Simple hybrid method for fine microaneurysm detection from non-dilated diabetic retinopathy retinal images

Automatic Detection of Microaneurysms in OCT Images Using Bag of Features

Diabetic retinopathy (DR) caused by diabetes occurs as a result of changes in the retinal vessels and causes visual impairment. Microaneurysms (MAs) are the early clinical signs of DR, whose timely diagnosis can help detecting DR in the early stages of its development. It has been observed that MAs are more common in the inner retinal layers compared to the outer retinal layers in eyes suffering from DR. Optical coherence tomography (OCT) is a noninvasive imaging technique that provides a cross-sectional view of the retina, and it has been used in recent years to diagnose many eye diseases. As a result, this paper attempts to identify areas with MA from normal areas of the retina using OCT images. This work is done using the dataset collected from FA and OCT images of 20 patients with DR. In this regard, firstly fluorescein angiography (FA) and OCT images were registered. Then, the MA and normal areas were separated, and the features of each of these areas were extracted using the Bag of Features (BOF) approach with the Speeded-Up Robust Feature (SURF) descriptor. Finally, the classification process was performed using a multilayer perceptron network. For each of the criteria of accuracy, sensitivity, specificity, and precision, the obtained results were 96.33%, 97.33%, 95.4%, and 95.28%, respectively. Utilizing OCT images to detect MAs automatically is a new idea, and the results obtained as preliminary research in this field are promising.

Untangling Computer-Aided Diagnostic System for Screening Diabetic Retinopathy Based on Deep Learning Techniques

Diabetic Retinopathy (DR) is a predominant cause of visual impairment and loss. Approximately 285 million worldwide population is affected with diabetes, and one-third of these patients have symptoms of DR. Specifically, it tends to affect the patients with 20 years or more with diabetes, but it can be reduced by early detection and proper treatment. Diagnosis of DR by using manual methods is a time-consuming and expensive task which involves trained ophthalmologists to observe and evaluate DR using digital fundus images of the retina. This study aims to systematically find and analyze high-quality research work for the diagnosis of DR using deep learning approaches. This research comprehends the DR grading, staging protocols and also presents the DR taxonomy. Furthermore, identifies, compares, and investigates the deep learning-based algorithms, techniques, and, methods for classifying DR stages. Various publicly available dataset used for deep learning have also been analyzed and dispensed for descriptive and empirical understanding for real-time DR applications. Our in-depth study shows that in the last few years there has been an increasing inclination towards deep learning approaches. 35% of the studies have used Convolutional Neural Networks (CNNs), 26% implemented the Ensemble CNN (ECNN) and, 13% Deep Neural Networks (DNN) are amongst the most used algorithms for the DR classification. Thus using the deep learning algorithms for DR diagnostics have future research potential for DR early detection and prevention based solution.

Deep Learning Approach for Automatic Microaneurysms Detection

In diabetic retinopathy (DR), the early signs that may lead the eyesight towards complete vision loss are considered as microaneurysms (MAs). The shape of these MAs is almost circular, and they have a darkish color and are tiny in size, which means they may be missed by manual analysis of ophthalmologists. In this case, accurate early detection of microaneurysms is helpful to cure DR before non-reversible blindness. In the proposed method, early detection of MAs is performed using a hybrid feature embedding approach of pre-trained CNN models, named as VGG-19 and Inception-v3. The performance of the proposed approach was evaluated using publicly available datasets, namely "E-Ophtha" and "DIARETDB1", and achieved 96% and 94% classification accuracy, respectively. Furthermore, the developed approach outperformed the state-of-the-art approaches in terms of sensitivity and specificity for microaneurysms detection.

Ultra-Widefield Fluorescein Angiography Image Brightness Compensation Based on Geometrical Features

Ultra-widefield fluorescein angiography (UWFA) is an emerging imaging modality used to characterise pathologies in the retinal vasculature, such as microaneurysms (MAs) and vascular leakages. Despite its potential value for diagnosis and disease screening, objective quantitative assessment of retinal pathologies by UWFA is currently limited because laborious manual processing is required. In this report, we describe a geometrical method for uneven brightness compensation inherent to UWFA imaging technique. The correction function is based on the geometrical eyeball shape, therefore it is fully automated and depends only on pixel distance from the center of the imaged retina. The method's performance was assessed on a database containing 256 UWFA images with the use of several image quality measures that show the correction method improves image quality. The method is also compared to the commonly used CLAHE approach and was also employed in a pilot study for vascular segmentation, giving a noticeable improvement in segmentation results. Therefore, the method can be used as an image preprocessing step in retinal UWFA image analysis.

Progress of artificial intelligence in diabetic retinopathy screening

Diabetic retinopathy (DR) is one of the leading causes of blindness worldwide, and the limited availability of qualified ophthalmologists restricts its early diagnosis. For the past few years, artificial intelligence technology has developed rapidly and has been applied in DR screening. The upcoming technology provides support on DR screening and improves the identification of DR lesions with a high sensitivity and specificity. This review aims to summarize the progress on automatic detection and classification models for the diagnosis of DR.

Automatic microaneurysm detection in fundus image based on local cross-section transformation and multi-feature fusion

BACKGROUND AND OBJECTIVE

Retinal microaneurysm (MA) is one of the earliest clinical signs of diabetic retinopathy(DR). Its detection is essential for controlling DR and preventing vision loss. However, the spatial scale of MA is extremely small and the contrast to surrounding background is subtle, which make MA detection challenging. The purpose of this work is to automatically detect MAs from fundus images.

METHODS

Our MA detector involves two stages: MA candidate extraction and classification. In MA candidate extraction stage, local minimum region extraction and block filtering are used to exploit the regions where MA may exist. In this way, most of irrelavent background regions are discarded , which subsequently facilitates the training of MA classifier. In the second stage, multiple features are extracted to train the MA classifier. To distinguish MA from vascular regions, we propose a series of descriptors according to the cross-section profile of MA. Specially, as MAs are small and their contrast to surroundings is subtle, we propose local cross-section transformation (LCT) to amplify the difference between the MA and confusing structures. Finally, an under-sampling boosting-based classifier (RUSBoost) is trained to determine whether the candidate is an MA.

RESULTS

The proposed method is evaluated on three public available databases i.e. e-ophtha-MA, DiaretDB1 and ROC training set. It achieves high sensitivities for low false positive rates on the three databases. Using the FROC metric, the final scores are 0.516, 0.402 and 0.293 respectively, which are comparable to existing state-of-the-art methods.

CONCLUSIONS

The proposed local cross-section transformation enhances the discrimination of descriptors by amplifying difference between MAs and confusing structures, which facilitates the classification and improves the detection performances. With the powerful descriptors, our method achieves state-of-the-art performances on three public datasets consistently.

Analysis of the location of retinal lesions in central retinographies of patients with Type 2 diabetes

PURPOSE

To describe the distribution of Type 2 DM retinal lesions and determine whether it is symmetrical between the two eyes, is random or follows a certain pattern.

METHODS

Cross-sectional study of Type 2 DM patients who had been referred for an outpatients' ophthalmology visit for diabetic retinopathy screening in primary health care. Retinal photographic images were taken using central projection non-mydriatic retinography. The lesions under study were microaneurysms/haemorrhages, and hard and soft exudates. The lesions were placed numerically along the x- and y-axes obtained, with the fovea as the origin.

RESULTS

From among the 94 patients included in the study, 4770 lesions were identified. The retinal lesions were not distributed randomly, but rather followed a determined pattern. The left eye exhibited more microaneurysms/haemorrhages and hard exudates of a greater density in the central retina than was found in the right eye. Furthermore, more cells containing lesions were found in the upper temporal quadrants, (especially in the left eye), and tended to be more central in the left eye than in the right, while the hard exudates were more central than the microaneurysms/haemorrhages.

CONCLUSION

The distribution of DR lesions is neither homogeneous nor random but rather follows a determined pattern for both microaneurysms/haemorrhages and hard exudates. This distribution means that the areas of the retina most vulnerable to metabolic alteration can be identified. The results may be useful for automated DR detection algorithms and for determining the underlying vascular and non-vascular physiopathological mechanisms that can explain these differences.

FILM: finding the location of microaneurysms on the retina

Diabetes retinopathy (DR) is one of the leading cause of blindness among people suffering from diabetes. It is a lesion based disease which starts off as small red spots on the retina. These small red lesions are known as microaneurysms (MA). These microaneurysms gradually increase in size as the DR progresses, which eventually leads to blindness. Thus, DR can be prevented at a very early stage by eliminating the retinal microaneurysms. However, elimination of MA is a two step process. The first step requires detecting the presence of MA on the retina. The second step involves pinpointing the location of MA on the retina. Even though, these two steps are interdependent, there is no model available that can perform both steps simultaneously. Most of the models perform the first step successfully, while the second step is performed by opthamologists manually. Hence we have proposed an object detection model that integrates the two steps by detecting (first step) and pinpointing (second step) the MA on the retina simultaneously. This would help the opthamologists in directly finding the exact location of MA on the retina, thereby simplifying the process and eliminating any manual intervention.

Statistical Geometrical Features for Microaneurysm Detection

Automated microaneurysm (MA) detection is still an open challenge due to its small size and similarity with blood vessels. In this paper, we present a novel method which is simple, efficient, and real-time for segmenting and detecting MA in color fundus images (CFI). To do this, a novel set of features based on statistics of geometrical properties of connected regions, that can easily discriminate lesion and non-lesion pixels are used. For large-scale evaluation proposed method is validated on DIARETDB1, ROC, STARE, and MESSIDOR dataset. It proves robust with respect to different image characteristics and camera settings. The best performance was achieved on per-image evaluation on DIARETDB1 dataset with sensitivity of 88.09 at 92.65% specificity which is quite encouraging for clinical use.

A review on computer-aided recent developments for automatic detection of diabetic retinopathy

Diabetic retinopathy is a serious microvascular disorder that might result in loss of vision and blindness. It seriously damages the retinal blood vessels and reduces the light-sensitive inner layer of the eye. Due to the manual inspection of retinal fundus images on diabetic retinopathy to detect the morphological abnormalities in Microaneurysms (MAs), Exudates (EXs), Haemorrhages (HMs), and Inter retinal microvascular abnormalities (IRMA) is very difficult and time consuming process. In order to avoid this, the regular follow-up screening process, and early automatic Diabetic Retinopathy detection are necessary. This paper discusses various methods of analysing automatic retinopathy detection and classification of different grading based on the severity levels. In addition, retinal blood vessel detection techniques are also discussed for the ultimate detection and diagnostic procedure of proliferative diabetic retinopathy. Furthermore, the paper elaborately discussed the systematic review accessed by authors on various publicly available databases collected from different medical sources. In the survey, meta-analysis of several methods for diabetic feature extraction, segmentation and various types of classifiers have been used to evaluate the system performance metrics for the diagnosis of DR. This survey will be helpful for the technical persons and researchers who want to focus on enhancing the diagnosis of a system that would be more powerful in real life.

Recent Development on Detection Methods for the Diagnosis of Diabetic Retinopathy

Diabetic retinopathy (DR) is a complication of diabetes that exists throughout the world. DR occurs due to a high ratio of glucose in the blood, which causes alterations in the retinal microvasculature. Without preemptive symptoms of DR, it leads to complete vision loss. However, early screening through computer-assisted diagnosis (CAD) tools and proper treatment have the ability to control the prevalence of DR. Manual inspection of morphological changes in retinal anatomic parts are tedious and challenging tasks. Therefore, many CAD systems were developed in the past to assist ophthalmologists for observing inter- and intra-variations. In this paper, a recent review of state-of-the-art CAD systems for diagnosis of DR is presented. We describe all those CAD systems that have been developed by various computational intelligence and image processing techniques. The limitations and future trends of current CAD systems are also described in detail to help researchers. Moreover, potential CAD systems are also compared in terms of statistical parameters to quantitatively evaluate them. The comparison results indicate that there is still a need for accurate development of CAD systems to assist in the clinical diagnosis of diabetic retinopathy.

Secondary Observer System for Detection of Microaneurysms in Fundus Images Using Texture Descriptors

The increase of diabetic retinopathy patients and diabetic mellitus worldwide yields lot of challenges to ophthalmologists in the screening of diabetic retinopathy. Different signs of diabetic retinopathy were identified in retinal images taken through fundus photography. Among these stages, the early stage of diabetic retinopathy termed as microaneurysms plays a vital role in diabetic retinopathy patients. To assist the ophthalmologists, and to avoid vision loss among diabetic retinopathy patients, a computer-aided diagnosis is essential that can be used as a second opinion while screening diabetic retinopathy. On this vision, a new methodology is proposed to detect the microaneurysms and non-microaneurysms through the stages of image pre-processing, candidate extraction, feature extraction, and classification. The feature extractor, generalized rotational invariant local binary pattern, contributes in extracting the texture-based features of microaneurysms. As a result, our proposed system achieved a free-response receiver operating characteristic score of 0.421 with Retinopathy Online Challenge database.

Microaneurysm detection in fundus images using a two-step convolutional neural network

Background and objectives

Diabetic retinopathy (DR) is the leading cause of blindness worldwide, and therefore its early detection is important in order to reduce disease-related eye injuries. DR is diagnosed by inspecting fundus images. Since microaneurysms (MA) are one of the main symptoms of the disease, distinguishing this complication within the fundus images facilitates early DR detection. In this paper, an automatic analysis of retinal images using convolutional neural network (CNN) is presented.

Methods

Our method incorporates a novel technique utilizing a two-stage process with two online datasets which results in accurate detection while solving the imbalance data problem and decreasing training time in comparison with previous studies. We have implemented our proposed CNNs using the Keras library.

Results

In order to evaluate our proposed method, an experiment was conducted on two standard publicly available datasets, i.e., Retinopathy Online Challenge dataset and E-Ophtha-MA dataset. Our results demonstrated a promising sensitivity value of about 0.8 for an average of >6 false positives per image, which is competitive with state of the art approaches.

Conclusion

Our method indicates significant improvement in MA-detection using retinal fundus images for monitoring diabetic retinopathy.

Particle swarm optimization method for small retinal vessels detection on multiresolution fundus images

Retinal vessel segmentation plays an important role in the diagnosis of eye diseases and is considered as one of the most challenging tasks in computer-aided diagnosis (CAD) systems. The main goal of this study was to propose a method for blood-vessel segmentation that could deal with the problem of detecting vessels of varying diameters in high- and low-resolution fundus images. We proposed to use the particle swarm optimization (PSO) algorithm to improve the multiscale line detection (MSLD) method. The PSO algorithm was applied to find the best arrangement of scales in the MSLD method and to handle the problem of multiscale response recombination. The performance of the proposed method was evaluated on two low-resolution (DRIVE and STARE) and one high-resolution fundus (HRF) image datasets. The data include healthy (H) and diabetic retinopathy (DR) cases. The proposed approach improved the sensitivity rate against the MSLD by 4.7% for the DRIVE dataset and by 1.8% for the STARE dataset. For the high-resolution dataset, the proposed approach achieved 87.09% sensitivity rate, whereas the MSLD method achieves 82.58% sensitivity rate at the same specificity level. When only the smallest vessels were considered, the proposed approach improved the sensitivity rate by 11.02% and by 4.42% for the healthy and the diabetic cases, respectively. Integrating the proposed method in a comprehensive CAD system for DR screening would allow the reduction of false positives due to missed small vessels, misclassified as red lesions.

Automatic detection of microaneurysms in diabetic retinopathy fundus images using the L*a*b color space

We develop an automated image processing system for detecting microaneurysm (MA) in diabetic patients. Diabetic retinopathy is one of the main causes of preventable blindness in working age diabetic people with the presence of an MA being one of the first signs. We transform the eye fundus images to the L*a*b* color space in order to separately process the L* and a* channels, looking for MAs in each of them. We then fuse the results, and last send the MA candidates to a k-nearest neighbors classifier for final assessment. The performance of the method, measured against 50 images with an ophthalmologist's hand-drawn ground-truth, shows high sensitivity (100%) and accuracy (84%), and running times around 10 s. This kind of automatic image processing application is important in order to reduce the burden on the public health system associated with the diagnosis of diabetic retinopathy given the high number of potential patients that need periodic screening.

A method to assist in the diagnosis of early diabetic retinopathy: Image processing applied to detection of microaneurysms in fundus images

Diabetes increases the risk of developing any deterioration in the blood vessels that supply the retina, an ailment known as Diabetic Retinopathy (DR). Since this disease is asymptomatic, it can only be diagnosed by an ophthalmologist. However, the growth of the number of ophthalmologists is lower than the growth of the population with diabetes so that preventive and early diagnosis is difficult due to the lack of opportunity in terms of time and cost. Preliminary, affordable and accessible ophthalmological diagnosis will give the opportunity to perform routine preventive examinations, indicating the need to consult an ophthalmologist during a stage of non proliferation. During this stage, there is a lesion on the retina known as microaneurysm (MA), which is one of the first clinically observable lesions that indicate the disease. In recent years, different image processing algorithms, which allow the detection of the DR, have been developed; however, the issue is still open since acceptable levels of sensitivity and specificity have not yet been reached, preventing its use as a pre-diagnostic tool. Consequently, this work proposes a new approach for MA detection based on (1) reduction of non-uniform illumination; (2) normalization of image grayscale content to improve dependence of images from different contexts; (3) application of the bottom-hat transform to leave reddish regions intact while suppressing bright objects; (4) binarization of the image of interest with the result that objects corresponding to MAs, blood vessels, and other reddish objects (Regions of Interest-ROIs) are completely separated from the background; (5) application of the hit-or-miss Transformation on the binary image to remove blood vessels from the ROIs; (6) two features are extracted from a candidate to distinguish real MAs from FPs, where one feature discriminates round shaped candidates (MAs) from elongated shaped ones (vessels) through application of Principal Component Analysis (PCA); (7) the second feature is a count of the number of times that the radon transform of the candidate ROI, evaluated at the set of discrete angle values {0°, 1°, 2°, …, 180°}, is characterized by a valley between two peaks. The proposed approach is tested on the public databases DiaretDB1 and Retinopathy Online Challenge (ROC) competition. The proposed MA detection method achieves sensitivity, specificity and precision of 92.32%, 93.87% and 95.93% for the diaretDB1 database and 88.06%, 97.47% and 92.19% for the ROC database. Theory, results, challenges and performance related to the proposed MA detecting method are presented.

Genetic algorithm based feature selection combined with dual classification for the automated detection of proliferative diabetic retinopathy

Proliferative diabetic retinopathy (PDR) is a condition that carries a high risk of severe visual impairment. The hallmark of PDR is the growth of abnormal new vessels. In this paper, an automated method for the detection of new vessels from retinal images is presented. This method is based on a dual classification approach. Two vessel segmentation approaches are applied to create two separate binary vessel map which each hold vital information. Local morphology features are measured from each binary vessel map to produce two separate 4-D feature vectors. Independent classification is performed for each feature vector using a support vector machine (SVM) classifier. The system then combines these individual outcomes to produce a final decision. This is followed by the creation of additional features to generate 21-D feature vectors, which feed into a genetic algorithm based feature selection approach with the objective of finding feature subsets that improve the performance of the classification. Sensitivity and specificity results using a dataset of 60 images are 0.9138 and 0.9600, respectively, on a per patch basis and 1.000 and 0.975, respectively, on a per image basis.

Automated detection of proliferative diabetic retinopathy using a modified line operator and dual classification

Proliferative diabetic retinopathy (PDR) is a condition that carries a high risk of severe visual impairment. The hallmark of PDR is neovascularisation, the growth of abnormal new vessels. This paper describes an automated method for the detection of new vessels in retinal images. Two vessel segmentation approaches are applied, using the standard line operator and a novel modified line operator. The latter is designed to reduce false responses to non-vessel edges. Both generated binary vessel maps hold vital information which must be processed separately. This is achieved with a dual classification system. Local morphology features are measured from each binary vessel map to produce two separate feature sets. Independent classification is performed for each feature set using a support vector machine (SVM) classifier. The system then combines these individual classification outcomes to produce a final decision. Sensitivity and specificity results using a dataset of 60 images are 0.862 and 0.944 respectively on a per patch basis and 1.00 and 0.90 respectively on a per image basis.