Diabetes is a chronic end organ disease that occurs when the pancreas does not secrete enough insulin or the body is unable to process it properly. Over time, diabetes affects the circulatory system, including that of the retina. Diabetic retinopathy is a medical condition where the retina is damaged because fluid leaks from blood vessels into the retina. Ophthalmologists recognize diabetic retinopathy based on features, such as blood vessel area, exudes, hemorrhages, microaneurysms and texture. In this paper we review algorithms used for the extraction of these features from digital fundus images. Furthermore, we discuss systems that use these features to classify individual fundus images. The classifications efficiency of different DR systems is discussed. Most of the reported systems are highly optimized with respect to the analyzed fundus images, therefore a generalization of individual results is difficult. However, this review shows that the classification results improved has improved recently, and it is getting closer to the classification capabilities of human ophthalmologists.

Algorithms for the Automated Detection of Diabetic Retinopathy Using Digital Fundus Images: A Review

Diabetic retinopathy (DR) is caused by damage to the small blood vessels of the retina in the posterior part of the eye of the diabetic patient. The main stages of diabetic retinopathy are non-proliferate diabetes retinopathy (NPDR) and proliferate diabetes retinopathy (PDR). The retinal fundus photographs are widely used in the diagnosis and treatment of various eye diseases in clinics. It is also one of the main resources for mass screening of diabetic retinopathy. In this work, we have proposed a computer-based approach for the detection of diabetic retinopathy stage using fundus images. Image preprocessing, morphological processing techniques and texture analysis methods are applied on the fundus images to detect the features such as area of hard exudates, area of the blood vessels and the contrast. Our protocol uses total of 140 subjects consisting of two stages of DR and normal. Our extracted features are statistically significant (p?<?0.0001) with distinct mean?±?SD as shown in Table 1. These features are then used as an input to the artificial neural network (ANN) for an automatic classification. The detection results are validated by comparing it with expert ophthalmologists. We demonstrated a classification accuracy of 93%, sensitivity of 90% and specificity of 100%.

Automated Identification of Diabetic Retinopathy Stages Using Digital Fundus Images

Currently, there is an increasing interest for setting up medical systems that can screen a large number of people for sight threatening diseases, such as diabetic retinopathy. This paper presents a method for automated identification of exudate pathologies in retinopathy images based on computational intelligence techniques. The color retinal images are segmented using fuzzy c-means clustering following some preprocessing steps, i.e., color normalization and contrast enhancement. The entire segmented images establish a dataset of regions. To classify these segmented regions into exudates and nonexudates, a set of initial features such as color, size, edge strength, and texture are extracted. A genetic-based algorithm is used to rank the features and identify the subset that gives the best classification results. The selected feature vectors are then classified using a multilayer neural network classifier. The algorithm was implemented using a large image dataset consisting of 300 manually labeled retinal images, and could identify affected retinal images with 96.0% sensitivity while it recognized 94.6% of the normal images, i.e., the specificity. Moreover, the proposed scheme illustrated an accuracy including 93.5% sensitivity and 92.1% predictivity for identification of retinal exudates at the pixel level.

A Computational-Intelligence-Based Approach for Detection of Exudates in Diabetic Retinopathy Images

Retinal exudates are typically manifested as spatially random yellow/white patches of varying sizes and shapes. They are a characteristic feature of retinal diseases such as diabetic maculopathy. An automatic method for the detection of exudate regions is introduced comprising image colour normalisation, enhancing the contrast between the objects and background, segmenting the colour retinal image into homogenous regions using Fuzzy C-Means clustering, and classifying the regions into exudates and non exudates patches using a neural network. Experimental results indicate that we are able to achieve 92% sensitivity and 82% specificity.

Automatic Recognition of Exudative Maculopathy using Fuzzy C- Means Clustering and Neural Networks

Diabetes mellitus is a major cause of visual impairment and blindness. Twenty years after the onset of diabetes, almost all patients with type 1 diabetes and over 60% of patients with type 2 diabetes will have some degree of retinopathy. Prolonged diabetes retinopathy leads to maculopathy, which impairs the normal vision depending on the severity of damage of the macula. This paper presents a computer-based intelligent system for the identification of clinically significant maculopathy, non-clinically significant maculopathy and normal fundus eye images. Features are extracted from these raw fundus images which are then fed to the classifier. Our protocol uses feed-forward architecture in an artificial neural network classifier for classification of different stages. Three different kinds of eye disease conditions were tested in 350 subjects. We demonstrated a sensitivity of more than 95% for these classifiers with a specificity of 100%, and results are very promising. Our systems are ready to run clinically on large amounts of datasets.

Automatic identification of diabetic maculopathy stages using fundus images.

The design of neural network classifiers for the identification of diabetic retinopathy is discussed. Red-free digitised fundal images are tiled, and a neural network is trained to distinguish exudates from drusen (similar appearing lesions). By quantifying the degree of retinopathy, the approach can be used to screen diabetic patients for referral. A novel form of hierarchical feature selection using sensitivity analysis is presented. The resulting neural network is compact, and achieves 91% sensitivity and specificity on a test set.

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Quantification of Diabetic Retinopathy using Neural Networks and Sensitivity Analysis

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Quantification of Diabetic Retinopathy using Neural Networks and Sensitivity Analysis