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

Eye Disease Detection Using Computer Vision

Glaucoma and Diabetic Retinopathy(DR) are among the leading causes of blindness. Belated handling of Cataract can impact the vision causing blindness. Often the scarcity of experts can lead to delayed diagnosis, resulting in untreatable conditions. But detection of these diseases at earliest stage and treatment can aid patient in avoiding vision loss. An automatic disease detection system can help this by providing accurate and early diagnosis. In proposed system, diagnosis will be obtained using image processing and mining techniques on fundus image. Feature extraction using DCT. K-NN classification algorithm will be used to classify the image in a specific class (Normal,Glaucoma,DR or Cataract)

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

Bright Lesion Detection in Color Fundus Images Based on Texture Features

In this paper a computer aided screening system for the detection of bright lesions or exudates using color fundus images is proposed. The proposed screening system is used to identify the suspicious regions for bright lesions. A texture feature extraction method is also demonstrated to describe the characteristics of region of interest. In final stage the normal and abnormal images are classified using Support vector machine classifier. Our proposed system obtained the effective detection performance compared to some of the state–of–art methods

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

Retinal blood vessel localization to expedite PDR diagnosis

Ophthalmologist relies on the retinal fundus image segmentation for accurate diagnosis of Diabetic Retinopathy caused due to prolonged deterioration in retinal blood vessels. Blood vessel and optical disc localization determines the vascular alterations helpful in identifying retinal diseases with accurate identification of pathologies like microaneurysms and exudates. This work comprises evaluation of proposed Optical Disc Segmentation and blood vessel localization techniques followed by a statistical analysis using three fractal dimensions; box count, information and correlation. Fractal dimensions explored are beneficial for Proliferative Diabetic Retinopathy (PDR) diagnosis as its value for vascular structures increases with increasing level of PDR. Two benchmark fundus image databases, DRIVE and STARE were evaluated by utilizing shape and fractal features for performance validation and average accuracies of 96.79% and 95.68% were achieved for extracted blood vessels using proposed approach

Retinal Image Analysis: A Review

Images of the eye ground or retina not only provide an insight to important parts of the visual system but also reflect the general state of health of the entire human body. Automated retina image analysis is becoming an important screening tool for early detection of certain risks and diseases like diabetic retinopathy, hypertensive retinopathy, age related macular degeneration, glaucoma etc. This can in turn be used to reduce human errors or to provide services to remote areas. In this review paper, we discuss some of the current techniques used to automatically detect the important clinical features of retinal image, such as the blood vessels, optic disc and macula. The quantitative analysis and measurements of these features can be used to better understand the relationship between various diseases and the retinal features

Application of the morphological ultimate opening to the detection of microaneurysms on eye fundus images from a clinical database

International audienceDiabetic Retinopathy (DR) is a severe disease which can cause blindness. OPHDIAT is a telemedicine network for DR mass screening, which has gathered thousands of clinical high resolution color eye fundus images. The TELEOPHTA project has been launched in order to develop a computer aided diagnosis system of DR, which aims at performing a preliminary analysis of the OPHDIAT images in order to filter most images corresponding to healthy eyes. Microaneurysms (MAs) are likely to be the lesions present at the earliest stage of the disease. In this paper, a new method of MAs detection, using the recently proposed ultimate opening, is presented. The proposed method does not use any supervised classification, while provides a competitive and efficient way to detect MAs, especially for our clinical database. Further improvements may be brought through the accurate detection of the retinal elements and other retinal diseases, or through the estimation of the image quality