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Badawi SA, Fraz MM, Shehzad M, Mahmood I, Javed S, Mosalam E, Nileshwar AK. Detection and Grading of Hypertensive Retinopathy Using Vessels Tortuosity and Arteriovenous Ratio. J Digit Imaging 2022; 35:281-301. [PMID: 35013827 PMCID: PMC8921404 DOI: 10.1007/s10278-021-00545-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 11/09/2021] [Accepted: 11/11/2021] [Indexed: 10/19/2022] Open
Abstract
Hypertensive retinopathy (HR) refers to changes in the morphological diameter of the retinal vessels due to persistent high blood pressure. Early detection of such changes helps in preventing blindness or even death due to stroke. These changes can be quantified by computing the arteriovenous ratio and the tortuosity severity in the retinal vasculature. This paper presents a decision support system for detecting and grading HR using morphometric analysis of retinal vasculature, particularly measuring the arteriovenous ratio (AVR) and retinal vessel tortuosity. In the first step, the retinal blood vessels are segmented and classified as arteries and veins. Then, the width of arteries and veins is measured within the region of interest around the optic disk. Next, a new iterative method is proposed to compute the AVR from the caliber measurements of arteries and veins using Parr-Hubbard and Knudtson methods. Moreover, the retinal vessel tortuosity severity index is computed for each image using 14 tortuosity severity metrics. In the end, a hybrid decision support system is proposed for the detection and grading of HR using AVR and tortuosity severity index. Furthermore, we present a new publicly available retinal vessel morphometry (RVM) dataset to evaluate the proposed methodology. The RVM dataset contains 504 retinal images with pixel-level annotations for vessel segmentation, artery/vein classification, and optic disk localization. The image-level labels for vessel tortuosity index and HR grade are also available. The proposed methods of iterative AVR measurement, tortuosity index, and HR grading are evaluated using the new RVM dataset. The results indicate that the proposed method gives superior performance than existing methods. The presented methodology is a novel advancement in automated detection and grading of HR, which can potentially be used as a clinical decision support system.
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Affiliation(s)
- Sufian A Badawi
- School of Electrical Engineering and Computer Science, National University of Sciences and Technology (NUST), Islamabad, Pakistan
| | - Muhammad Moazam Fraz
- School of Electrical Engineering and Computer Science, National University of Sciences and Technology (NUST), Islamabad, Pakistan.
| | - Muhammad Shehzad
- School of Electrical Engineering and Computer Science, National University of Sciences and Technology (NUST), Islamabad, Pakistan
| | - Imran Mahmood
- School of Electrical Engineering and Computer Science, National University of Sciences and Technology (NUST), Islamabad, Pakistan
| | - Sajid Javed
- Department of Electrical Engineering and Computer Science, Khalifa University, Abu Dhabi, UAE
| | - Emad Mosalam
- Department of Ophthalmology, RAK Medical and Health Sciences University, Ras Al Khaimah, UAE.,Department of Ophthalmology, Saqr Hospital, Ministry of Health and Prevention, Ras Al Khaimah, UAE
| | - Ajay Kamath Nileshwar
- Department of Ophthalmology, RAK Medical and Health Sciences University, Ras Al Khaimah, UAE.,Department of Ophthalmology, Saqr Hospital, Ministry of Health and Prevention, Ras Al Khaimah, UAE
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Ashraf MN, Hussain M, Habib Z. Review of Various Tasks Performed in the Preprocessing Phase of a Diabetic Retinopathy Diagnosis System. Curr Med Imaging 2021; 16:397-426. [PMID: 32410541 DOI: 10.2174/1573405615666190219102427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 12/31/2018] [Accepted: 01/20/2019] [Indexed: 12/15/2022]
Abstract
Diabetic Retinopathy (DR) is a major cause of blindness in diabetic patients. The increasing population of diabetic patients and difficulty to diagnose it at an early stage are limiting the screening capabilities of manual diagnosis by ophthalmologists. Color fundus images are widely used to detect DR lesions due to their comfortable, cost-effective and non-invasive acquisition procedure. Computer Aided Diagnosis (CAD) of DR based on these images can assist ophthalmologists and help in saving many sight years of diabetic patients. In a CAD system, preprocessing is a crucial phase, which significantly affects its performance. Commonly used preprocessing operations are the enhancement of poor contrast, balancing the illumination imbalance due to the spherical shape of a retina, noise reduction, image resizing to support multi-resolution, color normalization, extraction of a field of view (FOV), etc. Also, the presence of blood vessels and optic discs makes the lesion detection more challenging because these two artifacts exhibit specific attributes, which are similar to those of DR lesions. Preprocessing operations can be broadly divided into three categories: 1) fixing the native defects, 2) segmentation of blood vessels, and 3) localization and segmentation of optic discs. This paper presents a review of the state-of-the-art preprocessing techniques related to three categories of operations, highlighting their significant aspects and limitations. The survey is concluded with the most effective preprocessing methods, which have been shown to improve the accuracy and efficiency of the CAD systems.
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Affiliation(s)
| | - Muhammad Hussain
- Department of Computer Science, College of Computer and Information Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Zulfiqar Habib
- Department of Computer Science, COMSATS University Islamabad, Lahore, Pakistan
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Krishna Adithya V, Williams BM, Czanner S, Kavitha S, Friedman DS, Willoughby CE, Venkatesh R, Czanner G. EffUnet-SpaGen: An Efficient and Spatial Generative Approach to Glaucoma Detection. J Imaging 2021; 7:92. [PMID: 39080880 PMCID: PMC8321378 DOI: 10.3390/jimaging7060092] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/21/2021] [Accepted: 05/27/2021] [Indexed: 12/11/2022] Open
Abstract
Current research in automated disease detection focuses on making algorithms "slimmer" reducing the need for large training datasets and accelerating recalibration for new data while achieving high accuracy. The development of slimmer models has become a hot research topic in medical imaging. In this work, we develop a two-phase model for glaucoma detection, identifying and exploiting a redundancy in fundus image data relating particularly to the geometry. We propose a novel algorithm for the cup and disc segmentation "EffUnet" with an efficient convolution block and combine this with an extended spatial generative approach for geometry modelling and classification, termed "SpaGen" We demonstrate the high accuracy achievable by EffUnet in detecting the optic disc and cup boundaries and show how our algorithm can be quickly trained with new data by recalibrating the EffUnet layer only. Our resulting glaucoma detection algorithm, "EffUnet-SpaGen", is optimized to significantly reduce the computational burden while at the same time surpassing the current state-of-art in glaucoma detection algorithms with AUROC 0.997 and 0.969 in the benchmark online datasets ORIGA and DRISHTI, respectively. Our algorithm also allows deformed areas of the optic rim to be displayed and investigated, providing explainability, which is crucial to successful adoption and implementation in clinical settings.
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Affiliation(s)
- Venkatesh Krishna Adithya
- Department of Glaucoma, Aravind Eye Care System, Thavalakuppam, Pondicherry 605007, India; (V.K.A.); (S.K.); (R.V.)
| | - Bryan M. Williams
- School of Computing and Communications, Lancaster University, Bailrigg, Lancaster LA1 4WA, UK;
| | - Silvester Czanner
- School of Computer Science and Mathematics, Liverpool John Moores University, Liverpool L3 3AF, UK;
| | - Srinivasan Kavitha
- Department of Glaucoma, Aravind Eye Care System, Thavalakuppam, Pondicherry 605007, India; (V.K.A.); (S.K.); (R.V.)
| | - David S. Friedman
- Glaucoma Center of Excellence, Harvard Medical School, Boston, MA 02114, USA;
| | - Colin E. Willoughby
- Biomedical Research Institute, Ulster University, Coleraine, Co. Londonderry BT52 1SA, UK;
| | - Rengaraj Venkatesh
- Department of Glaucoma, Aravind Eye Care System, Thavalakuppam, Pondicherry 605007, India; (V.K.A.); (S.K.); (R.V.)
| | - Gabriela Czanner
- School of Computer Science and Mathematics, Liverpool John Moores University, Liverpool L3 3AF, UK;
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Romero-Oraá R, García M, Oraá-Pérez J, López MI, Hornero R. A robust method for the automatic location of the optic disc and the fovea in fundus images. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 196:105599. [PMID: 32574904 DOI: 10.1016/j.cmpb.2020.105599] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 06/01/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND OBJECTIVE The location of the optic disc (OD) and the fovea is usually crucial in automatic screening systems for diabetic retinopathy. Previous methods aimed at their location often fail when these structures do not have the standard appearance. The purpose of this work is to propose novel, robust methods for the automatic detection of the OD and the fovea. METHODS The proposed method comprises a preprocessing stage, a method for retinal background extraction, a vasculature segmentation phase and the computation of various novel saliency maps. The main novelty of this work is the combination of the proposed saliency maps, which represent the spatial relationships between some structures of the retina and the visual appearance of the OD and fovea. Another contribution is the method to extract the retinal background, based on region-growing. RESULTS The proposed methods were evaluated over a proprietary database and three 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%). CONCLUSIONS Our results suggest that the proposed methods are robust and effective to automatically detect the OD and the fovea. This way, they can be useful in automatic screening systems for diabetic retinopathy as well as other retinal diseases.
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Affiliation(s)
- Roberto Romero-Oraá
- Biomedical Engineering Group, E.T.S. Ingenieros de Telecomunicación, Universidad de Valladolid, Paseo Belén 15, Valladolid 47011, Spain.; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Spain.
| | - María García
- Biomedical Engineering Group, E.T.S. Ingenieros de Telecomunicación, Universidad de Valladolid, Paseo Belén 15, Valladolid 47011, Spain.; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Spain.
| | - Javier Oraá-Pérez
- Biomedical Engineering Group, E.T.S. Ingenieros de Telecomunicación, Universidad de Valladolid, Paseo Belén 15, Valladolid 47011, Spain..
| | - María I López
- Biomedical Engineering Group, E.T.S. Ingenieros de Telecomunicación, Universidad de Valladolid, Paseo Belén 15, Valladolid 47011, Spain.; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Spain; Department of Ophthalmology, Hospital Clínico Universitario de Valladolid, Valladolid 47003, Spain.; Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid 47011, Spain..
| | - Roberto Hornero
- Biomedical Engineering Group, E.T.S. Ingenieros de Telecomunicación, Universidad de Valladolid, Paseo Belén 15, Valladolid 47011, Spain.; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Spain; Instituto de Investigación en Matemáticas (IMUVA), Universidad de Valladolid, Valladolid 47011, Spain..
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A Review on the optic disc and optic cup segmentation and classification approaches over retinal fundus images for detection of glaucoma. SN APPLIED SCIENCES 2020. [DOI: 10.1007/s42452-020-03221-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
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A region growing and local adaptive thresholding-based optic disc detection. PLoS One 2020; 15:e0227566. [PMID: 31999720 PMCID: PMC6991997 DOI: 10.1371/journal.pone.0227566] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 12/21/2019] [Indexed: 11/23/2022] Open
Abstract
Automatic optic disc (OD) localization and segmentation is not a simple process as the OD appearance and size may significantly vary from person to person. This paper presents a novel approach for OD localization and segmentation which is fast as well as robust. In the proposed method, the image is first enhanced by de-hazing and then cropped around the OD region. The cropped image is converted to HSV domain and then V channel is used for OD detection. The vessels are extracted from the Green channel in the cropped region by multi-scale line detector and then removed by the Laplace Transform. Local adaptive thresholding and region growing are applied for binarization. Furthermore, two region properties, eccentricity, and area are then used to detect the true OD region. Finally, ellipse fitting is used to fill the region. Several datasets are used for testing the proposed method. Test results show that the accuracy and sensitivity of the proposed method are much higher than the existing state-of-the-art methods.
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Multiloss Function Based Deep Convolutional Neural Network for Segmentation of Retinal Vasculature into Arterioles and Venules. BIOMED RESEARCH INTERNATIONAL 2019; 2019:4747230. [PMID: 31111055 PMCID: PMC6487175 DOI: 10.1155/2019/4747230] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 02/20/2019] [Accepted: 03/20/2019] [Indexed: 02/02/2023]
Abstract
The arterioles and venules (AV) classification of retinal vasculature is considered as the first step in the development of an automated system for analysing the vasculature biomarker association with disease prognosis. Most of the existing AV classification methods depend on the accurate segmentation of retinal blood vessels. Moreover, the unavailability of large-scale annotated data is a major hindrance in the application of deep learning techniques for AV classification. This paper presents an encoder-decoder based fully convolutional neural network for classification of retinal vasculature into arterioles and venules, without requiring the preliminary step of vessel segmentation. An optimized multiloss function is used to learn the pixel-wise and segment-wise retinal vessel labels. The proposed method is trained and evaluated on DRIVE, AVRDB, and a newly created AV classification dataset; and it attains 96%, 98%, and 97% accuracy, respectively. The new AV classification dataset is comprised of 700 annotated retinal images, which will offer the researchers a benchmark to compare their AV classification results.
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Martinez-Perez ME, Witt N, Parker KH, Hughes AD, Thom SA. Automatic optic disc detection in colour fundus images by means of multispectral analysis and information content. PeerJ 2019; 7:e7119. [PMID: 31293825 PMCID: PMC6599671 DOI: 10.7717/peerj.7119] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 05/09/2019] [Indexed: 11/20/2022] Open
Abstract
The optic disc (OD) in retinal fundus images is widely used as a reference in computer-based systems for the measurement of the severity of retinal disease. A number of algorithms have been published in the past 5 years to locate and measure the OD in digital fundus images. Our proposed algorithm, automatically: (i) uses the three channels (RGB) of the digital colour image to locate the region of interest (ROI) where the OD lies, (ii) measures the Shannon information content per channel in the ROI, to decide which channel is most appropriate for searching for the OD centre using the circular Hough transform. A series of evaluations were undertaken to test our hypothesis that using the three channels gives a better performance than a single channel. Three different databases were used for evaluation purposes with a total of 2,371 colour images giving a misdetection error of 3% in the localisation of the centre of the OD. We find that the area determined by our algorithm which assumes that the OD is circular, is similar to that found by other algorithms that detected the shape of the OD. Five metrics were measured for comparison with other recent studies. Combining the two databases where expert delineation of the OD is available (1,240 images), the average results for our multispectral algorithm are: TPR = 0.879, FPR = 0.003, Accuracy = 0.994, Overlap = 80.6% and Dice index = 0.878.
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Affiliation(s)
- M. Elena Martinez-Perez
- Institute of Research on Applied Mathematics and Systems, Department of Computer Science, Universidad Nacional Autónoma de México, Mexico City, Mexico
- National Heart & Lung Institute, Imperial College, London, UK
| | - Nicholas Witt
- Department of Bioengineering, Imperial College, London, UK
| | - Kim H. Parker
- Department of Bioengineering, Imperial College, London, UK
| | - Alun D. Hughes
- National Heart & Lung Institute, Imperial College, London, UK
- Institute of Cardiovascular Sciences, University College London, London, UK
| | - Simon A.M. Thom
- National Heart & Lung Institute, Imperial College, London, UK
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Uribe-Valencia LJ, Martínez-Carballido JF. Automated Optic Disc region location from fundus images: Using local multi-level thresholding, best channel selection, and an Intensity Profile Model. Biomed Signal Process Control 2019. [DOI: 10.1016/j.bspc.2019.02.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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10
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Diabetic retinopathy techniques in retinal images: A review. Artif Intell Med 2018; 97:168-188. [PMID: 30448367 DOI: 10.1016/j.artmed.2018.10.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 10/08/2018] [Accepted: 10/24/2018] [Indexed: 12/23/2022]
Abstract
The diabetic retinopathy is the main reason of vision loss in people. Medical experts recognize some clinical, geometrical and haemodynamic features of diabetic retinopathy. These features include the blood vessel area, exudates, microaneurysm, hemorrhages and neovascularization, etc. In Computer Aided Diagnosis (CAD) systems, these features are detected in fundus images using computer vision techniques. In this paper, we review the methods of low, middle and high level vision for automatic detection and classification of diabetic retinopathy.We give a detailed review of 79 algorithms for detecting different features of diabetic retinopathy during the last eight years.
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Dense Fully Convolutional Segmentation of the Optic Disc and Cup in Colour Fundus for Glaucoma Diagnosis. Symmetry (Basel) 2018. [DOI: 10.3390/sym10040087] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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12
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Automated fuzzy optic disc detection algorithm using branching of vessels and color properties in fundus images. Biocybern Biomed Eng 2018. [DOI: 10.1016/j.bbe.2018.08.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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13
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Multiscale segmentation of exudates in retinal images using contextual cues and ensemble classification. Biomed Signal Process Control 2017. [DOI: 10.1016/j.bspc.2017.02.012] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Jordan KC, Menolotto M, Bolster NM, Livingstone IAT, Giardini ME. A review of feature-based retinal image analysis. EXPERT REVIEW OF OPHTHALMOLOGY 2017. [DOI: 10.1080/17469899.2017.1307105] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abdullah M, Fraz MM, Barman SA. Localization and segmentation of optic disc in retinal images using circular Hough transform and grow-cut algorithm. PeerJ 2016; 4:e2003. [PMID: 27190713 PMCID: PMC4867714 DOI: 10.7717/peerj.2003] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Accepted: 04/12/2016] [Indexed: 11/20/2022] Open
Abstract
Automated retinal image analysis has been emerging as an important diagnostic tool for early detection of eye-related diseases such as glaucoma and diabetic retinopathy. In this paper, we have presented a robust methodology for optic disc detection and boundary segmentation, which can be seen as the preliminary step in the development of a computer-assisted diagnostic system for glaucoma in retinal images. The proposed method is based on morphological operations, the circular Hough transform and the grow-cut algorithm. The morphological operators are used to enhance the optic disc and remove the retinal vasculature and other pathologies. The optic disc center is approximated using the circular Hough transform, and the grow-cut algorithm is employed to precisely segment the optic disc boundary. The method is quantitatively evaluated on five publicly available retinal image databases DRIVE, DIARETDB1, CHASE_DB1, DRIONS-DB, Messidor and one local Shifa Hospital Database. The method achieves an optic disc detection success rate of 100% for these databases with the exception of 99.09% and 99.25% for the DRIONS-DB, Messidor, and ONHSD databases, respectively. The optic disc boundary detection achieved an average spatial overlap of 78.6%, 85.12%, 83.23%, 85.1%, 87.93%, 80.1%, and 86.1%, respectively, for these databases. This unique method has shown significant improvement over existing methods in terms of detection and boundary extraction of the optic disc.
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Affiliation(s)
- Muhammad Abdullah
- School of Electrical Engineering and Computer Science, National University of Sciences and Technology , Islamabad , Pakistan
| | - Muhammad Moazam Fraz
- School of Electrical Engineering and Computer Science, National University of Sciences and Technology , Islamabad , Pakistan
| | - Sarah A Barman
- Faculty of Science Engineering and Computing, Kingston University , London , United Kingdom
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