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Szewczuk A, Wawrzyniak ZM, Szaflik JP, Zaleska-Żmijewska A. Is Primary Open-Angle Glaucoma a Vascular Disease? Assessment of the Relationship between Retinal Arteriolar Morphology and Glaucoma Severity Using Adaptive Optics. J Clin Med 2024; 13:478. [PMID: 38256612 PMCID: PMC10817033 DOI: 10.3390/jcm13020478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/02/2024] [Accepted: 01/13/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Retinal vascular abnormalities may be associated with glaucomatous damage. Adaptive optics (AO) is a new technology that enables the analysis of retinal vasculature at the cellular level in vivo. The purpose of this study was to evaluate retinal arteriolar parameters using the rtx1 adaptive optics fundus camera (AO-FC) in patients with primary open-angle glaucoma (POAG) at different stages and to investigate the relationship between these parameters and changes in spectral-domain optical coherence tomography (SD-OCT) and perimetry. METHODS Parameters of the retinal supratemporal and infratemporal arterioles (wall thickness (WT), lumen diameter (LD), total diameter (TD), wall-to-lumen ratio (WLR), and cross-sectional area of the vascular wall (WCSA)) were analysed with the rtx1 in 111 POAG eyes, which were divided into three groups according to the severity of the disease, and 70 healthy eyes. The associations between RTX1 values and the cup-to-disk ratio, SD-OCT parameters, and visual field parameters were assessed. RESULTS Compared with the control group, the POAG groups showed significantly smaller TD and LD values (p < 0.05) and significantly higher WLR and WT values (p < 0.05) for the supratemporal and infratemporal arterioles. TD was significantly positively correlated with the retinal nerve fibre layer (RNFL) and ganglion cell complex (GCC) (p < 0.05). LD was significantly positively correlated with the RNFL, GCC, and rim area (p < 0.05). The WLR was significantly negatively correlated with the RNFL, GCC, rim area, and MD (p < 0.05), while it was significantly positively correlated with the cup-to-disc ratio and PSD (p < 0.05). CONCLUSIONS The results suggest that vascular dysfunction is present in POAG, even at a very early stage of glaucoma, and increases with the severity of the disease.
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Affiliation(s)
- Alina Szewczuk
- Department of Ophthalmology, Public Ophthalmic Clinical Hospital (SPKSO), 00-576 Warsaw, Poland
| | - Zbigniew M. Wawrzyniak
- Faculty of Electronics and Information Technology, Warsaw University of Technology, 00-665 Warsaw, Poland;
| | - Jacek P. Szaflik
- Department of Ophthalmology, Public Ophthalmic Clinical Hospital (SPKSO), Medical University of Warsaw, 02-091 Warsaw, Poland; (J.P.S.); (A.Z.-Ż.)
| | - Anna Zaleska-Żmijewska
- Department of Ophthalmology, Public Ophthalmic Clinical Hospital (SPKSO), Medical University of Warsaw, 02-091 Warsaw, Poland; (J.P.S.); (A.Z.-Ż.)
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Sadykov E, Hosak L, Stepanov A, Zapletalova J, Studnicka J. Retinal microvascular abnormalities in major depression. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2023. [PMID: 37465892 DOI: 10.5507/bp.2023.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND The aim of our study was to find a possible association between retinal microvascular abnormality and major depression in a non-geriatric population. METHOD The participants with major depression were hospitalised at the University Hospital in Hradec Kralove, Department of Psychiatry. Retinal images were obtained using a stationary Fundus camera FF450 by Zeiss and a hand-held camera by oDocs. RESULTS Fifty patients (men n=18, women n=32) aged 16 to 55 (men's average age 33.7±9.9 years, women's average age 37.9±11.5 years) were compared with fifty mentally healthy subjects (men n=28, women n=22) aged 18 to 61 (men's average age 35.3±9.2 years, women's average age 36.6±10.6 years) in a cross-sectional design. The patients were diagnosed with a single depressive episode (n=26) or a recurrent depressive disorder (n=24) according to the ICD-10 classification. Our results confirmed significant microvascular changes in the retina in patients with depressive disorder in comparison to the control group of mentally healthy subjects, with significantly larger arteriolar (P<0.0001) as well as venular (P<0.001-0.0001) calibres in major depression. CONCLUSION According to the literature, acute and chronic neuroinflammation is associated with changes in microvascular form and function. The endothelium becomes a major participant in the inflammatory response damaging the surrounding tissue and its function. Because the retina and brain tissue share a common embryonic origin, we suspect similar microvascular pathology in the retina and in the brain in major depression. Our results may contribute to a better understanding of depression etiopathogenesis and to its personalized treatment.
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Affiliation(s)
- Evgenii Sadykov
- Department of Psychiatry, Faculty of Medicine in Hradec Kralove, Charles University and University Hospital Hradec Kralove, Czech Republic
| | - Ladislav Hosak
- Department of Psychiatry, Faculty of Medicine in Hradec Kralove, Charles University and University Hospital Hradec Kralove, Czech Republic
| | - Alexandr Stepanov
- Department of Ophthalmology, Faculty of Medicine in Hradec Kralove, Charles University and University Hospital Hradec Kralove, Czech Republic
| | - Jana Zapletalova
- Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Jan Studnicka
- Department of Ophthalmology, Faculty of Medicine in Hradec Kralove, Charles University and University Hospital Hradec Kralove, Czech Republic
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Leveque AS, Bouisse M, Labarere J, Trucco E, Hogg S, MacGillivray T, Aptel F, Chiquet C. Retinal vessel architecture and geometry are not impaired in normal-tension glaucoma. Sci Rep 2023; 13:6713. [PMID: 37185916 PMCID: PMC10130140 DOI: 10.1038/s41598-023-33361-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 04/12/2023] [Indexed: 05/17/2023] Open
Abstract
To investigate the associations between retinal vessel parameters and normal-tension glaucoma (NTG). We conducted a case-control study with a prospective cohort, allowing to record 23 cases of NTG. We matched NTG patient with one primary open-angle glaucoma (POAG) and one control per case by age, systemic hypertension, diabetes, and refraction. Central retinal artery equivalent (CRAE), central retinal venule equivalent (CRVE), Arteriole-To-Venule ratio (AVR), Fractal Dimension and tortuosity of the vascular network were measured using VAMPIRE software. Our sample consisted of 23 NTG, 23 POAG, and 23 control individuals, with a median age of 65 years (25-75th percentile, 56-74). No significant differences were observed in median values for CRAE (130.6 µm (25-75th percentile, 122.8; 137.0) for NTG, 128.4 µm (124.0; 132.9) for POAG, and 135.3 µm (123.3; 144.8) for controls, P = .23), CRVE (172.1 µm (160.0; 188.3), 172.8 µm (163.3; 181.6), and 175.9 µm (167.6; 188.4), P = .43), AVR (0.76, 0.75, 0.74, P = .71), tortuosity and fractal parameters across study groups. Vascular morphological parameters were not significantly associated with retinal nerve fiber layer thickness or mean deviation for the NTG and POAG groups. Our results suggest that vascular dysregulation in NTG does not modify the architecture and geometry of the retinal vessel network.
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Affiliation(s)
- Anne-Sophie Leveque
- Department of Ophthalmology, University Hospital of Grenoble, Grenoble Alpes University Hospital, CS 10217, 38043, Grenoble Cedex 09, France
| | - Magali Bouisse
- Clinical Epidemiology Unit, Grenoble Alpes University Hospital, Grenoble, France
- Univ. Grenoble Alpes, CNRS, UMR 5525, TIMC, Grenoble, France
| | - José Labarere
- Clinical Epidemiology Unit, Grenoble Alpes University Hospital, Grenoble, France
- Univ. Grenoble Alpes, CNRS, UMR 5525, TIMC, Grenoble, France
| | - Emanuele Trucco
- VAMPIRE Project, Computing, School of Science and Engineering, University of Dundee, Dundee, UK
| | - Stephen Hogg
- VAMPIRE Project, Computing, School of Science and Engineering, University of Dundee, Dundee, UK
| | - Tom MacGillivray
- VAMPIRE Project, Centre for Clinical Brain Science, University of Edinburgh, Edinburgh, UK
| | - Florent Aptel
- Department of Ophthalmology, University Hospital of Grenoble, Grenoble Alpes University Hospital, CS 10217, 38043, Grenoble Cedex 09, France
- Univ. Grenoble Alpes, HP2 Laboratory, INSERM U1300, Grenoble, France
| | - Christophe Chiquet
- Department of Ophthalmology, University Hospital of Grenoble, Grenoble Alpes University Hospital, CS 10217, 38043, Grenoble Cedex 09, France.
- Univ. Grenoble Alpes, HP2 Laboratory, INSERM U1300, Grenoble, France.
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Schanner C, Hautala N, Rauscher FG, Falck A. The impact of the image conversion factor and image centration on retinal vessel geometric characteristics. Front Med (Lausanne) 2023; 10:1112652. [PMID: 37007779 PMCID: PMC10063888 DOI: 10.3389/fmed.2023.1112652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/02/2023] [Indexed: 03/19/2023] Open
Abstract
BackgroundThis study aims to use fundus image material from a long-term retinopathy follow-up study to identify problems created by changing imaging modalities or imaging settings (e.g., image centering, resolution, viewing angle, illumination wavelength). Investigating the relationship of image conversion factor and imaging centering on retinal vessel geometric characteristics (RVGC), offers solutions for longitudinal retinal vessel analysis for data obtained in clinical routine.MethodsRetinal vessel geometric characteristics were analyzed in scanned fundus photographs with Singapore-I-Vessel-Assessment using a constant image conversion factor (ICF) and an individual ICF, applying them to macula centered (MC) and optic disk centered (ODC) images. The ICF is used to convert pixel measurements into μm for vessel diameter measurements and to establish the size of the measuring zone. Calculating a constant ICF, the width of all analyzed optic disks is included, and it is used for all images of a cohort. An individual ICF, in turn, uses the optic disk diameter of the eye analyzed. To investigate agreement, Bland-Altman mean difference was calculated between ODC images analyzed with individual and constant ICF and between MC and ODC images.ResultsWith constant ICF (n = 104 eyes of 52 patients) the mean central retinal equivalent was 160.9 ± 17.08 μm for arteries (CRAE) and 208.7 ± 14.7.4 μm for veins (CRVE). The individual ICFs resulted in a mean CRAE of 163.3 ± 15.6 μm and a mean CRVE of 219.0 ± 22.3 μm. On Bland–Altman analysis, the individual ICF RVGC are more positive, resulting in a positive mean difference for most investigated parameters. Arteriovenous ratio (p = 0.86), simple tortuosity (p = 0.08), and fractal dimension (p = 0.80) agreed well between MC and ODC images, while the vessel diameters were significantly smaller in MC images (p < 0.002).ConclusionScanned images can be analyzed using vessel assessment software. Investigations of individual ICF versus constant ICF point out the asset of utilizing an individual ICF. Image settings (ODC vs. MC) were shown to have good agreement.
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Affiliation(s)
- Carolin Schanner
- Department of Ophthalmology and Medical Research Center, Oulu University Hospital, Oulu, Finland
- PEDEGO Research Unit, University of Oulu, Oulu, Finland
- Institute for Medical Informatics, Statistics, and Epidemiology, Leipzig University, Leipzig, Germany
| | - Nina Hautala
- Department of Ophthalmology and Medical Research Center, Oulu University Hospital, Oulu, Finland
- PEDEGO Research Unit, University of Oulu, Oulu, Finland
| | - Franziska G. Rauscher
- Institute for Medical Informatics, Statistics, and Epidemiology, Leipzig University, Leipzig, Germany
| | - Aura Falck
- Department of Ophthalmology and Medical Research Center, Oulu University Hospital, Oulu, Finland
- PEDEGO Research Unit, University of Oulu, Oulu, Finland
- *Correspondence: Aura Falck,
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Li P, Liu J. Quantitative Analysis of Vascular Abnormalities in Full-Term Infants With Mild Familial Exudative Vitreoretinopathy. Transl Vis Sci Technol 2023; 12:16. [PMID: 36930137 PMCID: PMC10036951 DOI: 10.1167/tvst.12.3.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
Purpose Our goal was to build a system that combined deep convolutional neural networks (DCNNs) and feature extraction algorithms, which automatically extracted and quantified vascular abnormalities in posterior pole retinal images of full-term infants clinically diagnosed with mild familial exudative retinopathy (FEVR). Methods Using posterior pole retinal images taken from 4628 full-term infants with a total of 9256 eyes, we created data sets, trained DCNNs, and performed tests and comparisons. With the segmented images, our system extracted peripapillary vascular densities, mean tortuosities, and maximum diameter ratios within the region of interest. We also compared them with normal eyes statistically. Results In the test data set, the trained system obtained a sensitivity of 0.78 and a specificity of 0.98 for vascular segmentation, with 0.94 and 0.99 for optic disc, respectively. While in the comparison data set, compared with normal, we found a significant increase in vascular densities in retinal images with mild FEVR (5.3211% ± 0.7600% vs. 4.5998% ± 0.6586%) and a significant increase in the maximum diameter ratios (1.8805 ± 0.3197 vs. 1.5087 ± 0.2877), while the mean tortuosities significantly decreased (2.1018 ± 0.2933 [104 cm-3] vs. 3.3344 ± 0.3890 [104 cm-3]). All values were statistically significantly different. Conclusions Our system could automatically segment the posterior pole retinal images and extract from vascular features associated with mild FEVR. Quantitative analysis of these parameters may help ophthalmologists in the early detection of FEVR. Translational Relevance This system may contribute to the early detection of FEVR and facilitate the promotion of artificial intelligence-assisted diagnostic techniques in clinical applications.
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Affiliation(s)
- Peng Li
- College of Electronic and Information Engineering, Tongji University, Shanghai, China
- Department of Electronic and Information Engineering, Tongji Zhejiang College, Jiaxing, China
| | - Jia Liu
- Optometry Center, Jiaxing Maternity and Child Health Care Hospital, Jiaxing, China
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Abstract
Topological and geometrical analysis of retinal blood vessels could be a cost-effective way to detect various common diseases. Automated vessel segmentation and vascular tree analysis models require powerful generalization capability in clinical applications. In this work, we constructed a novel benchmark RETA with 81 labelled vessel masks aiming to facilitate retinal vessel analysis. A semi-automated coarse-to-fine workflow was proposed for vessel annotation task. During database construction, we strived to control inter-annotator and intra-annotator variability by means of multi-stage annotation and label disambiguation on self-developed dedicated software. In addition to binary vessel masks, we obtained other types of annotations including artery/vein masks, vascular skeletons, bifurcations, trees and abnormalities. Subjective and objective quality validations of the annotated vessel masks demonstrated significantly improved quality over the existing open datasets. Our annotation software is also made publicly available serving the purpose of pixel-level vessel visualization. Researchers could develop vessel segmentation algorithms and evaluate segmentation performance using RETA. Moreover, it might promote the study of cross-modality tubular structure segmentation and analysis.
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Mautuit T, Cunnac P, Cheung CY, Wong TY, Hogg S, Trucco E, Daien V, Macgillivray TJ, Labarère J, Chiquet C. Concordance between SIVA, IVAN, and VAMPIRE Software Tools for Semi-Automated Analysis of Retinal Vessel Caliber. Diagnostics (Basel) 2022; 12:1317. [PMID: 35741127 PMCID: PMC9221842 DOI: 10.3390/diagnostics12061317] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/12/2022] [Accepted: 05/17/2022] [Indexed: 12/10/2022] Open
Abstract
We aimed to compare measurements from three of the most widely used software packages in the literature and to generate conversion algorithms for measurement of the central retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE) between SIVA and IVAN and between SIVA and VAMPIRE. We analyzed 223 retinal photographs from 133 human participants using both SIVA, VAMPIRE and IVAN independently for computing CRAE and CRVE. Agreement between measurements was assessed using Bland–Altman plots and intra-class correlation coefficients. A conversion algorithm between measurements was carried out using linear regression, and validated using bootstrapping and root-mean-square error. The agreement between VAMPIRE and IVAN was poor to moderate: The mean difference was 20.2 µm (95% limits of agreement, LOA, −12.2–52.6 µm) for CRAE and 21.0 µm (95% LOA, −17.5–59.5 µm) for CRVE. The agreement between VAMPIRE and SIVA was also poor to moderate: the mean difference was 36.6 µm (95% LOA, −12.8–60.4 µm) for CRAE, and 40.3 µm (95% LOA, 5.6–75.0 µm) for CRVE. The agreement between IVAN and SIVA was good to excellent: the mean difference was 16.4 µm (95% LOA, −4.25–37.0 µm) for CRAE, and 19.3 µm (95% LOA, 0.09–38.6 µm) for CRVE. We propose an algorithm converting IVAN and VAMPIRE measurements into SIVA-estimated measurements, which could be used to homogenize sets of vessel measurements obtained with different software packages.
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Shi D, Lin Z, Wang W, Tan Z, Shang X, Zhang X, Meng W, Ge Z, He M. A Deep Learning System for Fully Automated Retinal Vessel Measurement in High Throughput Image Analysis. Front Cardiovasc Med 2022; 9:823436. [PMID: 35391847 PMCID: PMC8980780 DOI: 10.3389/fcvm.2022.823436] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 02/22/2022] [Indexed: 11/27/2022] Open
Abstract
Motivation Retinal microvasculature is a unique window for predicting and monitoring major cardiovascular diseases, but high throughput tools based on deep learning for in-detail retinal vessel analysis are lacking. As such, we aim to develop and validate an artificial intelligence system (Retina-based Microvascular Health Assessment System, RMHAS) for fully automated vessel segmentation and quantification of the retinal microvasculature. Results RMHAS achieved good segmentation accuracy across datasets with diverse eye conditions and image resolutions, having AUCs of 0.91, 0.88, 0.95, 0.93, 0.97, 0.95, 0.94 for artery segmentation and 0.92, 0.90, 0.96, 0.95, 0.97, 0.95, 0.96 for vein segmentation on the AV-WIDE, AVRDB, HRF, IOSTAR, LES-AV, RITE, and our internal datasets. Agreement and repeatability analysis supported the robustness of the algorithm. For vessel analysis in quantity, less than 2 s were needed to complete all required analysis.
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Affiliation(s)
- Danli Shi
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zhihong Lin
- Faculty of Engineering, Monash University, Melbourne, VIC, Australia
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zachary Tan
- Centre for Eye Research Australia, East Melbourne, VIC, Australia
| | - Xianwen Shang
- Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Eye Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xueli Zhang
- Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Eye Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Wei Meng
- Guangzhou Vision Tech Medical Technology Co., Ltd., Guangzhou, China
| | - Zongyuan Ge
- Research Center and Faculty of Engineering, Monash University, Melbourne, VIC, Australia
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- Centre for Eye Research Australia, East Melbourne, VIC, Australia
- Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Eye Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
- *Correspondence: Mingguang He
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Wagner SK, Hughes F, Cortina-Borja M, Pontikos N, Struyven R, Liu X, Montgomery H, Alexander DC, Topol E, Petersen SE, Balaskas K, Hindley J, Petzold A, Rahi JS, Denniston AK, Keane PA. AlzEye: longitudinal record-level linkage of ophthalmic imaging and hospital admissions of 353 157 patients in London, UK. BMJ Open 2022; 12:e058552. [PMID: 35296488 PMCID: PMC8928293 DOI: 10.1136/bmjopen-2021-058552] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
PURPOSE Retinal signatures of systemic disease ('oculomics') are increasingly being revealed through a combination of high-resolution ophthalmic imaging and sophisticated modelling strategies. Progress is currently limited not mainly by technical issues, but by the lack of large labelled datasets, a sine qua non for deep learning. Such data are derived from prospective epidemiological studies, in which retinal imaging is typically unimodal, cross-sectional, of modest number and relates to cohorts, which are not enriched with subpopulations of interest, such as those with systemic disease. We thus linked longitudinal multimodal retinal imaging from routinely collected National Health Service (NHS) data with systemic disease data from hospital admissions using a privacy-by-design third-party linkage approach. PARTICIPANTS Between 1 January 2008 and 1 April 2018, 353 157 participants aged 40 years or older, who attended Moorfields Eye Hospital NHS Foundation Trust, a tertiary ophthalmic institution incorporating a principal central site, four district hubs and five satellite clinics in and around London, UK serving a catchment population of approximately six million people. FINDINGS TO DATE Among the 353 157 individuals, 186 651 had a total of 1 337 711 Hospital Episode Statistics admitted patient care episodes. Systemic diagnoses recorded at these episodes include 12 022 patients with myocardial infarction, 11 735 with all-cause stroke and 13 363 with all-cause dementia. A total of 6 261 931 retinal images of seven different modalities and across three manufacturers were acquired from 1 54 830 patients. The majority of retinal images were retinal photographs (n=1 874 175) followed by optical coherence tomography (n=1 567 358). FUTURE PLANS AlzEye combines the world's largest single institution retinal imaging database with nationally collected systemic data to create an exceptional large-scale, enriched cohort that reflects the diversity of the population served. First analyses will address cardiovascular diseases and dementia, with a view to identifying hidden retinal signatures that may lead to earlier detection and risk management of these life-threatening conditions.
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Affiliation(s)
- Siegfried Karl Wagner
- Institute of Ophthalmology, University College London, London, UK
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Fintan Hughes
- Department of Anaesthesiology, Duke University Hospital, Durham, North Carolina, USA
| | | | - Nikolas Pontikos
- Institute of Ophthalmology, University College London, London, UK
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Robbert Struyven
- Institute of Ophthalmology, University College London, London, UK
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Xiaoxuan Liu
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- Centre for Regulatory Science and Innovation, Birmingham Health Partners, Birmingham, UK
| | - Hugh Montgomery
- Centre for Human Health and Performance, University College London, London, UK
| | - Daniel C Alexander
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK
| | - Eric Topol
- Scripps Research Institute, La Jolla, California, USA
| | - Steffen Erhard Petersen
- William Harvey Research Institute, Queen Mary University of London, London, UK
- Barts Heart Centre, Barts Health NHS Trust, London, UK
| | - Konstantinos Balaskas
- Institute of Ophthalmology, University College London, London, UK
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
- Medical Retina Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Jack Hindley
- Department of Information Governance, University College London, London, UK
| | - Axel Petzold
- Institute of Ophthalmology, University College London, London, UK
- Institute of Neurology, University College London, London, UK
- Department of Neurophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Jugnoo S Rahi
- Institute of Ophthalmology, University College London, London, UK
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
- Great Ormond Street Institute of Child Health, University College London, London, UK
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
- Ulverscroft Vision Research Group, University College London, London, UK
| | - Alastair K Denniston
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- Centre for Regulatory Science and Innovation, Birmingham Health Partners, Birmingham, UK
| | - Pearse A Keane
- Institute of Ophthalmology, University College London, London, UK
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
- Medical Retina Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
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Mautuit T, Semecas R, Hogg S, Daien V, Gavard O, Chateau N, Macgillivray T, Trucco E, Chiquet C. Comparing Measurements of Vascular Diameter Using Adaptative Optics Imaging and Conventional Fundus Imaging. Diagnostics (Basel) 2022; 12:705. [PMID: 35328258 PMCID: PMC8947285 DOI: 10.3390/diagnostics12030705] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/04/2022] [Accepted: 03/08/2022] [Indexed: 11/25/2022] Open
Abstract
The aim of this prospective study was to compare retinal vascular diameter measurements taken from standard fundus images and adaptive optics (AO) images. We analysed retinal images of twenty healthy subjects with 45-degree funduscopic colour photographs (CR-2 Canon fundus camera, Canon™) and adaptive optics (AO) fundus images (rtx1 camera, Imagine Eyes®). Diameters were measured using three software applications: the VAMPIRE (Vessel Assessment and Measurement Platform for Images of the REtina) annotation tool, IVAN (Interactive Vessel ANalyzer) for funduscopic colour photographs, and AO_Detect_Artery™ for AO images. For the arterial diameters, the mean difference between AO_Detect_Artery™ and IVAN was 9.1 µm (−27.4 to 9.2 µm, p = 0.005) and the measurements were significantly correlated (r = 0.79). The mean difference between AO_Detect_Artery™ and VAMPIRE annotation tool was 3.8 µm (−34.4 to 26.8 µm, p = 0.16) and the measurements were poorly correlated (r = 0.12). For the venous diameters, the mean difference between the AO_Detect_Artery™ and IVAN was 3.9 µm (−40.9 to 41.9 µm, p = 0.35) and the measurements were highly correlated (r = 0.83). The mean difference between the AO_Detect_Artery™ and VAMPIRE annotation tool was 0.4 µm (−17.44 to 25.3 µm, p = 0.91) and the correlations were moderate (r = 0.41). We found that the VAMPIRE annotation tool, an entirely manual software, is accurate for the measurement of arterial and venular diameters, but the correlation with AO measurements is poor. On the contrary, IVAN, a semi-automatic software tool, presents slightly greater differences with AO imaging, but the correlation is stronger. Data from arteries should be considered with caution, since IVAN seems to significantly under-estimate arterial diameters.
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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: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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12
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Enache AE, Dietrich UM, Drury O, Trucco E, MacGillivray T, Syme H, Elliott J, Chang YM. Changes in retinal vascular diameters in senior and geriatric cats in association with variation in systemic blood pressure. J Feline Med Surg 2021; 23:1129-1139. [PMID: 33739170 DOI: 10.1177/1098612x21997629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Early diagnosis of arterial hypertension is essential to prevent target organ damage. In humans, retinal arteriolar narrowing predicts hypertension. This blinded prospective observational study investigated the retinal vessel diameters in senior and geriatric cats of varying systolic blood pressure (SBP) status and evaluated retinal vascular changes in hypertensive cats after treatment. METHODS Cats with a median age of 14 years (range 9.1-22 years) were categorised into five groups: group 1, healthy normotensive (SBP <140 mmHg; n = 40) cats; group 2, pre-hypertensive (SBP 140-160 mmHg; n = 14) cats; group 3, cats with chronic kidney disease (CKD) and normotensive (n = 26); group 4, cats with CKD and pre-hypertensive (n = 13); and group 5, hypertensive cats (SBP >160 mmHg, n = 15). Colour fundus images (Optibrand ClearView) were assessed for hypertensive lesions. Retinal vascular diameters and bifurcation angles were annotated and calculated using the Vascular Assessment and Measurement Platform for Images of the Retina annotation tool (VAMPIRE-AT). When available, measurements were obtained at 3 and 6 months after amlodipine besylate treatment. RESULTS Ten hypertensive cats had retinal lesions, most commonly intraretinal haemorrhages and retinal exudates. Arteriole and venule diameters decreased significantly with increasing age (-0.17 ± 0.05 pixels/year [P = 0.0004]; -0.19 ± 0.05 pixels/year). Adjusted means ± SEM for arteriole and venule diameter (pixels) were 6.3 ± 0.2 and 8.9 ± 0.2 (group 1); 7.6 ± 0.3 and 10.1 ± 0.4 (group 2); 6.9 ± 0.2 and 9.5 ± 0.3 (group 3); 7.4 ± 0.3 and 10.0 ± 0.4 (group 4); and 7.0 ± 0.3 and 9.8 ± 0.4 (group 5). Group 1 arteriole and venule diameters were significantly lower than those of groups 2 and 4. Group 2 arteriole bifurcation angle was significantly narrower than those of groups 1 and 3. Post-treatment, vessel diameters decreased significantly at 3 and 6 months in seven hypertensive cats. CONCLUSIONS AND RELEVANCE Increased age was associated with reduced vascular diameters. Longitudinal studies are required to assess if vessel diameters are a risk indicator for hypertension in cats.
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Affiliation(s)
- Andra-Elena Enache
- North Downs, Specialist Referrals, 3 & 4 The Brewerstreet Dairy Business Park, Brewer Street, Bletchingley, UK
| | | | - Oscar Drury
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London, UK
| | - Emanuele Trucco
- VAMPIRE Project, Computing, School of Science and Engineering, University of Dundee, Dundee, UK
| | - Tom MacGillivray
- VAMPIRE Project, Centre for Clinical Brain Sciences, University of Edinburgh, UK
| | - Harriet Syme
- Department of Clinical Sciences and Services, Queen Mother Hospital for Animals, Royal Veterinary College, London, UK
| | - Jonathan Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London, UK
| | - Yu-Mei Chang
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London, UK
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13
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Dash S, Verma S, Kavita, Khan MS, Wozniak M, Shafi J, Ijaz MF. A Hybrid Method to Enhance Thick and Thin Vessels for Blood Vessel Segmentation. Diagnostics (Basel) 2021; 11:2017. [PMID: 34829365 DOI: 10.3390/diagnostics11112017] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/25/2021] [Accepted: 10/25/2021] [Indexed: 11/16/2022] Open
Abstract
Retinal blood vessels have been presented to contribute confirmation with regard to tortuosity, branching angles, or change in diameter as a result of ophthalmic disease. Although many enhancement filters are extensively utilized, the Jerman filter responds quite effectively at vessels, edges, and bifurcations and improves the visualization of structures. In contrast, curvelet transform is specifically designed to associate scale with orientation and can be used to recover from noisy data by curvelet shrinkage. This paper describes a method to improve the performance of curvelet transform further. A distinctive fusion of curvelet transform and the Jerman filter is presented for retinal blood vessel segmentation. Mean-C thresholding is employed for the segmentation purpose. The suggested method achieves average accuracies of 0.9600 and 0.9559 for DRIVE and CHASE_DB1, respectively. Simulation results establish a better performance and faster implementation of the suggested scheme in comparison with similar approaches seen in the literature.
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14
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Quinn N, Jenkins A, Ryan C, Januszewski A, Peto T, Brazionis L. Imaging the eye and its relevance to diabetes care. J Diabetes Investig 2021; 12:897-908. [PMID: 33190401 PMCID: PMC8169343 DOI: 10.1111/jdi.13462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/08/2020] [Accepted: 11/10/2020] [Indexed: 11/28/2022] Open
Abstract
Diabetes is a major cause of vision loss globally, yet this devastating complication is largely preventable. Early detection and treatment of diabetic retinopathy necessitates screening. Ocular imaging is widely used clinically, both for the screening and management of diabetic retinopathy. Common eye conditions, such as glaucoma, cataracts and retinal vessel thrombosis, and signs of systemic conditions, such as hypertension, are frequently revealed. As well as imaging by a skilled clinician during an eye examination, non-ophthalmic clinicians, such as general practitioners, endocrinologists, nurses and trained health workers, can also can carry out diabetic eye screening. This process usually comprises local imaging with remote grading, mostly human grading. However, grading incorporating artificial intelligence is emerging. In a clinical research context, retinal vasculature analyses using semi-automated software in many populations have identified associations between retinal vessel geometry, such as vessel caliber, and the risk of diabetic retinopathy and other chronic complications of type 1 and type 2 diabetes. Similarly, evaluation of corneal nerves by corneal confocal microscopy is revealing diabetes-related abnormalities, and associations with and predictive power for other chronic diabetes complications. As yet, the value of retinal vessel geometry and corneal confocal microscopy measures at an individual level is uncertain. In this article, targeting non-ocular clinicians and researchers, we review existent and emerging ocular imaging and grading tools, including artificial intelligence, and their associations between ocular imaging findings and diabetes and its chronic complications.
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Affiliation(s)
- Nicola Quinn
- National Health and Medical Research Council Clinical Trials CenterThe University of SydneySydneyNew South WalesAustralia
- Center for Public HealthQueen’s University BelfastBelfastUK
| | - Alicia Jenkins
- National Health and Medical Research Council Clinical Trials CenterThe University of SydneySydneyNew South WalesAustralia
- Center for Public HealthQueen’s University BelfastBelfastUK
| | - Chris Ryan
- National Health and Medical Research Council Clinical Trials CenterThe University of SydneySydneyNew South WalesAustralia
- Department of MedicineThe University of MelbourneMelbourneVictoriaAustralia
| | - Andrzej Januszewski
- National Health and Medical Research Council Clinical Trials CenterThe University of SydneySydneyNew South WalesAustralia
- Department of MedicineThe University of MelbourneMelbourneVictoriaAustralia
| | - Tunde Peto
- Center for Public HealthQueen’s University BelfastBelfastUK
| | - Laima Brazionis
- National Health and Medical Research Council Clinical Trials CenterThe University of SydneySydneyNew South WalesAustralia
- Department of MedicineThe University of MelbourneMelbourneVictoriaAustralia
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15
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Semecas R, Arnould L, Aptel F, Gavard O, Mautuit T, Creuzot-Garcher C, Bron A, MacGillivray T, Hogg S, Trucco E, Chiquet C. Retinal Vessel Phenotype in Patients with a History of Retinal Vein Occlusion. Ophthalmic Res 2021; 65:722-729. [PMID: 33910213 PMCID: PMC9808644 DOI: 10.1159/000516235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 02/26/2021] [Indexed: 01/07/2023]
Abstract
INTRODUCTION The aim of the study was to estimate the phenotype of retinal vessels using central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), tortuosity, and fractal analysis in the unaffected contralateral eye of patients with central or branch retinal vein occlusion (CRVO or BRVO). METHODS Thirty-four patients suffering from CRVO, 15 suffering from BRVO, and 49 controlled matched subjects had a fundus image analyzed using the VAMPIRE software. The intraclass correlation coefficient and a Bland-Altman plot were done for the reproducibility study. RESULTS There was a lack of evidence of difference between the control group and the CRVO group for CRAE (p = 0.06), CRVE (p = 0.3), and arterio-venule ratio (AVR, p = 0.6). Contralateral eyes of CRVO exhibited a significantly higher arterial and minimum arterial tortuosity values (p = 0.012), as compared with control eyes. Contralateral eyes of patients with a history of BRVO had a significantly higher CRAE (p = 0.02), AVR (p = 0.006), and minimal arterial tortuosity (p = 0.05). Fractal analysis showed that contralateral eyes of BRVO had higher values of fractal parameters (D0a, p = 0.005). CONCLUSION This study suggests that CVRO or BRVO is not triggered by the same retinal vascular phenotypes in the contralateral eye. The morphology of retinal vasculature may be associated with the occurrence of RVO, independently of known risk factors.
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Affiliation(s)
- Rachel Semecas
- Department of Ophthalmology, University Hospital of Grenoble, Grenoble, France,Grenoble Alpes University, Grenoble, France,HP2 Laboratory, INSERM U1042, University Grenoble Alpes, Grenoble, France
| | - Louis Arnould
- Department of Ophthalmology, University Hospital of Dijon, Dijon, France,Clinical Epidemiology/Clinical Trials Unit, INSERM, CIC1432, Dijon University Hospital, Clinical Investigation Center, Dijon, France
| | - Florent Aptel
- Department of Ophthalmology, University Hospital of Grenoble, Grenoble, France,Grenoble Alpes University, Grenoble, France,HP2 Laboratory, INSERM U1042, University Grenoble Alpes, Grenoble, France
| | - Olivier Gavard
- Department of Ophthalmology, University Hospital of Grenoble, Grenoble, France,Grenoble Alpes University, Grenoble, France,HP2 Laboratory, INSERM U1042, University Grenoble Alpes, Grenoble, France
| | - Thibaud Mautuit
- Department of Ophthalmology, University Hospital of Grenoble, Grenoble, France,Grenoble Alpes University, Grenoble, France,HP2 Laboratory, INSERM U1042, University Grenoble Alpes, Grenoble, France
| | - Catherine Creuzot-Garcher
- Department of Ophthalmology, University Hospital of Dijon, Dijon, France,Eye and Nutrition Research Group, CSGA, UMR 1324 INRA, Dijon, France
| | - Alain Bron
- Department of Ophthalmology, University Hospital of Dijon, Dijon, France,Eye and Nutrition Research Group, CSGA, UMR 1324 INRA, Dijon, France
| | - Tom MacGillivray
- VAMPIRE Project, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Stephen Hogg
- VAMPIRE project, Computing, School of Science and Engineering, University of Dundee, Dundee, UK
| | - Emmanuel Trucco
- VAMPIRE project, Computing, School of Science and Engineering, University of Dundee, Dundee, UK
| | - Christophe Chiquet
- Department of Ophthalmology, University Hospital of Grenoble, Grenoble, France,Grenoble Alpes University, Grenoble, France,HP2 Laboratory, INSERM U1042, University Grenoble Alpes, Grenoble, France,*Christophe Chiquet,
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16
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Torp TL, Kawasaki R, Wong TY, Peto T, Grauslund J. Retinal arteriolar calibre and venular fractal dimension predict progression of proliferative diabetic retinopathy 6 months after panretinal photocoagulation: a prospective, clinical interventional study. BMJ Open Ophthalmol 2021; 6:e000661. [PMID: 33786381 PMCID: PMC7986874 DOI: 10.1136/bmjophth-2020-000661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 03/02/2021] [Accepted: 03/03/2021] [Indexed: 11/08/2022] Open
Abstract
Objective We examined the hypothesis that baseline retinal vascular geometry in patients with proliferative diabetic retinopathy (PDR) predicts disease activity 6 months after panretinal photocoagulation (PRP). Methods and analysis We included 47 eyes from 40 patients with treatment-naïve PDR in a 6-month prospective study. Diagnosis of PDR and disease activity was evaluated by wide-field fluorescein angiography (Optomap, Optos, Dunfermline, Scotland, UK). At baseline and 6-month follow-up, the retinal vessel geometry was measured on optic disc centred images using semiautomated software Vessel Assessment and Measurement Platform for Images of the Retina (VAMPIRE, Dundee, Scotland). Results At baseline, mean age and duration of diabetes was 51.6 and 21.4 years, and 62.5% were men. Seventeen eyes (36.2%) had progression of PDR during follow-up. At baseline, we found higher retinal arteriolar calibre (31.3±0.8 vs 28.8±0.8 pixels, p=0.02) and venous fractal dimension (FD) (1.257±0.011 vs 1.222±0.011, p=0.02) in eyes with progression of PDR as compared with eyes with non-progression. In a multiple logistic regression model, both higher retinal arteriolar calibre (OR 1.34, 95% CI, 1.09 to 1.64, p<0.01) and venular FD (OR 1.15, 95% CI, 1.04 to 1.27, p<0.01) predicted progression of PDR. Venular calibre was seen to increase from baseline to month six regardless of disease progression (non-progression 45.0±0.7 vs 52.7±1.8 pixels, p<0.01; progression 46.2±0.8 vs 51.0±1.7 pixels, p<0.01). Conclusion Our prospective study showed that arteriolar calibre and venular FD at baseline were predictive of disease activity 6 months after PRP treatment in patients with treatment-naïve PDR.
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Affiliation(s)
- Thomas Lee Torp
- Department of Ophthalmology, Odense Universitetshospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Ryo Kawasaki
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Vision Informatics, Osaka University School of Medicine Graduate School of Medicine, Suita, Osaka, Japan
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Center, Duke-NUS Medical School, National University of Singapore, Singapore
| | - Tunde Peto
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Centre for Public Health, Blackwell's Queen's University Belfast, Belfast, UK
| | - Jakob Grauslund
- Department of Ophthalmology, Odense Universitetshospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Steno Diabetes Center, Odense University Hospital, Odense, Denmark
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17
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Dinesen S, Jensen PS, Bloksgaard M, Blindbæk SL, De Mey J, Rasmussen LM, Lindholt JS, Grauslund J. Retinal Vascular Fractal Dimensions and Their Association with Macrovascular Cardiac Disease. Ophthalmic Res 2021; 64:561-566. [PMID: 33454711 DOI: 10.1159/000514442] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 01/14/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION As the only part of the human vasculature, the retina is available for direct, noninvasive inspection. Retinal vascular fractal dimension (DF) is a method to measure the structure of the retinal vascular tree, with higher noninteger values between 1 and 2 representing a more complex and dense retinal vasculature. Retinal vascular structure has been associated with a variety of systemic diseases, and this study examined the association of DF and macrovascular cardiac disease in a case-control design. METHODS Retinal fundus photos were captured with Topcon TRC-50X in 38 persons that had coronary artery bypass grafting (CABG, cases) and 37 cardiovascular healthy controls. The semiautomatic software VAMPIRE was used to measure retinal DF. RESULTS Patients with CABG had lower DF of the retinal main venular vessels compared to the control group (1.15 vs. 1.18, p = 0.01). In a multivariable regression model adjusted for gender and age, eyes in the fourth quartile with higher DF were less likely to have CABG compared to patients in the first (OR, 7.20; 95% confidence interval: 1.63-31.86; p = 0.009) and second (OR, 8.25; 95% confidence interval: 1.70-40.01; p = 0.009) quartiles. CONCLUSIONS This study demonstrates that lower complexity of main venular vessels associates with higher risk of having CABG. The research supports the hypothesis that the retinal vascular structure can be used to assess nonocular macrovascular disease.
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Affiliation(s)
- Sebastian Dinesen
- Department of Ophthalmology, Odense University Hospital, Odense, Denmark
| | - Pia S Jensen
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark.,Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, Odense, Denmark
| | - Maria Bloksgaard
- Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | | | - Jo De Mey
- Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark.,Department of Cardiac, Thoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark.,Department of Pharmacology and Personalized Medicine, Maastricht University, Maastricht, The Netherlands
| | - Lars M Rasmussen
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark.,Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Jes S Lindholt
- Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, Odense, Denmark.,Department of Cardiac, Thoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Jakob Grauslund
- Department of Ophthalmology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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18
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Muhiddin HS, Panggalo I, Ichsan AM, Budu, Trucco E, Ellis J. Retinal vascular caliber changes after laser photocoagulation in diabetic retinopathy. Med J Indones 2020. [DOI: 10.13181/mji.oa.203806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Diabetic retinopathy causes vascular dilatation caused by hypoxia, whereas oxygen tension improvement leads to retinal vessels narrowing. Given that laser photocoagulation aims to increase the oxygen tension in the retina, we hypothesized that the narrowing of vessel caliber after the treatment could be possibly demonstrated. This study aimed to assess the changes in the caliber of retinal vessels before and after laser photocoagulation in diabetic retinopathy.
METHODS This research was a prospective cohort study on the treatment of diabetic retinopathy by laser photocoagulation, and it was conducted at Universitas Hasanuddin Hospital, Makassar, Indonesia between November 2017–April 2018. Retinal vascular caliber changes were analyzed before and 6–8 weeks after photocoagulation in 30 diabetic eyes. Central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) were measured using the vessel assessment and measurement platform software for images of the retina (VAMPIRE) manual annotation tool.
RESULTS A significant decrease of CRVE was observed after laser photocoagulation (p<0.001), but CRAE was not reduced significantly (p = 0.067). No difference was recorded between CRVE and CRAE post-laser photocoagulation (p = 0.14), implying a reduction in vein caliber toward normal in the treated eyes.
CONCLUSIONS Laser photocoagulation decreases the CRVE in diabetic retinopathy despite the absence of changes in the grade of diabetic retinopathy.
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Nadal J, Deverdun J, Champfleur NM, Carriere I, Creuzot‐Garcher C, Delcourt C, Chiquet C, Kawasaki R, Villain M, Ritchie K, Le Bars E, Daien V. Retinal vascular fractal dimension and cerebral blood flow, a pilot study. Acta Ophthalmol 2020; 98:e63-e71. [PMID: 31545560 DOI: 10.1111/aos.14232] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 08/07/2019] [Indexed: 01/12/2023]
Abstract
PURPOSE Ocular and brain microcirculation share embryological and histological similarities. The retinal vascular fractal dimension (FD) is a marker of retinal vascular complexity of the vascular tree. The purpose of this study was to explore the relationship between cerebral blood flow (CBF), retinal vascular FD and other retinal vascular markers. METHODS Cross-sectional analysis comprising 26 individuals ≥65 years old from the Cognitive REServe and Clinical ENDOphenotype (CRESCENDO) cohort of relative healthy older adults. Retinal vascular FD was measured from fundus photographs by using the semi-automated Singapore Eye Vessel Assessment (SIVA) software. CBF was estimated using a 2D pulsed ASL MRI sequence. Associations between blood flow and retinal parameters were analysed using linear regression models adjusted for age and sex. RESULTS Cerebral blood flow was positively associated with venular FD (R2 = 0.32, p = 0.03). This association was stronger in the anterior versus posterior brain territories (R2 = 0.35 [p = 0.001] versus R2 = 0.16 [p = 0.07], respectively). Global CBF was correlated with arteriolar branching angle (R2 = 0.23, p = 0.01) and tortuosity (R2 = 0.20, p = 0.02). Global CBF was not correlated with other SIVA parameters. CONCLUSIONS Retinal venular complexity summarized by the FD was associated with cerebral blood flow as well as retinal arteriolar tortuosity and branching angle. Larger prospective clinical studies are needed to confirm these results.
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Affiliation(s)
- Jeremy Nadal
- Department of Ophthalmology Nîmes University Hospital Nîmes Cedex 9 France
- I2FH Institut d'Imagerie Fonctionnelle Humaine Montpellier University Hospital Center Gui de Chauliac Hospital Montpellier France
| | - Jeremy Deverdun
- I2FH Institut d'Imagerie Fonctionnelle Humaine Montpellier University Hospital Center Gui de Chauliac Hospital Montpellier France
| | - Nicolas Menjot Champfleur
- I2FH Institut d'Imagerie Fonctionnelle Humaine Montpellier University Hospital Center Gui de Chauliac Hospital Montpellier France
- Department of Neuroradiology Montpellier University Hospital Center Gui de Chauliac Hospital Montpellier France
- Laboratoire Charles Coulomb University of Montpellier Montpellier France
- Department of Medical Imaging Caremeau University Hospital Center Nimes France
| | - Isabelle Carriere
- Neuropsychiatry: Epidemiological and Clinical Research INSERM Université de Montpellier Montpellier France
| | - Catherine Creuzot‐Garcher
- Department of Ophthalmology Dijon University Hospital Dijon France
- Eye and Nutrition Research Group CSGA UMR 1324 INRA 6265 CNRS Burgundy University Dijon France
| | - Cécile Delcourt
- Bordeaux Population Health Research Center Team LEHA Inserm UMR 1219 Univ. Bordeaux Bordeaux France
| | - Christophe Chiquet
- Grenoble Alpes University Grenoble France
- Department of Ophthalmology University Hospital Grenoble France
| | - Ryo Kawasaki
- Department of Public Health Faculty of Medicine Yamagata University Yamagata Japan
- Osaka University Graduate School of Medicine Osaka Japan
| | - Max Villain
- Department of Ophthalmology Gui De Chauliac Hospital Montpellier France
| | - Karen Ritchie
- Neuropsychiatry: Epidemiological and Clinical Research INSERM Université de Montpellier Montpellier France
- Centre for Clinical Brain Sciences University of Edinburgh Edinburgh UK
| | - Emmanuelle Le Bars
- I2FH Institut d'Imagerie Fonctionnelle Humaine Montpellier University Hospital Center Gui de Chauliac Hospital Montpellier France
- Department of Neuroradiology Montpellier University Hospital Center Gui de Chauliac Hospital Montpellier France
| | - Vincent Daien
- Neuropsychiatry: Epidemiological and Clinical Research INSERM Université de Montpellier Montpellier France
- Department of Ophthalmology Gui De Chauliac Hospital Montpellier France
- The Save Sight Institute Sydney Medical School The University of Sydney Sydney NSW Australia
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20
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Badawi SA, Fraz MM. Multiloss Function Based Deep Convolutional Neural Network for Segmentation of Retinal Vasculature into Arterioles and Venules. Biomed Res Int 2019; 2019:4747230. [PMID: 31111055 DOI: 10.1155/2019/4747230] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [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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Toh H, Smolentsev A, Bozadjian RV, Keeley PW, Lockwood MD, Sadjadi R, Clegg DO, Blodi BA, Coffey PJ, Reese BE, Thomson JA. Vascular changes in diabetic retinopathy-a longitudinal study in the Nile rat. J Transl Med 2019; 99:1547-1560. [PMID: 31101854 PMCID: PMC6788790 DOI: 10.1038/s41374-019-0264-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 03/11/2019] [Accepted: 03/24/2019] [Indexed: 12/15/2022] Open
Abstract
Diabetic retinopathy is the most common microvascular complication of diabetes and is a major cause of blindness, but an understanding of the pathogenesis of the disease has been hampered by a lack of accurate animal models. Here, we explore the dynamics of retinal cellular changes in the Nile rat (Arvicanthis niloticus), a carbohydrate-sensitive model for type 2 diabetes. The early retinal changes in diabetic Nile rats included increased acellular capillaries and loss of pericytes that correlated linearly with the duration of diabetes. These vascular changes occurred in the presence of microglial infiltration but in the absence of retinal ganglion cell loss. After a prolonged duration of diabetes, the Nile rat also exhibits a spectrum of retinal lesions commonly seen in the human condition including vascular leakage, capillary non-perfusion, and neovascularization. Our longitudinal study documents a range and progression of retinal lesions in the diabetic Nile rat remarkably similar to those observed in human diabetic retinopathy, and suggests that this model will be valuable in identifying new therapeutic strategies.
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Affiliation(s)
- Huishi Toh
- Center for Stem Cell Biology and Engineering, University of California at Santa Barbara, Santa Barbara, CA, USA. .,Neuroscience Research Institute, University of California at Santa Barbara, Santa Barbara, CA, USA.
| | - Alexander Smolentsev
- Center for Stem Cell Biology and Engineering, University of California at Santa Barbara, Santa Barbara, California, USA,Neuroscience Research Institute, University of California at Santa Barbara, Santa Barbara, California, USA
| | - Rachel V. Bozadjian
- Neuroscience Research Institute, University of California at Santa Barbara, Santa Barbara, California, USA
| | - Patrick W. Keeley
- Neuroscience Research Institute, University of California at Santa Barbara, Santa Barbara, California, USA
| | - Madison D. Lockwood
- Center for Stem Cell Biology and Engineering, University of California at Santa Barbara, Santa Barbara, California, USA,Neuroscience Research Institute, University of California at Santa Barbara, Santa Barbara, California, USA
| | - Ryan Sadjadi
- Center for Stem Cell Biology and Engineering, University of California at Santa Barbara, Santa Barbara, California, USA,Neuroscience Research Institute, University of California at Santa Barbara, Santa Barbara, California, USA
| | - Dennis O. Clegg
- Center for Stem Cell Biology and Engineering, University of California at Santa Barbara, Santa Barbara, California, USA,Neuroscience Research Institute, University of California at Santa Barbara, Santa Barbara, California, USA,Department of Molecular, Cellular, and Developmental Biology, University of California, Santa Barbara, Santa Barbara, California, USA
| | - Barbara A. Blodi
- University of Wisconsin Fundus Photograph Reading Center, University of Wisconsin, Madison, Wisconsin, USA
| | - Peter J. Coffey
- Center for Stem Cell Biology and Engineering, University of California at Santa Barbara, Santa Barbara, California, USA,Neuroscience Research Institute, University of California at Santa Barbara, Santa Barbara, California, USA,NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, UCL Institute of Ophthalmology, London, UK,The London Project to Cure Blindness, ORBIT, Institute of Ophthalmology, University College London (UCL), London, UK
| | - Benjamin E. Reese
- Neuroscience Research Institute, University of California at Santa Barbara, Santa Barbara, California, USA,Department of Psychological and Brain Sciences, University of California at Santa Barbara, Santa Barbara, California, USA
| | - James A. Thomson
- Center for Stem Cell Biology and Engineering, University of California at Santa Barbara, Santa Barbara, California, USA,Neuroscience Research Institute, University of California at Santa Barbara, Santa Barbara, California, USA,Department of Molecular, Cellular, and Developmental Biology, University of California, Santa Barbara, Santa Barbara, California, USA,Morgridge Institute for Research, Madison, Wisconsin, USA,Department of Cell and Regenerative Biology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
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22
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Son J, Park SJ, Jung KH. Towards Accurate Segmentation of Retinal Vessels and the Optic Disc in Fundoscopic Images with Generative Adversarial Networks. J Digit Imaging 2019; 32:499-512. [PMID: 30291477 PMCID: PMC6499859 DOI: 10.1007/s10278-018-0126-3] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Automatic segmentation of the retinal vasculature and the optic disc is a crucial task for accurate geometric analysis and reliable automated diagnosis. In recent years, Convolutional Neural Networks (CNN) have shown outstanding performance compared to the conventional approaches in the segmentation tasks. In this paper, we experimentally measure the performance gain for Generative Adversarial Networks (GAN) framework when applied to the segmentation tasks. We show that GAN achieves statistically significant improvement in area under the receiver operating characteristic (AU-ROC) and area under the precision and recall curve (AU-PR) on two public datasets (DRIVE, STARE) by segmenting fine vessels. Also, we found a model that surpassed the current state-of-the-art method by 0.2 - 1.0% in AU-ROC and 0.8 - 1.2% in AU-PR and 0.5 - 0.7% in dice coefficient. In contrast, significant improvements were not observed in the optic disc segmentation task on DRIONS-DB, RIM-ONE (r3) and Drishti-GS datasets in AU-ROC and AU-PR.
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Affiliation(s)
- Jaemin Son
- VUNO Inc., 6F, 507, Gangnam-daero, Seocho-gu, Seoul, Republic of Korea
| | - Sang Jun Park
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Kyu-Hwan Jung
- VUNO Inc., 6F, 507, Gangnam-daero, Seocho-gu, Seoul, Republic of Korea
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McGrory S, Ballerini L, Doubal FN, Staals J, Allerhand M, Valdes-Hernandez MDC, Wang X, MacGillivray T, Doney ASF, Dhillon B, Starr JM, Bastin ME, Trucco E, Deary IJ, Wardlaw JM. Retinal microvasculature and cerebral small vessel disease in the Lothian Birth Cohort 1936 and Mild Stroke Study. Sci Rep 2019; 9:6320. [PMID: 31004095 PMCID: PMC6474900 DOI: 10.1038/s41598-019-42534-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 03/28/2019] [Indexed: 01/06/2023] Open
Abstract
Research has suggested that the retinal vasculature may act as a surrogate marker for diseased cerebral vessels. Retinal vascular parameters were measured using Vessel Assessment and Measurement Platform for Images of the Retina (VAMPIRE) software in two cohorts: (i) community-dwelling older subjects of the Lothian Birth Cohort 1936 (n = 603); and (ii) patients with recent minor ischaemic stroke of the Mild Stroke Study (n = 155). Imaging markers of small vessel disease (SVD) (white matter hyperintensities [WMH] on structural MRI, visual scores and volume; perivascular spaces; lacunes and microbleeds), and vascular risk measures were assessed in both cohorts. We assessed associations between retinal and brain measurements using structural equation modelling and regression analysis. In the Lothian Birth Cohort 1936 arteriolar fractal dimension accounted for 4% of the variance in WMH load. In the Mild Stroke Study lower arteriolar fractal dimension was associated with deep WMH scores (odds ratio [OR] 0.53; 95% CI, 0.32–0.87). No other retinal measure was associated with SVD. Reduced fractal dimension, a measure of vascular complexity, is related to SVD imaging features in older people. The results provide some support for the use of the retinal vasculature in the study of brain microvascular disease.
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Affiliation(s)
- Sarah McGrory
- VAMPIRE project, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK. .,Department of Psychology, University of Edinburgh, Edinburgh, UK.
| | - Lucia Ballerini
- VAMPIRE project, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Fergus N Doubal
- VAMPIRE project, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Julie Staals
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Mike Allerhand
- Department of Psychology, University of Edinburgh, Edinburgh, UK.,Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | | | - Xin Wang
- VAMPIRE project, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Tom MacGillivray
- VAMPIRE project, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Alex S F Doney
- Division of Cardiovascular and Diabetes Medicine, Medical Research Institute, Ninewells Hospital and Medical School, Dundee, UK
| | - Baljean Dhillon
- VAMPIRE project, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - John M Starr
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK.,Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK
| | - Mark E Bastin
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK.,Scottish Imaging Network, a Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh, UK
| | - Emanuele Trucco
- VAMPIRE project, Computing, School of Science and Engineering, University of Dundee, Dundee, UK
| | - Ian J Deary
- Department of Psychology, University of Edinburgh, Edinburgh, UK.,Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Joanna M Wardlaw
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK.,Scottish Imaging Network, a Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh, UK.,UK Dementia Research Institute at the University of Edinburgh, Chancellor's Building, Edinburgh, UK
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24
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Akbar S, Akram MU, Sharif M, Tariq A, Khan SA. Decision support system for detection of hypertensive retinopathy using arteriovenous ratio. Artif Intell Med 2018; 90:15-24. [DOI: 10.1016/j.artmed.2018.06.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 04/23/2018] [Accepted: 06/25/2018] [Indexed: 11/20/2022]
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25
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McGrory S, Taylor AM, Pellegrini E, Ballerini L, Kirin M, Doubal FN, Wardlaw JM, Doney ASF, Dhillon B, Starr JM, Trucco E, Deary IJ, MacGillivray TJ. Towards Standardization of Quantitative Retinal Vascular Parameters: Comparison of SIVA and VAMPIRE Measurements in the Lothian Birth Cohort 1936. Transl Vis Sci Technol 2018; 7:12. [PMID: 29600120 PMCID: PMC5868859 DOI: 10.1167/tvst.7.2.12] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 02/14/2018] [Indexed: 12/22/2022] Open
Abstract
Purpose Semiautomated software applications derive quantitative retinal vascular parameters from fundus camera images. However, the extent of agreement between measurements from different applications is unclear. We evaluate the agreement between retinal measures from two software applications, the Singapore "I" Vessel Assessment (SIVA) and the Vessel Assessment and Measurement Platform for Images of the Retina (VAMPIRE), and examine respective associations between retinal and systemic outcomes. Method Fundus camera images from 665 Lothian Birth Cohort 1936 participants were analyzed with SIVA and VAMPIRE. Intraclass correlation coefficients (ICC) and Bland-Altman plots assessed agreement between retinal parameters: measurements of vessel width, fractal dimension, and tortuosity. Retinal-systemic variable associations were assessed with Pearson's correlation, and intersoftware correlation magnitude differences were examined with Williams's test. Results ICC values indicated poor to limited agreement for all retinal parameters (0.159-0.410). Bland-Altman plots revealed proportional bias in the majority, and systematic bias in all measurements. SIVA and VAMPIRE measurements were associated most consistently with systemic variables relating to blood pressure (SIVA r's from -0.122 to -0.183; VAMPIRE r's from -0.078 to -0.177). Williams's tests indicated significant differences in the magnitude of association between retinal and systemic variables for 7 of 77 comparisons (P < 0.05). Conclusions Agreement between two common software applications was poor. Further studies are required to determine whether associations with systemic variables are software-dependent. Translational Relevance Standardization of the measurement of retinal vascular parameters is warranted to ensure that they are reliable and application-independent. This would be an important step towards realizing the potential of the retina as a source of imaging-derived biomarkers that are clinically useful.
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Affiliation(s)
- Sarah McGrory
- VAMPIRE project, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.,Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Adele M Taylor
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Enrico Pellegrini
- VAMPIRE project, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Lucia Ballerini
- VAMPIRE project, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Mirna Kirin
- Faculty of Medicine, University of Split, Split, Croatia
| | - Fergus N Doubal
- VAMPIRE project, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Joanna M Wardlaw
- VAMPIRE project, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.,UK Dementia Research Institute at the University of Edinburgh, Chancellor's Building, Edinburgh, UK.,Scottish Imaging Network, a Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh, UK.,Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Alex S F Doney
- Division of Cardiovascular and Diabetes Medicine, Medical Research Institute, Ninewells Hospital and Medical School, Dundee, UK
| | - Baljean Dhillon
- VAMPIRE project, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - John M Starr
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK.,Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK
| | - Emanuele Trucco
- VAMPIRE project, Computing, School of Science and Engineering, University of Dundee, Dundee, UK
| | - Ian J Deary
- Department of Psychology, University of Edinburgh, Edinburgh, UK.,Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Thomas J MacGillivray
- VAMPIRE project, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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26
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Kirin M, Nagy R, MacGillivray TJ, Polašek O, Hayward C, Rudan I, Campbell H, Wild S, Wright AF, Wilson JF, Vitart V. Determinants of retinal microvascular features and their relationships in two European populations. J Hypertens 2017; 35:1646-59. [PMID: 28509723 DOI: 10.1097/HJH.0000000000001408] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Supplemental Digital Content is available in the text Objectives: To examine factors influencing retinal vasculature in two environmentally contrasted, cross-sectional studies of adult participants of European descent and to estimate the extent and specificity of genetic contributions to each retinal vasculature feature. Methods: Retinal images from 1088 participants in the Orkney Complex Disease Study and 387 in the CROATIA-Korčula study, taken using the same nonmydriatic camera system and graded by the same person, were evaluated. Using general linear models, we estimated the influence of an extensive range of systemic risk factors, calculated retinal traits heritabilities and genetic correlations. Main results: Systemic covariates explained little (<4%) of the variation in vessel tortuosity, substantially more (>10%, up to 31.7%) of the variation in vessel width and monofractal dimension. Suggestive not well trodden associations of biological interest included that of urate, tissue plasminogen activator and cardiac PR interval with arteriolar narrowing, that of carotid intima–media thickness with less-tortuous arterioles and of cardiac QT interval with more tortuous venules. The genetic underpinning of tortuosity is largely distinct from that of the other retinal vascular features, whereas that of fractal dimension and vessel width greatly overlaps. The previously recognized influence of ocular axial length on vessel widths was high and can be expected to lead to artefactual genetic associations [genetic correlation with central retinal arteriolar equivalent: −0.53 (standard error 0.11)]. The significant genetic correlation between SBP and central retinal arteriolar equivalent, −0.53 (standard error 0.22) (after adjusting for age, sex and axial length of the eye), augurs more favourably for the discovery of genetic variants relevant to vascular physiology.
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Huang F, Dashtbozorg B, Yeung AKS, Zhang J, Berendschot TTJM, ter Haar Romeny BM. A Comparative Study Towards the Establishment of an Automatic Retinal Vessel Width Measurement Technique. In: Cardoso MJ, Arbel T, Melbourne A, Bogunovic H, Moeskops P, Chen X, Schwartz E, Garvin M, Robinson E, Trucco E, Ebner M, Xu Y, Makropoulos A, Desjardin A, Vercauteren T, editors. Fetal, Infant and Ophthalmic Medical Image Analysis. Cham: Springer International Publishing; 2017. pp. 227-34. [DOI: 10.1007/978-3-319-67561-9_26] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Chan KKW, Tang F, Tham CCY, Young AL, Cheung CY. Retinal vasculature in glaucoma: a review. BMJ Open Ophthalmol 2017; 1:e000032. [PMID: 29354699 PMCID: PMC5721639 DOI: 10.1136/bmjophth-2016-000032] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 02/13/2017] [Accepted: 03/20/2017] [Indexed: 01/03/2023] Open
Abstract
Despite the critical impact of glaucoma on global blindness, its aetiology is not fully characterised. Elevated intraocular pressure is highly associated with glaucomatous optic neuropathy. However, visual field loss still progresses in some patients with normal or even low intraocular pressure. Vascular factors have been suggested to play a role in glaucoma development, based on numerous studies showing associations of glaucoma with blood pressure, ocular perfusion pressure, vasospasm, cardiovascular disease and ocular blood flow. As the retinal vasculature is the only part of the human circulation that readily allows non-invasive visualisation of the microcirculation, a number of quantitative retinal vascular parameters measured from retinal photographs using computer software (eg, calibre, fractal dimension, tortuosity and branching angle) are currently being explored for any association with glaucoma and its progression. Several population-based and clinical studies have reported that changes in retinal vasculature (eg, retinal arteriolar narrowing and decreased fractal dimension) are associated with optic nerve damage and glaucoma, supporting the vascular theory of glaucoma pathogenesis. This review summarises recent findings on the relationships between quantitatively measured structural retinal vascular changes with glaucoma and other markers of optic nerve head damage, including retinal nerve fibre layer thickness. Clinical implications, recent new advances in retinal vascular imaging (eg, optical coherence tomography angiography) and future research directions are also discussed.
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Affiliation(s)
- Karen K W Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital and Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China
| | - Fangyao Tang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Clement C Y Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Alvin L Young
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital and Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China
| | - Carol Y Cheung
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
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McGrory S, Cameron JR, Pellegrini E, Warren C, Doubal FN, Deary IJ, Dhillon B, Wardlaw JM, Trucco E, MacGillivray TJ. The application of retinal fundus camera imaging in dementia: A systematic review. Alzheimers Dement (Amst) 2016; 6:91-107. [PMID: 28229127 PMCID: PMC5312461 DOI: 10.1016/j.dadm.2016.11.001] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Introduction The ease of imaging the retinal vasculature, and the evolving evidence suggesting this microvascular bed might reflect the cerebral microvasculature, presents an opportunity to investigate cerebrovascular disease and the contribution of microvascular disease to dementia with fundus camera imaging. Methods A systematic review and meta-analysis was carried out to assess the measurement of retinal properties in dementia using fundus imaging. Results Ten studies assessing retinal properties in dementia were included. Quantitative measurement revealed significant yet inconsistent pathologic changes in vessel caliber, tortuosity, and fractal dimension. Retinopathy was more prevalent in dementia. No association of age-related macular degeneration with dementia was reported. Discussion Inconsistent findings across studies provide tentative support for the application of fundus camera imaging as a means of identifying changes associated with dementia. The potential of fundus image analysis in differentiating between dementia subtypes should be investigated using larger well-characterized samples. Future work should focus on refining and standardizing methods and measurements.
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Affiliation(s)
- Sarah McGrory
- Centre for Clinical Brain Sciences, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - James R Cameron
- Centre for Clinical Brain Sciences, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK; Anne Rowling Regenerative Neurology Clinic, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Enrico Pellegrini
- Centre for Clinical Brain Sciences, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Claire Warren
- College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Fergus N Doubal
- Centre for Clinical Brain Sciences, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Ian J Deary
- Department of Psychology, University of Edinburgh, Edinburgh, UK; Department of Psychology, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Baljean Dhillon
- Centre for Clinical Brain Sciences, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Joanna M Wardlaw
- Centre for Clinical Brain Sciences, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK; Department of Psychology, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; Scottish Imaging Network: A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh, UK
| | - Emanuele Trucco
- VAMPIRE Project and Computer Vision and Image Processing Group School of Science and Engineering (Computing), University of Dundee, Dundee, UK
| | - Thomas J MacGillivray
- Centre for Clinical Brain Sciences, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK; VAMPIRE Project and Edinburgh Clinical Research Facility, University of Edinburgh, Edinburgh, UK
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30
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Besenczi R, Tóth J, Hajdu A. A review on automatic analysis techniques for color fundus photographs. Comput Struct Biotechnol J 2016; 14:371-384. [PMID: 27800125 PMCID: PMC5072151 DOI: 10.1016/j.csbj.2016.10.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 10/01/2016] [Accepted: 10/03/2016] [Indexed: 12/25/2022] Open
Abstract
In this paper, we give a review on automatic image processing tools to recognize diseases causing specific distortions in the human retina. After a brief summary of the biology of the retina, we give an overview of the types of lesions that may appear as biomarkers of both eye and non-eye diseases. We present several state-of-the-art procedures to extract the anatomic components and lesions in color fundus photographs and decision support methods to help clinical diagnosis. We list publicly available databases and appropriate measurement techniques to compare quantitatively the performance of these approaches. Furthermore, we discuss on how the performance of image processing-based systems can be improved by fusing the output of individual detector algorithms. Retinal image analysis using mobile phones is also addressed as an expected future trend in this field.
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Key Words
- ACC, accuracy
- AMD, age-related macular degeneration
- AUC, area under the receiver operator characteristics curve
- Biomedical imaging
- Clinical decision support
- DR, diabetic retinopathy
- FN, false negative
- FOV, field-of-view
- FP, false positive
- FPI, false positive per image
- Fundus image analysis
- MA, microaneurysm
- NA, not available
- OC, optic cup
- OD, optic disc
- PPV, positive predictive value (precision)
- ROC, Retinopathy Online Challenge
- RS, Retinopathy Online Challenge score
- Retinal diseases
- SCC, Spearman's rank correlation coefficient
- SE, sensitivity
- SP, specificity
- TN, true negative
- TP, true positive
- kNN, k-nearest neighbor
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Affiliation(s)
- Renátó Besenczi
- Faculty of Informatics, University of Debrecen 4002 Debrecen PO Box 400, Hungary
| | - János Tóth
- Faculty of Informatics, University of Debrecen 4002 Debrecen PO Box 400, Hungary
| | - András Hajdu
- Faculty of Informatics, University of Debrecen 4002 Debrecen PO Box 400, Hungary
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Oloumi F, Rangayyan RM, Ells AL. Computer-aided diagnosis of retinopathy in retinal fundus images of preterm infants via quantification of vascular tortuosity. J Med Imaging (Bellingham) 2016; 3:044505. [PMID: 28018938 PMCID: PMC5157208 DOI: 10.1117/1.jmi.3.4.044505] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 11/18/2016] [Indexed: 11/14/2022] Open
Abstract
Retinopathy of prematurity (ROP), a disorder of the retina occurring in preterm infants, is the leading cause of preventable childhood blindness. An active phase of ROP that requires treatment is associated with the presence of plus disease, which is diagnosed clinically in a qualitative manner by visual assessment of the existence of a certain level of increase in the thickness and tortuosity of retinal vessels. The present study performs computer-aided diagnosis (CAD) of plus disease via quantitative measurement of tortuosity in retinal fundus images of preterm infants. Digital image processing techniques were developed for the detection of retinal vessels and measurement of their tortuosity. The total lengths of abnormally tortuous vessels in each quadrant and the entire image were then computed. A minimum-length diagnostic-decision-making criterion was developed to assess the diagnostic sensitivity and specificity of the values obtained. The area ([Formula: see text]) under the receiver operating characteristic curve was used to assess the overall diagnostic accuracy of the methods. Using a set of 19 retinal fundus images of preterm infants with plus disease and 91 without plus disease, the proposed methods provided an overall diagnostic accuracy of [Formula: see text]. Using the total length of all abnormally tortuous vessel segments in an image, our techniques are capable of CAD of plus disease with high accuracy without the need for manual selection of vessels to analyze. The proposed methods may be used in a clinical or teleophthalmological setting.
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Affiliation(s)
- Faraz Oloumi
- University of Calgary, Department of Electrical and Computer Engineering, Schulich School of Engineering, 2500 University Drive N.W., Calgary, AB T2N 1N4, Canada
| | - Rangaraj M. Rangayyan
- University of Calgary, Department of Electrical and Computer Engineering, Schulich School of Engineering, 2500 University Drive N.W., Calgary, AB T2N 1N4, Canada
| | - Anna L. Ells
- University of Calgary, Department of Electrical and Computer Engineering, Schulich School of Engineering, 2500 University Drive N.W., Calgary, AB T2N 1N4, Canada
- University of Calgary, Division of Ophthalmology, Department of Surgery, Cumming School of Medicine, 2500 University Drive N.W., Calgary, AB T2N 1N4, Canada
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Meena S, Surya Prasath VB, Kassim YM, Maude RJ, Glinskii OV, Glinsky VV, Huxley VH, Palaniappan K. Multiquadric Spline-Based Interactive Segmentation of Vascular Networks. Annu Int Conf IEEE Eng Med Biol Soc 2016; 2016:5913-5916. [PMID: 28261011 PMCID: PMC5324779 DOI: 10.1109/embc.2016.7592074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Commonly used drawing tools for interactive image segmentation and labeling include active contours or boundaries, scribbles, rectangles and other shapes. Thin vessel shapes in images of vascular networks are difficult to segment using automatic or interactive methods. This paper introduces the novel use of a sparse set of user-defined seed points (supervised labels) for precisely, quickly and robustly segmenting complex biomedical images. A multiquadric spline-based binary classifier is proposed as a unique approach for interactive segmentation using as features color values and the location of seed points. Epifluorescence imagery of the dura mater microvasculature are difficult to segment for quantitative applications due to challenging tissue preparation, imaging conditions, and thin, faint structures. Experimental results based on twenty epifluorescence images is used to illustrate the benefits of using a set of seed points to obtain fast and accurate interactive segmentation compared to four interactive and automatic segmentation approaches.
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Affiliation(s)
- Sachin Meena
- Computational Imaging and VisAnalysis Lab, Department of Computer Science, Columbia, MO 65201 USA
| | - V B Surya Prasath
- Computational Imaging and VisAnalysis Lab, Department of Computer Science, Columbia, MO 65201 USA
| | - Yasmin M Kassim
- Computational Imaging and VisAnalysis Lab, Department of Computer Science, Columbia, MO 65201 USA
| | - Richard J Maude
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Harvard TH Chan School of Public Health, Harvard University, Boston, USA
| | - Olga V Glinskii
- Research Service, Harry S. Truman Memorial Veterans Hospital, Columbia, MO 65201 USA; Department of Medical Pharmacology and Physiology, University of Missouri-Columbia, MO 65211 USA
| | - Vladislav V Glinsky
- Research Service, Harry S. Truman Memorial Veterans Hospital, Columbia, MO 65201 USA; Department of Pathology and Anatomical Sciences, University of Missouri-Columbia, MO 65211 USA
| | - Virginia H Huxley
- Department of Medical Pharmacology and Physiology, University of Missouri-Columbia, MO 65211 USA; National Center for Gender Physiology, University of Missouri-Columbia, MO 65211 USA
| | - Kannappan Palaniappan
- Computational Imaging and VisAnalysis Lab, Department of Computer Science, Columbia, MO 65201 USA
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Cameron JR, Ballerini L, Langan C, Warren C, Denholm N, Smart K, MacGillivray TJ. Modulation of retinal image vasculature analysis to extend utility and provide secondary value from optical coherence tomography imaging. J Med Imaging (Bellingham) 2016; 3:020501. [PMID: 27175375 DOI: 10.1117/1.jmi.3.2.020501] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 04/15/2016] [Indexed: 11/14/2022] Open
Abstract
Retinal image analysis is emerging as a key source of biomarkers of chronic systemic conditions affecting the cardiovascular system and brain. The rapid development and increasing diversity of commercial retinal imaging systems present a challenge to image analysis software providers. In addition, clinicians are looking to extract maximum value from the clinical imaging taking place. We describe how existing and well-established retinal vasculature segmentation and measurement software for fundus camera images has been modulated to analyze scanning laser ophthalmoscope retinal images generated by the dual-modality Heidelberg SPECTRALIS(®) instrument, which also features optical coherence tomography.
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Affiliation(s)
- James R Cameron
- University of Edinburgh, Anne Rowling Regenerative Neurology Clinic, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, United Kingdom; University of Edinburgh, Centre for Clinical Brain Sciences, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, United Kingdom
| | - Lucia Ballerini
- University of Edinburgh, Centre for Clinical Brain Sciences, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, United Kingdom; University of Edinburgh, Clinical Research Imaging Centre, VAMPIRE Project, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, United Kingdom
| | - Clare Langan
- University of Edinburgh , College of Medicine and Veterinary Medicine, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, United Kingdom
| | - Claire Warren
- University of Edinburgh , College of Medicine and Veterinary Medicine, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, United Kingdom
| | - Nicholas Denholm
- University of Edinburgh , College of Medicine and Veterinary Medicine, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, United Kingdom
| | - Katie Smart
- University of Edinburgh , College of Medicine and Veterinary Medicine, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, United Kingdom
| | - Thomas J MacGillivray
- University of Edinburgh, Centre for Clinical Brain Sciences, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, United Kingdom; University of Edinburgh, Clinical Research Imaging Centre, VAMPIRE Project, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, United Kingdom
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Welikala R, Fraz M, Foster P, Whincup P, Rudnicka A, Owen C, Strachan D, Barman S. Automated retinal image quality assessment on the UK Biobank dataset for epidemiological studies. Comput Biol Med 2016; 71:67-76. [DOI: 10.1016/j.compbiomed.2016.01.027] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 01/14/2016] [Accepted: 01/30/2016] [Indexed: 12/01/2022]
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Welikala RA, Fraz MM, Hayat S, Rudnicka AR, Foster PJ, Whincup PH, Owen CG, Strachan DP, Barman SA. Automated retinal vessel recognition and measurements on large datasets. Annu Int Conf IEEE Eng Med Biol Soc 2016; 2015:5239-42. [PMID: 26737473 DOI: 10.1109/embc.2015.7319573] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The characteristics of the retinal vascular network have been prospectively associated with many systemic and vascular diseases. QUARTZ is a fully automated software that has been developed to localize and quantify the morphological characteristics of blood vessels in retinal images for use in epidemiological studies. This software was used to analyse a dataset containing 16,000 retinal images from the EPIC-Norfolk cohort study. The objective of this paper is to both assess the suitability of this dataset for computational analysis and to further evaluate the QUARTZ software.
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Ataer-Cansizoglu E, Bolon-Canedo V, Campbell JP, Bozkurt A, Erdogmus D, Kalpathy-Cramer J, Patel S, Jonas K, Chan RVP, Ostmo S, Chiang MF. Computer-Based Image Analysis for Plus Disease Diagnosis in Retinopathy of Prematurity: Performance of the "i-ROP" System and Image Features Associated With Expert Diagnosis. Transl Vis Sci Technol 2015; 4:5. [PMID: 26644965 DOI: 10.1167/tvst.4.6.5] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Accepted: 10/06/2015] [Indexed: 12/20/2022] Open
Abstract
PURPOSE We developed and evaluated the performance of a novel computer-based image analysis system for grading plus disease in retinopathy of prematurity (ROP), and identified the image features, shapes, and sizes that best correlate with expert diagnosis. METHODS A dataset of 77 wide-angle retinal images from infants screened for ROP was collected. A reference standard diagnosis was determined for each image by combining image grading from 3 experts with the clinical diagnosis from ophthalmoscopic examination. Manually segmented images were cropped into a range of shapes and sizes, and a computer algorithm was developed to extract tortuosity and dilation features from arteries and veins. Each feature was fed into our system to identify the set of characteristics that yielded the highest-performing system compared to the reference standard, which we refer to as the "i-ROP" system. RESULTS Among the tested crop shapes, sizes, and measured features, point-based measurements of arterial and venous tortuosity (combined), and a large circular cropped image (with radius 6 times the disc diameter), provided the highest diagnostic accuracy. The i-ROP system achieved 95% accuracy for classifying preplus and plus disease compared to the reference standard. This was comparable to the performance of the 3 individual experts (96%, 94%, 92%), and significantly higher than the mean performance of 31 nonexperts (81%). CONCLUSIONS This comprehensive analysis of computer-based plus disease suggests that it may be feasible to develop a fully-automated system based on wide-angle retinal images that performs comparably to expert graders at three-level plus disease discrimination. TRANSLATIONAL RELEVANCE Computer-based image analysis, using objective and quantitative retinal vascular features, has potential to complement clinical ROP diagnosis by ophthalmologists.
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Affiliation(s)
| | | | - J Peter Campbell
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
| | - Alican Bozkurt
- Cognitive Systems Laboratory, Northeastern University, Boston, MA, USA
| | - Deniz Erdogmus
- Cognitive Systems Laboratory, Northeastern University, Boston, MA, USA
| | - Jayashree Kalpathy-Cramer
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Samir Patel
- Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA
| | - Karyn Jonas
- Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA
| | - R V Paul Chan
- Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA
| | - Susan Ostmo
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
| | - Michael F Chiang
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA ; Departments of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA
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Relan D, MacGillivray T, Ballerini L, Trucco E. Automatic retinal vessel classification using a Least Square-Support Vector Machine in VAMPIRE. Annu Int Conf IEEE Eng Med Biol Soc 2015; 2014:142-5. [PMID: 25569917 DOI: 10.1109/embc.2014.6943549] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
It is important to classify retinal blood vessels into arterioles and venules for computerised analysis of the vasculature and to aid discovery of disease biomarkers. For instance, zone B is the standardised region of a retinal image utilised for the measurement of the arteriole to venule width ratio (AVR), a parameter indicative of microvascular health and systemic disease. We introduce a Least Square-Support Vector Machine (LS-SVM) classifier for the first time (to the best of our knowledge) to label automatically arterioles and venules. We use only 4 image features and consider vessels inside zone B (802 vessels from 70 fundus camera images) and in an extended zone (1,207 vessels, 70 fundus camera images). We achieve an accuracy of 94.88% and 93.96% in zone B and the extended zone, respectively, with a training set of 10 images and a testing set of 60 images. With a smaller training set of only 5 images and the same testing set we achieve an accuracy of 94.16% and 93.95%, respectively. This experiment was repeated five times by randomly choosing 10 and 5 images for the training set. Mean classification accuracy are close to the above mentioned result. We conclude that the performance of our system is very promising and outperforms most recently reported systems. Our approach requires smaller training data sets compared to others but still results in a similar or higher classification rate.
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Cavallari M, Stamile C, Umeton R, Calimeri F, Orzi F. Novel Method for Automated Analysis of Retinal Images: Results in Subjects with Hypertensive Retinopathy and CADASIL. Biomed Res Int 2015; 2015:752957. [PMID: 26167496 DOI: 10.1155/2015/752957] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 03/16/2015] [Indexed: 11/24/2022]
Abstract
Morphological analysis of the retinal vessels by fundoscopy provides noninvasive means for detecting and staging systemic microvascular damage. However, full exploitation of fundoscopy in clinical settings is limited by paucity of quantitative, objective information obtainable through the observer-driven evaluations currently employed in routine practice. Here, we report on the development of a semiautomated, computer-based method to assess retinal vessel morphology. The method allows simultaneous and operator-independent quantitative assessment of arteriole-to-venule ratio, tortuosity index, and mean fractal dimension. The method was implemented in two conditions known for being associated with retinal vessel changes: hypertensive retinopathy and Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL). The results showed that our approach is effective in detecting and quantifying the retinal vessel abnormalities. Arteriole-to-venule ratio, tortuosity index, and mean fractal dimension were altered in the subjects with hypertensive retinopathy or CADASIL with respect to age- and gender-matched controls. The interrater reliability was excellent for all the three indices (intraclass correlation coefficient ≥ 85%). The method represents simple and highly reproducible means for discriminating pathological conditions characterized by morphological changes of retinal vessels. The advantages of our method include simultaneous and operator-independent assessment of different parameters and improved reliability of the measurements.
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MacGillivray TJ, Cameron JR, Zhang Q, El-Medany A, Mulholland C, Sheng Z, Dhillon B, Doubal FN, Foster PJ, Trucco E, Sudlow C. Suitability of UK Biobank Retinal Images for Automatic Analysis of Morphometric Properties of the Vasculature. PLoS One 2015; 10:e0127914. [PMID: 26000792 PMCID: PMC4441470 DOI: 10.1371/journal.pone.0127914] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 04/20/2015] [Indexed: 11/22/2022] Open
Abstract
Purpose To assess the suitability of retinal images held in the UK Biobank - the largest retinal data repository in a prospective population-based cohort - for computer assisted vascular morphometry, generating measures that are commonly investigated as candidate biomarkers of systemic disease. Methods Non-mydriatic fundus images from both eyes of 2,690 participants - people with a self-reported history of myocardial infarction (n=1,345) and a matched control group (n=1,345) - were analysed using VAMPIRE software. These images were drawn from those of 68,554 UK Biobank participants who underwent retinal imaging at recruitment. Four operators were trained in the use of the software to measure retinal vascular tortuosity and bifurcation geometry. Results Total operator time was approximately 360 hours (4 minutes per image). 2,252 (84%) of participants had at least one image of sufficient quality for the software to process, i.e. there was sufficient detection of retinal vessels in the image by the software to attempt the measurement of the target parameters. 1,604 (60%) of participants had an image of at least one eye that was adequately analysed by the software, i.e. the measurement protocol was successfully completed. Increasing age was associated with a reduced proportion of images that could be processed (p=0.0004) and analysed (p<0.0001). Cases exhibited more acute arteriolar branching angles (p=0.02) as well as lower arteriolar and venular tortuosity (p<0.0001). Conclusions A proportion of the retinal images in UK Biobank are of insufficient quality for automated analysis. However, the large size of the UK Biobank means that tens of thousands of images are available and suitable for computational analysis. Parametric information measured from the retinas of participants with suspected cardiovascular disease was significantly different to that measured from a matched control group.
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Affiliation(s)
- Thomas J MacGillivray
- VAMPIRE project, Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Clinical Research Facility, University of Edinburgh, Edinburgh, United Kingdom
- * E-mail:
| | - James R. Cameron
- The Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, United Kingdom
| | - Qiuli Zhang
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Ahmed El-Medany
- Medical School, University of Edinburgh, Edinburgh, United Kingdom
| | - Carl Mulholland
- Medical School, University of Edinburgh, Edinburgh, United Kingdom
| | - Ziyan Sheng
- Medical School, University of Edinburgh, Edinburgh, United Kingdom
| | - Bal Dhillon
- VAMPIRE project, School of Clinical Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Fergus N. Doubal
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Paul J. Foster
- National Institute for Health Research, Biomedical Research Centre at Moorfields Eye Hospital & University College London Institute of Ophthalmology, London, United Kingdom
| | - Emmanuel Trucco
- VAMPIRE project, School of Computing, University of Dundee, Dundee, United Kingdom
| | - Cathie Sudlow
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
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Maude RJ, Ahmed BUMW, Rahman AHMW, Rahman R, Majumder MI, Menezes DB, Abu Sayeed A, Hughes L, MacGillivray TJ, Borooah S, Dhillon B, Dondorp AM, Faiz MA. Retinal changes in visceral leishmaniasis by retinal photography. BMC Infect Dis 2014; 14:527. [PMID: 25270641 PMCID: PMC4261886 DOI: 10.1186/1471-2334-14-527] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 09/23/2014] [Indexed: 11/10/2022] Open
Abstract
Background In visceral leishmaniasis (VL), retinal changes have previously been noted but not described in detail and their clinical and pathological significance are unknown. A prospective observational study was undertaken in Mymensingh, Bangladesh aiming to describe in detail visible changes in the retina in unselected patients with VL. Methods Patients underwent assessment of visual function, indirect and direct ophthalmoscopy and portable retinal photography. The photographs were assessed by masked observers including assessment for vessel tortuosity using a semi-automated system. Results 30 patients with VL were enrolled, of whom 6 (20%) had abnormalities. These included 5 with focal retinal whitening, 2 with cotton wool spots, 2 with haemorrhages, as well as increased vessel tortuosity. Visual function was preserved. Conclusions These changes suggest a previously unrecognized retinal vasculopathy. An inflammatory aetiology is plausible such as a subclinical retinal vasculitis, possibly with altered local microvascular autoregulation, and warrants further investigation. Electronic supplementary material The online version of this article (doi:10.1186/1471-2334-14-527) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Richard James Maude
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
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Giachetti A, Ballerini L, Trucco E. Accurate and reliable segmentation of the optic disc in digital fundus images. J Med Imaging (Bellingham) 2014; 1:024001. [PMID: 26158034 DOI: 10.1117/1.jmi.1.2.024001] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 05/27/2014] [Accepted: 06/16/2014] [Indexed: 11/14/2022] Open
Abstract
We describe a complete pipeline for the detection and accurate automatic segmentation of the optic disc in digital fundus images. This procedure provides separation of vascular information and accurate inpainting of vessel-removed images, symmetry-based optic disc localization, and fitting of incrementally complex contour models at increasing resolutions using information related to inpainted images and vessel masks. Validation experiments, performed on a large dataset of images of healthy and pathological eyes, annotated by experts and partially graded with a quality label, demonstrate the good performances of the proposed approach. The method is able to detect the optic disc and trace its contours better than the other systems presented in the literature and tested on the same data. The average error in the obtained contour masks is reasonably close to the interoperator errors and suitable for practical applications. The optic disc segmentation pipeline is currently integrated in a complete software suite for the semiautomatic quantification of retinal vessel properties from fundus camera images (VAMPIRE).
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Affiliation(s)
- Andrea Giachetti
- Università di Verona , Dipartimento di Informatica, Strada Le Grazie 15 Verona 37134, Italy
| | - Lucia Ballerini
- University of Dundee , VAMPIRE, School of Computing, School of Computing, Queen Mother Building, Balfour Street, Dundee DD1 4HN, United Kingdom
| | - Emanuele Trucco
- University of Dundee , VAMPIRE, School of Computing, School of Computing, Queen Mother Building, Balfour Street, Dundee DD1 4HN, United Kingdom
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Pelapur R, Prasath VBS, Bunyak F, Glinskii OV, Glinsky VV, Huxley VH, Palaniappan K. Multi-focus image fusion using epifluorescence microscopy for robust vascular segmentation. Annu Int Conf IEEE Eng Med Biol Soc 2014; 2014:4735-8. [PMID: 25571050 PMCID: PMC4459514 DOI: 10.1109/embc.2014.6944682] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Automatic segmentation of three-dimensional mi-crovascular structures is needed for quantifying morphological changes to blood vessels during development, disease and treatment processes. Single focus two-dimensional epifluorescent imagery lead to unsatisfactory segmentations due to multiple out of focus vessel regions that have blurred edge structures and lack of detail. Additional segmentation challenges include varying contrast levels due to diffusivity of the lectin stain, leakage out of vessels and fine morphological vessel structure. We propose an approach for vessel segmentation that combines multi-focus image fusion with robust adaptive filtering. The robust adaptive filtering scheme handles noise without destroying small structures, while multi-focus image fusion considerably improves segmentation quality by deblurring out-of-focus regions through incorporating 3D structure information from multiple focus steps. Experiments using epifluorescence images of mice dura mater show an average of 30.4% improvement compared to single focus microvasculature segmentation.
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Zutis K, Trucco E, Hubschman JP, Reed D, Shah S, van Hemert J. Towards automatic detection of abnormal retinal capillaries in ultra-widefield-of-view retinal angiographic exams. Annu Int Conf IEEE Eng Med Biol Soc 2013; 2013:7372-5. [PMID: 24111448 DOI: 10.1109/embc.2013.6611261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Retinal capillary abnormalities include small, leaky, severely tortuous blood vessels that are associated with a variety of retinal pathologies. We present a prototype image-processing system for detecting abnormal retinal capillary regions in ultra-widefield-of-view (UWFOV) fluorescein angiography exams of the human retina. The algorithm takes as input an UWFOV FA frame and returns the candidate regions identified. An SVM classifier is trained on regions traced by expert ophthalmologists. Tests with a variety of feature sets indicate that edge features and allied properties differentiate best between normal and abnormal retinal capillary regions. Experiments with an initial set of images from patients showing branch retinal vein occlusion (BRVO) indicate promising area under the ROC curve of 0.950 and a weighted Cohen's Kappa value of 0.822.
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Trucco E, Ruggeri A. Towards a multi-site international public dataset for the validation of retinal image analysis software. Annu Int Conf IEEE Eng Med Biol Soc 2013; 2013:7152-5. [PMID: 24111394 DOI: 10.1109/embc.2013.6611207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This paper discusses concisely the main issues and challenges posed by the validation of retinal image analysis algorithms. It is designed to set the discussion for the IEEE EBMC 2013 invited session "From laboratory to clinic: the validation of retinal image processing tools ". The session carries forward an international initiative started at EMBC 2011, Boston, which resulted in the first large-consensus paper (14 international sites) on the validation of retinal image processing software, appearing in IOVS. This paper is meant as a focus for the session discussion, but the ubiquity and importance of validation makes its contents, arguably, of interest for the wider medical image processing community.
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Lupaşcu CA, Tegolo D, Trucco E. Accurate estimation of retinal vessel width using bagged decision trees and an extended multiresolution Hermite model. Med Image Anal 2013; 17:1164-80. [PMID: 24001930 DOI: 10.1016/j.media.2013.07.006] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Revised: 07/20/2013] [Accepted: 07/29/2013] [Indexed: 11/16/2022]
Abstract
We present an algorithm estimating the width of retinal vessels in fundus camera images. The algorithm uses a novel parametric surface model of the cross-sectional intensities of vessels, and ensembles of bagged decision trees to estimate the local width from the parameters of the best-fit surface. We report comparative tests with REVIEW, currently the public database of reference for retinal width estimation, containing 16 images with 193 annotated vessel segments and 5066 profile points annotated manually by three independent experts. Comparative tests are reported also with our own set of 378 vessel widths selected sparsely in 38 images from the Tayside Scotland diabetic retinopathy screening programme and annotated manually by two clinicians. We obtain considerably better accuracies compared to leading methods in REVIEW tests and in Tayside tests. An important advantage of our method is its stability (success rate, i.e., meaningful measurement returned, of 100% on all REVIEW data sets and on the Tayside data set) compared to a variety of methods from the literature. We also find that results depend crucially on testing data and conditions, and discuss criteria for selecting a training set yielding optimal accuracy.
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Affiliation(s)
- Carmen Alina Lupaşcu
- VAMPIRE Project, Dipartimento di Matematica e Informatica, Università degli Studi di Palermo, Via Archirafi 34, 90123 Palermo, Italy.
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Relan D, MacGillivray T, Ballerini L, Trucco E. Retinal vessel classification: sorting arteries and veins. Annu Int Conf IEEE Eng Med Biol Soc 2013; 2013:7396-7399. [PMID: 24111454 DOI: 10.1109/embc.2013.6611267] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
For the discovery of biomarkers in the retinal vasculature it is essential to classify vessels into arteries and veins. We automatically classify retinal vessels as arteries or veins based on colour features using a Gaussian Mixture Model, an Expectation-Maximization (GMM-EM) unsupervised classifier, and a quadrant-pairwise approach. Classification is performed on illumination-corrected images. 406 vessels from 35 images were processed resulting in 92% correct classification (when unlabelled vessels are not taken into account) as compared to 87.6%, 90.08%, and 88.28% reported in [12] [14] and [15]. The classifier results were compared against two trained human graders to establish performance parameters to validate the success of classification method. The proposed system results in specificity of (0.8978, 0.9591) and precision (positive predicted value) of (0.9045, 0.9408) as compared to specificity of (0.8920, 0.7918) and precision of (0.8802, 0.8118) for (arteries, veins) respectively as reported in [13]. The classification accuracy was found to be 0.8719 and 0.8547 for veins and arteries, respectively.
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Pinhas A, Dubow M, Shah N, Chui TY, Scoles D, Sulai YN, Weitz R, Walsh JB, Carroll J, Dubra A, Rosen RB. In vivo imaging of human retinal microvasculature using adaptive optics scanning light ophthalmoscope fluorescein angiography. Biomed Opt Express 2013; 4:1305-17. [PMID: 24009994 PMCID: PMC3756583 DOI: 10.1364/boe.4.001305] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 06/22/2013] [Accepted: 07/05/2013] [Indexed: 05/03/2023]
Abstract
The adaptive optics scanning light ophthalmoscope (AOSLO) allows visualization of microscopic structures of the human retina in vivo. In this work, we demonstrate its application in combination with oral and intravenous (IV) fluorescein angiography (FA) to the in vivo visualization of the human retinal microvasculature. Ten healthy subjects ages 20 to 38 years were imaged using oral (7 and/or 20 mg/kg) and/or IV (500 mg) fluorescein. In agreement with current literature, there were no adverse effects among the patients receiving oral fluorescein while one patient receiving IV fluorescein experienced some nausea and heaving. We determined that all retinal capillary beds can be imaged using clinically accepted fluorescein dosages and safe light levels according to the ANSI Z136.1-2000 maximum permissible exposure. As expected, the 20 mg/kg oral dose showed higher image intensity for a longer period of time than did the 7 mg/kg oral and the 500 mg IV doses. The increased resolution of AOSLO FA, compared to conventional FA, offers great opportunity for studying physiological and pathological vascular processes.
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Affiliation(s)
- Alexander Pinhas
- Department of Ophthalmology, New York Eye & Ear Infirmary, 310 E 14th St, New York, NY 10003, USA
- Icahn School of Medicine at Mount Sinai, 1428 Madison Ave, New York, NY 10029, USA
- Contributed equally to this manuscript and should be considered joint first authors
| | - Michael Dubow
- Department of Ophthalmology, New York Eye & Ear Infirmary, 310 E 14th St, New York, NY 10003, USA
- Icahn School of Medicine at Mount Sinai, 1428 Madison Ave, New York, NY 10029, USA
- Contributed equally to this manuscript and should be considered joint first authors
| | - Nishit Shah
- Department of Ophthalmology, New York Eye & Ear Infirmary, 310 E 14th St, New York, NY 10003, USA
| | - Toco Y. Chui
- Department of Ophthalmology, New York Eye & Ear Infirmary, 310 E 14th St, New York, NY 10003, USA
| | - Drew Scoles
- Department of Biomedical Engineering, University of Rochester, 500 Wilson Blvd, Rochester, NY 14627, USA
| | - Yusufu N. Sulai
- The Institute of Optics, University of Rochester, 500 Wilson Blvd, Rochester, NY 14627, USA
| | - Rishard Weitz
- Department of Ophthalmology, New York Eye & Ear Infirmary, 310 E 14th St, New York, NY 10003, USA
| | - Joseph B. Walsh
- Department of Ophthalmology, New York Eye & Ear Infirmary, 310 E 14th St, New York, NY 10003, USA
| | - Joseph Carroll
- Department of Ophthalmology, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226, USA
- Department of Biomedical Engineering, Marquette University, 1250 W Wisconsin Ave, Milwaukee, WI 53233, USA
- Department of Biophysics, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226, USA
- Department of Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226, USA
| | - Alfredo Dubra
- Department of Ophthalmology, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226, USA
- Department of Biomedical Engineering, Marquette University, 1250 W Wisconsin Ave, Milwaukee, WI 53233, USA
- Department of Biophysics, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226, USA
| | - Richard B. Rosen
- Department of Ophthalmology, New York Eye & Ear Infirmary, 310 E 14th St, New York, NY 10003, USA
- Department of Ophthalmology, New York Medical College, 40 Sunshine Cottage Rd, Valhalla, NY 10595, USA
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