in order to produce an effective screening of diabetic retinopathy. In addition to the proposed diabetic retinopathy detection systems, this thesis will present a new dataset, and will highlight the dataset collection, the expert diagnosis process and the advantages of the new dataset, compared to other public eye fundus images datasets available. The new dataset will be useful to researchers and practitioners working in the retinal imaging area and would widely encourage comparative studies in the field of diabetic retinopathy research. It is envisaged that the proposed decision support system for clinical screening would greatly contribute to and assist the management and the detection of diabetic retinopathy. It is also hoped that the developed automatic detection techniques will assist clinicians to diagnose diabetic retinopathy at an early stage

The evidence for automated grading in diabetic retinopathy screening

Peer reviewedPostprin

Computerized Approaches for Retinal Microaneurysm Detection

The number of diabetic patients throughout the world is increasing with a very high rate. The patients suffering from long term diabetes have a very high risk of generating retinal disorder called Diabetic Retinopathy(DR). The disease is a complication of diabetes and may results in irreversible blindness to the patient. Early diagnosis and routine checkups by expert ophthalmologist possibly prevent the vision loss. But the number of people to be screen exceeds the number of experts, especially in rural areas. Thus the computerized screening systems are needed which will accurately screen the large amount of population and identify healthy and diseased people. Thus the workload on experts is reduced significantly. Microaneurysms(MA) are first recognizable signs of DR. Thus early detection of DR requires accurate detection of Microaneurysms. Computerized diagnosis insures reliable and accurate detection of MA's. The paper overviews the approaches for computerized detection of retinal Microaneurysms