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Real-time spatial referencing is an important alternative to tracking for designing spatially aware ophthalmic instrumentation for procedures such as laser photocoagulation and perimetry. It requires independent, fast registration of each image frame from a digital video stream (1024 x 1024 pixels) to a spatial map of the retina. Recently, we have introduced a spatial referencing algorithm that works in three primary steps: 1) tracing the retinal vasculature to extract image feature (landmarks); 2) invariant indexing to generate hypothesized landmark correspondences and initial transformations; and 3) alignment and verification steps to robustly estimate a 12-parameter quadratic spatial transformation between the image frame and the map. The goal of this paper is to introduce techniques to minimize the amount of computation for successful spatial referencing. The fundamental driving idea is to make feature extraction subservient to registration and, therefore, only produce the information needed for verified, accurate transformations. To this end, the image is analyzed along one-dimensional, vertical and horizontal grid lines to produce a regular sampling of the vasculature, needed for step 3) and to initiate step 1). Tracing of the vascular is then prioritized hierarchically to quickly extract landmarks and groups (constellations) of landmarks for indexing. Finally, the tracing and spatial referencing computations are integrated so that landmark constellations found by tracing are tested immediately. The resulting implementation is an order-of-magnitude faster with the same success rate. The average total computation time is 31.2 ms per image on a 2.2-GHz Pentium Xeon processor. Index Terms--Biomedical image analysis, feature-based image registration, mosaic synthesis, real-time computing, retinal image sequences, scheduling, spatial mapping, spatial referencing, vasculature tracing.

Objective: Many common eye diseases and cardiovascular diseases can be diagnosed through retinal imaging. However, due to uneven illumination, image blurring, and low contrast, retinal images with poor quality are not useful for diagnosis, especially in automated image analyzing systems. Here, we propose a new image enhancement method to improve color retinal image luminosity and contrast. Methods: A luminance gain matrix, which is obtained by gamma correction of the value channel in the HSV (hue, saturation, and value) color space, is used to enhance the R, G, and B (red, green and blue) channels, respectively. Contrast is then enhanced in the luminosity channel of L*a*b* color space by CLAHE (contrast-limited adaptive histogram equalization). Image enhancement by the proposed method is compared to other methods by evaluating quality scores of the enhanced images. Results: The performance of the method is mainly validated on a dataset of 961 poor-quality retinal images. Quality assessment (range 0–1) of image enhancement of this poor dataset indicated that our method improved color retinal image quality from an average of 0.0404 (standard deviation 0.0291) up to an average of 0.4565 (standard deviation 0.1000). Conclusion: The proposed method is shown to achieve superior image enhancement compared to contrast enhancement in other color spaces or by other related methods, while simultaneously preserving image naturalness. Significance: This method of color retinal image enhancement may be employed to assist ophthalmologists in more efficient screening of retinal diseases and in development of improved automated image analysis for clinical diagnosis. [ABSTRACT FROM PUBLISHER]

Retinal images can be used in several applications, such as ocular fundus operations as well as human recognition. Also, they play important roles in detection of some diseases in early stages, such as diabetes, which can be performed by comparison of the states of retinal blood vessels. Intrinsic characteristics of retinal images make the blood vessel detection process difficult. Here, we proposed a new algorithm to detect the retinal blood vessels effectively. Due to the high ability of the curvelet transform in representing the edges, modification of curvelet transform coefficients to enhance the retinal image edges better prepares the image for the segmentation part. The directionality feature of the multistructure elements method makes it an effective tool in edge detection. Hence, morphology operators using multistructure elements are applied to the enhanced image in order to find the retinal image ridges. Afterward, morphological operators by reconstruction eliminate the ridges not belonging to the vessel tree while trying to preserve the thin vessels unchanged. In order to increase the efficiency of the morphological operators by reconstruction, they were applied using multistructure elements. A simple thresholding method along with connected components analysis (CCA) indicates the remained ridges belonging to vessels. In order to utilize CCA more efficiently, we locally applied the CCA and length filtering instead of considering the whole image. Experimental results on a known database, DRIVE, and achieving to more than 94% accuracy in about 50 s for blood vessel detection, proved that the blood vessels can be effectively detected by applying our method on the retinal images. [ABSTRACT FROM PUBLISHER]

An algorithm for the real-time registration of a retinal video sequence captured with a scanning digital ophthal moscope (SDO) to a retinal composite image is presented. This method is designed for a computer-assisted retinal laser photocoagulation system to compensate for retinal motion and hence enhance the accuracy, speed, and patient safety of retinal laser treatments. The procedure combines intensity and feature-based registration techniques. For the registration of an individual frame, the translational frame-to-frame motion between preceding and current frame is detected by normalized cross correlation. Next, vessel points on the current video frame are identified and an initial transformation estimate is constructed from the calculated translation vector and the quadratic registration matrix of the previous frame. The vessel points are then iteratively matched to the segmented vessel centerline of the composite image to refine the initial transformation and register the video frame to the composite image. Criteria for image quality and algorithm convergence are introduced, which assess the exclusion of single frames from the registration process and enable a loss of tracking signal if necessary. The algorithm was successfully applied to ten different video sequences recorded from patients. It revealed an average accuracy of 2.47 \pm 2.0 pixels (\sim23.2 \pm 18.8 \mu \m) for 2764 evaluated video frames and demonstrated that it meets the clinical requirements. [ABSTRACT FROM AUTHOR]

Under the framework of computer-aided eye disease diagnosis, this paper presents an automatic optic disc (OD) detection technique. The proposed technique makes use of the unique circular brightness structure associated with the OD, i.e., the OD usually has a circular shape and is brighter than the surrounding pixels whose intensity becomes darker gradually with their distances from the OD center. A line operator is designed to capture such circular brightness structure, which evaluates the image brightness variation along multiple line segments of specific orientations that pass through each retinal image pixel. The orientation of the line segment with the minimum/maximum variation has specific pattern that can be used to locate the OD accurately. The proposed technique has been tested over four public datasets that include 130, 89, 40, and 81 images of healthy and pathological retinas, respectively. Experiments show that the designed line operator is tolerant to different types of retinal lesion and imaging artifacts, and an average OD detection accuracy of 97.4% is obtained. [ABSTRACT FROM AUTHOR]

This paper presents a new supervised method for segmentation of blood vessels in retinal photographs. This method uses an ensemble system of bagged and boosted decision trees and utilizes a feature vector based on the orientation analysis of gradient vector field, morphological transformation, line strength measures, and Gabor filter responses. The feature vector encodes information to handle the healthy as well as the pathological retinal image. The method is evaluated on the publicly available DRIVE and STARE databases, frequently used for this purpose and also on a new public retinal vessel reference dataset CHASE_DB1 which is a subset of retinal images of multiethnic children from the Child Heart and Health Study in England (CHASE) dataset. The performance of the ensemble system is evaluated in detail and the incurred accuracy, speed, robustness, and simplicity make the algorithm a suitable tool for automated retinal image analysis. [ABSTRACT FROM PUBLISHER]

Retinal arteriovenous (AV) nicking is one of the prominent and significant microvascular abnormalities. It is characterized by the decrease in the venular caliber at both sides of an artery-vein crossing. Recent research suggests that retinal AV nicking is a strong predictor of eye diseases such as branch retinal vein occlusion and cardiovascular diseases such as stroke. In this study, we present a novel method for objective and quantitative AV nicking assessment. From the input retinal image, the vascular network is first extracted using the multiscale line detection method. The crossover point detection method is then performed to localize all AV crossing locations. At each detected crossover point, the four vessel segments, two associated with the artery and two associated with the vein, are identified and two venular segments are then recognized through the artery-vein classification method. The vessel widths along the two venular segments are measured and analyzed to compute the AV nicking severity of that crossover. The proposed method was validated on 47 high-resolution retinal images obtained from two population-based studies. The experimental results indicate a strong correlation between the computed AV nicking values and the expert grading with a Spearman correlation coefficient of 0.70. Sensitivity was 77% and specificity was 92% (Kappa \kappa = \0.70) when comparing AV nicking detected using the proposed method to that detected using a manual grading method, performed by trained photographic graders. [ABSTRACT FROM PUBLISHER]

The vascular tree of the retina is likely the most representative and stable feature for eye fundus images in registration. Based on the reconstructed vascular tree, we propose an elastic matching algorithm to register pairs of fundus images. The identified vessels are thinned and approximated using short line segments of equal length that results a set of elements. The set of elements corresponding to one vascular tree are elastically deformed to optimally match the set of elements of another vascular tree, with the guide of an energy function to finally establish pixel relation- ship between both vascular trees. The mapped positions of pixels in the transformed retinal image are computed to be the sum of their original locations and corresponding displacement vectors. For the purpose of performance comparison, a weak affine model based fast chamfer matching technique is proposed and implemented. Experiment results validated the effectiveness of the elastic matching algorithm and its advantage over the weak affine model for registration of retinal fundus images. [ABSTRACT FROM AUTHOR]

Emerging technologies in health care aim at reducing unnecessary visits to medical specialists, minimizing overall cost of treatment and optimizing the number of patients seen by each doctor. This paper explores image recognition for the screening of diabetic retinopathy, a complication of diabetes that can lead to blindness if not discovered in its initial stages. Many previous reports on DR imaging focus on the segmentation of the retinal image, on quality assessment, and on the analysis of presence of DR-related lesions. Although this study has advanced the detection of individual DR lesions from retinal images, the simple presence of any lesion is not enough to decide on the need for referral of a patient. Deciding if a patient should be referred to a doctor is an essential requirement for the deployment of an automated screening tool for rural and remote communities. We introduce an algorithm to make that decision based on the fusion of results by metaclassification. The input of the metaclassifier is the output of several lesion detectors, creating a powerful high-level feature representation for the retinal images. We explore alternatives for the bag-of-visual-words (BoVW)-based lesion detectors, which critically depends on the choices of coding and pooling the low-level local descriptors. The final classification approach achieved an area under the curve of 93.4% using SOFT–MAX BoVW (soft-assignment coding/max pooling), without the need of normalizing the high-level feature vector of scores. [ABSTRACT FROM PUBLISHER]

The presence of microaneurysms (MAs) is usually an early sign of diabetic retinopathy and their automatic detection from color retinal images is of clinical interest. In this paper, we present a new approach for automatic MA detection from digital color fundus images. We formulate MA detection as a problem of target detection from clutter, where the probability of occurrence of target is considerably smaller compared to the clutter. A successive rejection-based strategy is proposed to progressively lower the number of clutter responses. The processing stages are designed to reject specific classes of clutter while passing majority of true MAs, using a set of specialized features. The true positives that remain after the final rejector are assigned a score which is based on its similarity to a true MA. Results of extensive evaluation of the proposed approach on three different retinal image datasets are reported, and used to highlight the promise in the presented strategy. [ABSTRACT FROM PUBLISHER]

Proposes a real-time retinal tracking system for image-guided laser treatment. Strategy for retinal image segmentation; Detection of blood vessel boundaries using deformable models; Segmentation of the optic disc; Estimation of laser shot locations.

Coronary artery disease (CAD) is a cardiovascular condition with high morbidity and mortality. Intravascular optical coherence tomography (IVOCT) has been considered as an optimal imagining system for the diagnosis and treatment of CAD. Constrained by Nyquist theorem, dense sampling in IVOCT attains high resolving power to delineate cellular structures/features. There is a trade-off between high spatial resolution and fast scanning rate for coronary imaging. In this paper, we propose a viable spectral-spatial acquisition method that down-scales the sampling process in both spectral and spatial domain while maintaining high quality in image reconstruction. The down-scaling schedule boosts data acquisition speed without any hardware modifications. Additionally, we propose a unified multi-scale reconstruction framework, namely Multiscale-Spectral-Spatial-Magnification Network (MSSMN), to resolve highly down-scaled (compressed) OCT images with flexible magnification factors. We incorporate the proposed methods into Spectral Domain OCT (SD-OCT) imaging of human coronary samples with clinical features such as stent and calcified lesions. Our experimental results demonstrate that spectral-spatial down-scaled data can be better reconstructed than data that are down-scaled solely in either spectral or spatial domain. Moreover, we observe better reconstruction performance using MSSMN than using existing reconstruction methods. Our acquisition method and multi-scale reconstruction framework, in combination, may allow faster SD-OCT inspection with high resolution during coronary intervention. [ABSTRACT FROM AUTHOR]

The vascular tree of the retina is likely the most representative and stable feature for eye fundus images in registration. Based on the reconstructed vascular tree, we propose an elastic matching algorithm to register pairs of fundus images. The identified vessels are thinned and approximated using short line segments of equal length that results a set of elements. The set of elements corresponding to one vascular tree are elastically deformed to optimally match the set of elements of another vascular tree, with the guide of an energy function to finally establish pixel relationship between both vascular trees. The mapped positions of pixels in the transformed retinal image are computed to be the sum of their original locations and corresponding displacement vectors. For the purpose of performance comparison, a weak affine model based fast chamfer matching technique is proposed and implemented. Experiment results validated the effectiveness of the elastic matching algorithm and its advantage over the weak affine model for registration of retinal fundus images. Index Terms--Elastic matching, fast chafer matching, retinal image registration, vascular tree.

Measurements of retinal blood vessel morphology have been shown to be related to the risk of cardiovascular diseases. The wrong identification of vessels may result in a large variation of these measurements, leading to a wrong clinical diagnosis. In this paper, we address the problem of automatically identifying true vessels as a postprocessing step to vascular structure segmentation. We model the segmented vascular structure as a vessel segment graph and formulate the problem of identifying vessels as one of finding the optimal forest in the graph given a set of constraints. We design a method to solve this optimization problem and evaluate it on a large real-world dataset of 2446 retinal images. Experiment results are analyzed with respect to actual measurements of vessel morphology. The results show that the proposed approach is able to achieve 98.9% pixel precision and 98.7% recall of the true vessels for clean segmented retinal images, and remains robust even when the segmented image is noisy. [ABSTRACT FROM PUBLISHER]

Accurate placement of lesions is crucial for the effectiveness and safety of a retinal laser photocoagulation treatment. Computer assistance provides the capability for improvements to treatment accuracy and execution time. The idea is to use video frames acquired from a scanning digital ophthalmoscope (SDO) to compensate for retinal motion during laser treatment. This paper presents a method for the multimodal registration of the initial frame from an SDO retinal video sequence to a retinal composite image, which may contain a treatment plan. The retinal registration procedure comprises the following steps: 1) detection of vessel centerline points and identification of the optic disc; 2) prealignment of the video frame and the composite image based on optic disc parameters; and 3) iterative matching of the detected vessel centerline points in expanding matching regions. This registration algorithm was designed for the initialization of a real-time registration procedure that registers the subsequent video frames to the composite image. The algorithm demonstrated its capability to register various pairs of SDO video frames and composite images acquired from patients. [ABSTRACT FROM AUTHOR]

Objective: Presbyopia, an age-related ocular disorder, is characterized by the loss in the accommodative abilities of the human eye. Conventional methods of correcting presbyopia divide the field of view, thereby resulting in significant vision impairment. We demonstrate the design, assembly and evaluation of autofocusing eyeglasses for restoration of accommodation without dividing the field of view. Methods: The adaptive optics eyeglasses comprise of two variable-focus liquid lenses, a time-of-flight range sensor and low-power, dual microprocessor control electronics, housed within an ergonomic frame. Subject-specific accommodation deficiency models were utilized to demonstrate high-fidelity accommodative correction. The abilities of this system to reduce accommodation deficiency, its power consumption, response time, optical performance and MTF were evaluated. Results: Average corrected accommodation deficiencies for 5 subjects ranged from -0.021 D to 0.016 D. Each accommodation correction calculation was performed in ∼67 ms which consumed 4.86 mJ of energy. The optical resolution of the system was 10.5 cycles/degree, and featured a restorative accommodative range of 4.3 D. This system was capable of running for up to 19 hours between charge cycles and weighed ∼132 g. Conclusion: The design, assembly and performance of an autofocusing eyeglasses system to restore accommodation in presbyopes has been demonstrated. Significance: The new autofocusing eyeglasses system presented in this article has the potential to restore pre-presbyopic levels of accommodation in subjects diagnosed with presbyopia. [ABSTRACT FROM AUTHOR]

Color retinal photography is an important tool to detect the evidence of various eye diseases. Novel methods to extract the main features in color retinal images have been developed in this paper. Principal component analysis is employed to locate optic disc; A modified active shape model is proposed in the shape detection of optic disc; A fundus coordinate system is established to provide a better description of the features in the retinal images; An approach to detect exudates by the combined region growing and edge detection is proposed. The success rates of disc localization, disc boundary detection, and fovea localization are 99%, 94%, and 100%, respectively. The sensitivity and specificity of exudate detection are 100% and 71%, correspondingly. The success of the proposed algorithms can be attributed to the utilization of the model-bass methods. The detection and analysis could be applied to automatic mass screening and diagnosis of the retinal diseases. [ABSTRACT FROM AUTHOR]

Goal: The full-field electroretinogram (ffERG) is an objective tool to assess global retinal function, though as it is currently done, it is unable to localize sources of retinal dysfunction or damage. To overcome this, we have developed a new way to record multiple spatial derivations of the ERG using the rotating capability of the eye, thus creating “virtual electrodes”. We have termed this the multi-angular ERG (or maERG). With only 3 real electrodes and 11 varying gaze positions, we create 33 “virtual electrodes”. Methods: We created a realistic electrophysiological and anatomical eye model (i.e., forward model) to reconstruct the retinal activity (i.e., inverse problem) from the 33 virtual electrodes. We simulated 2 pathological scenarios (central and peripheral scotomas), which were compared to their respective theoretical source configurations using an Area under Receiver Operator Characteristic curve metric. Results: Our simulations show that the low-resolution brain electromagnetic tomography algorithm (LORETA) is the best method tested to reconstruct retinal sources when compared to the Minimum Norm Estimate algorithm. Furthermore, a signal to noise ratio of 50 dB is needed to accurately reconstruct the retina's functional map. Conclusion: Our proposed maERG recording method, combined with our solution to the electromagnetic inverse problem enables us to reconstruct the functional map of the human retina. Significance: We believe that this new functional retinal imaging technique will permit earlier detection of retinal malfunction and consequently optimize the clinical monitoring of patients affected with retinopathies. [ABSTRACT FROM AUTHOR]

Objective: Glaucoma is the second leading cause of blindness worldwide. Glaucomatous progression can be easily monitored by analyzing the degeneration of retinal ganglion cells (RGCs). Many researchers have screened glaucoma by measuring cup-to-disc ratios from fundus and optical coherence tomography scans. However, this paper presents a novel strategy that pays attention to the RGC atrophy for screening glaucomatous pathologies and grading their severity. Methods: The proposed framework encompasses a hybrid convolutional network that extracts the retinal nerve fiber layer, ganglion cell with the inner plexiform layer and ganglion cell complex regions, allowing thus a quantitative screening of glaucomatous subjects. Furthermore, the severity of glaucoma in screened cases is objectively graded by analyzing the thickness of these regions. Results: The proposed framework is rigorously tested on publicly available Armed Forces Institute of Ophthalmology (AFIO) dataset, where it achieved the F1 score of 0.9577 for diagnosing glaucoma, a mean dice coefficient score of 0.8697 for extracting the RGC regions and an accuracy of 0.9117 for grading glaucomatous progression. Furthermore, the performance of the proposed framework is clinically verified with the markings of four expert ophthalmologists, achieving a statistically significant Pearson correlation coefficient of 0.9236. Conclusion: An automated assessment of RGC degeneration yields better glaucomatous screening and grading as compared to the state-of-the-art solutions. Significance: An RGC-aware system not only screens glaucoma but can also grade its severity and here we present an end-to-end solution that is thoroughly evaluated on a standardized dataset and is clinically validated for analyzing glaucomatous pathologies. [ABSTRACT FROM AUTHOR]

Diabetic Macular Edema (DME) and macular edema secondary to retinal occlusion (RVO) are the two most common retinal vascular causes of visual impairment and leading cause of worldwide vision loss. The blood-retinal barrier is the key barrier for maintaining fluid balance within the retinal tissue. Vascular Endothelial Growth Factor (VEGF) has a significant role in the permeability of the blood-retinal barrier, which also leads to appearance of leakage foci. Intravitreal anti-VEGF therapy is the current gold standard treatment and has been demonstrated to improve macular thickening, improve vision acuity and reduce vascular leakage. However, treatment response and required dosing interval can vary widely across patients. Given the role of the blood-retinal barrier and vascular leakage in the pathogenesis of these disorders, the goal of this study was to present and evaluate new computer extracted features relating to morphology, spatial architecture and tortuosity of vessels and leakages from baseline ultra-widefield fluorescein angiography (UWFA) images. Specifically, we sought to evaluate the role of these computer extracted features from baseline UWFA images. Notably, these UWFA images were obtained from IRB-approved PERMEATE clinical trial , to distinguish eyes tolerating extended dosing intervals (n = 16) who are referred to as non-rebounders and those who require more frequent dosing (n = 12) and are called rebounders based on visual acuity loss with extended dosing challenges. A total of 64 features encapsulating different morphological and geometrical attributes of leakage patches including the anatomical (shape, size, density, area, minor and major axis, orientation, area, extent ratio, perimeter, radii) and geometrical characteristics (the proximity of each leakage foci to main vessels, to other leakage foci and to optical disc) as well as 54 tortuosity features (tortuosity of whole vessel network, local tortuosity of vessels in the vicinity of leakage foci) were extracted. The most significant and predictive biomarkers related to treatment response were proximity of leakage nodes to major and minor eye vessels as well as local vasculature tortuosity in the vicinity of the leakages. The imaging features were then used in conjunction with a Linear Discriminant Analysis (LDA) classifier to distinguish rebounders from non-rebounders. The 3-fold cross-validated Area Under Curve (AUC) was found to be 0.82 for the morphological based features and 0.85 for the tortuosity based features. Our findings suggest higher variation in leakage node proximity to retinal vessels in eyes tolerating extended interval dosing. In contrast, eyes with increased local vascular tortuosity demonstrated less tolerance of increased dosing interval. Moreover, a class activation map generated by a deep learning model identified regions that corresponded to regions of leakages proximal to the vessels, providing confirmation of the validity of predictive image features extracted from these regions in this study. [ABSTRACT FROM AUTHOR]

Objective: The focal length of available optical see-through (OST) head-mounted displays (HMDs) is at least 2 m; therefore, during manual tasks, the user eye cannot keep in focus both the virtual and real content at the same time. Another perceptual limitation is related to the vergence-accommodation conflict, the latter being present in binocular vision only. This paper investigates the effect of incorrect focus cues on the user performance, visual comfort, and workload during the execution of augmented reality (AR)-guided manual task with one of the most advanced OST HMD, the Microsoft HoloLens. Methods: An experimental study was designed to investigate the performance of 20 subjects in a connect-the-dots task, with and without the use of AR. The following tests were planned: AR-guided monocular and binocular, and naked-eye monocular and binocular. Each trial was analyzed to evaluate the accuracy in connecting dots. NASA Task Load Index and Likert questionnaires were used to assess the workload and the visual comfort. Results: No statistically significant differences were found in the workload, and in the perceived comfort between the AR-guided binocular and monocular test. User performances were significantly better during the naked eye tests. No statistically significant differences in performances were found in the monocular and binocular tests. The maximum error in AR tests was 5.9 mm. Conclusion: Even if there is a growing interest in using commercial OST HMD, for guiding high-precision manual tasks, attention should be paid to the limitations of the available technology not designed for the peripersonal space. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this paper is to propose a novel algorithm for joint optic disc and cup segmentation, which aids the glaucoma detection. Methods: By assuming the shapes of cup and disc regions to be elliptical, we proposed an end-to-end region-based convolutional neural network for joint optic disc and cup segmentation (referred to as JointRCNN). Atrous convolution is introduced to boost the performance of feature extraction module. In JointRCNN, disc proposal network (DPN) and cup proposal network (CPN) are proposed to generate bounding box proposals for the optic disc and cup, respectively. Given the prior knowledge that the optic cup is located in the optic disc, disc attention module is proposed to connect DPN and CPN, where a suitable bounding box of the optic disc is first selected and then continued to be propagated forward as the basis for optic cup detection in our proposed network. After obtaining the disc and cup regions, which are the inscribed ellipses of the corresponding detected bounding boxes, the vertical cup-to-disc ratio is computed and used as an indicator for glaucoma detection. Results: Comprehensive experiments clearly show that our JointRCNN model outperforms state-of-the-art methods for optic disc and cup segmentation task and glaucoma detection task. Conclusion: Joint optic disc and cup segmentation, which utilizes the connection between optic disc and cup, could improve the performance of optic disc and cup segmentation. Significance: The proposed method improves the accuracy of glaucoma detection. It is promising to be used for glaucoma screening. [ABSTRACT FROM AUTHOR]

In both movement training and neurorehabilitation, there have been numerous examples of how average performance can be manipulated through practice using enhanced visual feedback. Objective: Rather than just influencing the mean, our objective was to use a novel feedback technique called limit-push to influence the trial-to-trial variability of motion by distorting vision. Method : Limit-push was previously done using robotic forces; the present study employed only visual distortions that imitated the limit-push approach. Results: Like the robotic force treatment, our results showed how subjects significantly shifted the distributions of their motions. This effect was even greater than that of the original limit-push experiment that used robotic forces. Significance : Such visual distortion interventions do not require a robot for enhanced training. Conclusion: The visual limit-push technique appears to be able to selectively alter both the central tendency and variability in performance training applications. [ABSTRACT FROM AUTHOR]

Objective: Deep learning based methods for retinal vessel segmentation are usually trained based on pixel-wise losses, which treat all vessel pixels with equal importance in pixel-to-pixel matching between a predicted probability map and the corresponding manually annotated segmentation. However, due to the highly imbalanced pixel ratio between thick and thin vessels in fundus images, a pixel-wise loss would limit deep learning models to learn features for accurate segmentation of thin vessels, which is an important task for clinical diagnosis of eye-related diseases. Methods: In this paper, we propose a new segment-level loss which emphasizes more on the thickness consistency of thin vessels in the training process. By jointly adopting both the segment-level and the pixel-wise losses, the importance between thick and thin vessels in the loss calculation would be more balanced. As a result, more effective features can be learned for vessel segmentation without increasing the overall model complexity. Results: Experimental results on public data sets demonstrate that the model trained by the joint losses outperforms the current state-of-the-art methods in both separate-training and cross-training evaluations. Conclusion: Compared to the pixel-wise loss, utilizing the proposed joint-loss framework is able to learn more distinguishable features for vessel segmentation. In addition, the segment-level loss can bring consistent performance improvement for both deep and shallow network architectures. Significance: The findings from this study of using joint losses can be applied to other deep learning models for performance improvement without significantly changing the network architectures. [ABSTRACT FROM AUTHOR]

People with diabetes mellitus need annual screening to check for the development of diabetic retinopathy (DR). Tracking small retinal changes due to early diabetic retinopathy lesions in longitudinal fundus image sets is challenging due to intra- and intervisit variability in illumination and image quality, the required high registration accuracy, and the subtle appearance of retinal lesions compared to other retinal features. This paper presents a robust and flexible approach for automated detection of longitudinal retinal changes due to small red lesions by exploiting normalized fundus images that significantly reduce illumination variations and improve the contrast of small retinal features. To detect spatio-temporal retinal changes, the absolute difference between the extremes of the multiscale blobness responses of fundus images from two time points is proposed as a simple and effective blobness measure. DR related changes are then identified based on several intensity and shape features by a support vector machine classifier. The proposed approach was evaluated in the context of a regular diabetic retinopathy screening program involving subjects ranging from healthy (no retinal lesion) to moderate (with clinically relevant retinal lesions) DR levels. Evaluation shows that the system is able to detect retinal changes due to small red lesions with a sensitivity of \text80\% at an average false positive rate of 1 and 2.5 lesions per eye on small and large fields-of-view of the retina, respectively. [ABSTRACT FROM AUTHOR]

Objective: In this paper, we propose a robust, efficient, and automatic reconnection algorithm for bridging interrupted curvilinear skeletons in ophthalmologic images. Methods: This method employs the contour completion process, i.e., mathematical modeling of the direction process in the roto-translation group SE(2) \equiv \mathbb R^2 \rtimes S^1 to achieve line propagation/completion. The completion process can be used to reconstruct interrupted curves by considering their local consistency. An explicit scheme with finite-difference approximation is used to construct the three-dimensional (3-D) completion kernel, where we choose the Gamma distribution for time integration. To process structures in $SE(2)$, the orientation score framework is exploited to lift the 2-D curvilinear segments into the 3-D space. The propagation and reconnection of interrupted segments are achieved by convolving the completion kernel with orientation scores via iterative group convolutions. To overcome the problem of incorrect skeletonization of 2-D structures at junctions, a 3-D segment-wise thinning technique is proposed to process each segment separately in orientation scores. Results: Validations on 4 datasets with different image modalities show that our method achieves an average success rate of $95.24\%$ in reconnecting $40\,457$ gaps of sizes from $7 \times 7$ to $39 \times 39$, including challenging junction structures. Conclusion: The reconnection approach can be a useful and reliable technique for bridging complex curvilinear interruptions. Significance: The presented method is a critical work to obtain more complete curvilinear structures in ophthalmologic images. It provides better topological and geometric connectivities for further analysis. [ABSTRACT FROM PUBLISHER]

This paper presents a fully automated algorithm to segment fluid-associated (fluid-filled) and cyst regions in optical coherence tomography (OCT) retina images of subjects with diabetic macular edema. The OCT image is segmented using a novel neutrosophic transformation and a graph-based shortest path method. In neutrosophic domain, an image $g$ is transformed into three sets: $T$ (true), $I$ (indeterminate) that represents noise, and $F$ (false). This paper makes four key contributions. First, a new method is introduced to compute the indeterminacy set $I$ , and a new $\lambda$ -correction operation is introduced to compute the set $T$ in neutrosophic domain. Second, a graph shortest-path method is applied in neutrosophic domain to segment the inner limiting membrane and the retinal pigment epithelium as regions of interest (ROI) and outer plexiform layer and inner segment myeloid as middle layers using a novel definition of the edge weights . Third, a new cost function for cluster-based fluid/cyst segmentation in ROI is presented which also includes a novel approach in estimating the number of clusters in an automated manner. Fourth, the final fluid regions are achieved by ignoring very small regions and the regions between middle layers. The proposed method is evaluated using two publicly available datasets: Duke, Optima, and a third local dataset from the UMN clinic which is available online. The proposed algorithm outperforms the previously proposed Duke algorithm by 8% with respect to the dice coefficient and by 5% with respect to precision on the Duke dataset, while achieving about the same sensitivity. Also, the proposed algorithm outperforms a prior method for Optima dataset by 6%, 22%, and 23% with respect to the dice coefficient, sensitivity, and precision, respectively. Finally, the proposed algorithm also achieves sensitivity of 67.3%, 88.8%, and 76.7%, for the Duke, Optima, and the university of minnesota (UMN) datasets, respectively. [ABSTRACT FROM PUBLISHER]

Objective: Diabetic retinopathy (DR) is characterized by the progressive deterioration of retina with the appearance of different types of lesions that include microaneurysms, hemorrhages, exudates, etc. Detection of these lesions plays a significant role for early diagnosis of DR. Methods: To this aim, this paper proposes a novel and automated lesion detection scheme, which consists of the four main steps: vessel extraction and optic disc removal, preprocessing, candidate lesion detection, and postprocessing. The optic disc and the blood vessels are suppressed first to facilitate further processing. Curvelet-based edge enhancement is done to separate out the dark lesions from the poorly illuminated retinal background, while the contrast between the bright lesions and the background is enhanced through an optimally designed wideband bandpass filter. The mutual information of the maximum matched filter response and the maximum Laplacian of Gaussian response are then jointly maximized. Differential evolution algorithm is used to determine the optimal values for the parameters of the fuzzy functions that determine the thresholds of segmenting the candidate regions. Morphology-based postprocessing is finally applied to exclude the falsely detected candidate pixels. Results and Conclusions: Extensive simulations on different publicly available databases highlight an improved performance over the existing methods with an average accuracy of $97.71\%$ and robustness in detecting the various types of DR lesions irrespective of their intrinsic properties. [ABSTRACT FROM PUBLISHER]

Objective: Accurate segmentation of neurosensory retinal detachment (NRD) associated subretinal fluid in spectral domain optical coherence tomography (SD-OCT) is vital for the assessment of central serous chorioretinopathy (CSC). A novel two-stage segmentation algorithm was proposed, guided by Enface fundus imaging. Methods: In the first stage, Enface fundus image was segmented using thickness map prior to detecting the fluid-associated abnormalities with diffuse boundaries. In the second stage, the locations of the abnormalities were used to restrict the spatial extent of the fluid region, and a fuzzy level set method with a spatial smoothness constraint was applied to subretinal fluid segmentation in the SD-OCT scans. Results: Experimental results from 31 retinal SD-OCT volumes with CSC demonstrate that our method can achieve a true positive volume fraction (TPVF), false positive volume fraction (FPVF), and positive predicative value (PPV) of 94.3%, 0.97%, and 93.6%, respectively, for NRD regions. Our approach can also discriminate NRD-associated subretinal fluid from subretinal pigment epithelium fluid associated with pigment epithelial detachment with a TPVF, FPVF, and PPV of 93.8%, 0.40%, and 90.5%, respectively. Conclusion: We report a fully automatic method for the segmentation of subretinal fluid. Significance: Our method shows the potential to improve clinical therapy for CSC. [ABSTRACT FROM PUBLISHER]

Objective: We propose an effective automatic method for identification of four retinal layer boundaries from the spectral domain optical coherence tomography images in the presence and absence of pathologies and morphological changes due to disease. Methods: The approach first finds an approximate location of three reference layers and then uses these to bound the search space for the actual layers, which is achieved by modeling the problem as a graph and applying Dijkstra's shortest path algorithm. The edge weight between nodes is determined using pixel distance, slope similarity to a reference, and nonassociativity of the layers, which is designed to overcome the distorting effects that pathology can play in the boundary determination. Results: The accuracy of our method was evaluated on three different datasets. It outperforms the current five state-of-the-art methods. On average, the mean and standard deviation of the root-mean-square error in the form of mean $\pm$ standard deviation in pixels for our method is 1.57 $\pm$ 0.69, which is lower than compared to the existing top five methods of 16.17 $\pm$ 22.64, 6.66 $\pm$ 9.11, 5.70 $\pm$ 10.54, 3.69 $\pm$ 2.04, and 2.29 $\pm$ 1.54. Conclusion: Our method is highly accurate, robust, reliable, and consistent. This identification can enable to quantify the biomarkers of the retina in large-scale study for assessing, monitoring disease progression, as well as early detection of retinal diseases. Significance: Identification of these boundaries can help to determine the loss of neuroretinal cells or layers and the presence of retinal pathology, which can be used as features for the automatic determination of the stages of retinal diseases. [ABSTRACT FROM AUTHOR]

Goal: Reliable recognition of microaneurysms (MAs) is an essential task when developing an automated analysis system for diabetic retinopathy (DR) detection. In this study, we propose an integrated approach for automated MA detection with high accuracy. Methods: Candidate objects are first located by applying a dark object filtering process. Their cross-section profiles along multiple directions are processed through singular spectrum analysis. The correlation coefficient between each processed profile and a typical MA profile is measured and used as a scale factor to adjust the shape of the candidate profile. This is to increase the difference in their profiles between true MAs and other non-MA candidates. A set of statistical features of those profiles is then extracted for a K-nearest neighbor classifier. Results: Experiments show that by applying this process, MAs can be separated well from the retinal background, the most common interfering objects and artifacts. Conclusion: The results have demonstrated the robustness of the approach when testing on large scale datasets with clinically acceptable sensitivity and specificity. Significance: The approach proposed in the evaluated system has great potential when used in an automated DR screening tool or for large scale eye epidemiology studies. [ABSTRACT FROM AUTHOR]

This paper presents a novel unsupervised iterative blood vessel segmentation algorithm using fundus images. First, a vessel enhanced image is generated by tophat reconstruction of the negative green plane image. An initial estimate of the segmented vasculature is extracted by global thresholding the vessel enhanced image. Next, new vessel pixels are identified iteratively by adaptive thresholding of the residual image generated by masking out the existing segmented vessel estimate from the vessel enhanced image. The new vessel pixels are, then, region grown into the existing vessel, thereby resulting in an iterative enhancement of the segmented vessel structure. As the iterations progress, the number of false edge pixels identified as new vessel pixels increases compared to the number of actual vessel pixels. A key contribution of this paper is a novel stopping criterion that terminates the iterative process leading to higher vessel segmentation accuracy. This iterative algorithm is robust to the rate of new vessel pixel addition since it achieves 93.2–95.35% vessel segmentation accuracy with 0.9577–0.9638 area under ROC curve (AUC) on abnormal retinal images from the STARE dataset. The proposed algorithm is computationally efficient and consistent in vessel segmentation performance for retinal images with variations due to pathology, uneven illumination, pigmentation, and fields of view since it achieves a vessel segmentation accuracy of about 95% in an average time of 2.45, 3.95, and 8 s on images from three public datasets DRIVE, STARE, and CHASE_DB1, respectively. Additionally, the proposed algorithm has more than 90% segmentation accuracy for segmenting peripapillary blood vessels in the images from the DRIVE and CHASE_DB1 datasets. [ABSTRACT FROM PUBLISHER]

Objective: Glaucoma is an irreversible chronic eye disease that leads to vision loss. As it can be slowed down through treatment, detecting the disease in time is important. However, many patients are unaware of the disease because it progresses slowly without easily noticeable symptoms. Currently, there is no effective method for low-cost population-based glaucoma detection or screening. Recent studies have shown that automated optic nerve head assessment from 2-D retinal fundus images is promising for low-cost glaucoma screening. In this paper, we propose a method for cup to disc ratio (CDR) assessment using 2-D retinal fundus images. Methods: In the proposed method, the optic disc is first segmented and reconstructed using a novel sparse dissimilarity-constrained coding (SDC) approach which considers both the dissimilarity constraint and the sparsity constraint from a set of reference discs with known CDRs. Subsequently, the reconstruction coefficients from the SDC are used to compute the CDR for the testing disc. Results: The proposed method has been tested for CDR assessment in a database of 650 images with CDRs manually measured by trained professionals previously. Experimental results show an average CDR error of 0.064 and correlation coefficient of 0.67 compared with the manual CDRs, better than the state-of-the-art methods. Our proposed method has also been tested for glaucoma screening. The method achieves areas under curve of 0.83 and 0.88 on datasets of 650 and 1676 images, respectively, outperforming other methods. Conclusion: The proposed method achieves good accuracy for glaucoma detection. Significance: The method has a great potential to be used for large-scale population-based glaucoma screening. [ABSTRACT FROM PUBLISHER]

Distinctive feature detection is an essential task in computer-assisted minimally invasive surgery (MIS). For special conditions in an MIS imaging environment, such as specular reflections and texture homogeneous areas, the feature points extracted by general feature point detectors are less distinctive and repeatable in MIS images. We observe that abundant blood vessels are available on tissue surfaces and can be extracted as a new set of image features. In this paper, two types of blood vessel features are proposed for endoscopic images: branching points and branching segments. Two novel methods, ridgeness-based circle test and ridgeness-based branching segment detection are presented to extract branching points and branching segments, respectively. Extensive in vivo experiments were conducted to evaluate the performance of the proposed methods and compare them with the state-of-the-art methods. The numerical results verify that, in MIS images, the blood vessel features can produce a large number of points. More importantly, those points are more robust and repeatable than the other types of feature points. In addition, due to the difference in feature types, vessel features can be combined with other general features, which makes them new tools for MIS image analysis. These proposed methods are efficient and the code and datasets are made available to the public. [ABSTRACT FROM AUTHOR]

This paper presents a new real-time automated infrared video monitoring technique for detection of breathing anomalies, and its application in the diagnosis of obstructive sleep apnea. We introduce a novel motion model to detect subtle, cyclical breathing signals from video, a new 3-D unsupervised self-adaptive breathing template to learn individuals’ normal breathing patterns online, and a robust action classification method to recognize abnormal breathing activities and limb movements. This technique avoids imposing positional constraints on the patient, allowing patients to sleep on their back or side, with or without facing the camera, fully or partially occluded by the bed clothes. Moreover, shallow and abdominal breathing patterns do not adversely affect the performance of the method, and it is insensitive to environmental settings such as infrared lighting levels and camera view angles. The experimental results show that the technique achieves high accuracy (\94\% for the clinical data) in recognizing apnea episodes and body movements and is robust to various occlusion levels, body poses, body movements (i.e., minor head movement, limb movement, body rotation, and slight torso movement), and breathing behavior (e.g., shallow versus heavy breathing, mouth breathing, chest breathing, and abdominal breathing). [ABSTRACT FROM PUBLISHER]

Algorithms are presented for integrated analysis of both vascular and nonvascular changes observed in longitudinal time-series of color retinal fundus images, extending our prior work. A Bayesian model selection algorithm that combines color change information, and image understanding systems outputs in a novel manner is used to analyze vascular changes such as increase/decrease in width, and disappearance/ appearance of vessels, as well as nonvascular changes such as appearance/disappearance of different kinds of lesions. The overall system is robust to false changes due to inter-image and intra-image nonuniform illumination, imaging artifacts such as dust particles in the optical path, alignment errors and outliers in the training-data. An expert observer validated the algorithms on 54 regions selected from 34 image pairs. The regions were selected such that they represented diverse types of vascular changes of interest, as well as no-change regions. The algorithm achieved a sensitivity of 82% and a 9% false positive rate for vascular changes. For the nonvascular changes, 97% sensitivity and a 10% false positive rate are achieved. The combined system is intended for diverse applications including computer-assisted retinal screening, image-reading centers, quantitative monitoring of disease onset and progression, assessment of treatment efficacy, and scoring clinical trials. Index Terms--Bayesian classification, change analysis, change detection, diabetic retinopathy, illumination correction, retinal image analysis.

A fully automated approach is presented for robust detection and classification of changes in longitudinal time-series of color retinal fundus images of diabetic retinopathy. The method is robust to: 1) spatial variations in illumination resulting from instrument limitations and changes both within, and between patient visits; 2) imaging artifacts such as dust particles; 3) ontliers in the training data; 4) segmentation and alignment errors. Robustness to illumination variation is achieved by a novel iterativc algorithm to estimate the reflectance of the retina exploiting automatically extracted segmentations of the retinal vasculature, optic disk, fovea, and pathologies. Robustness to dust artifacts is achieved by exploiting their spectral characteristics, enabling application to film-based, as well as digital imaging systems. False changes from alignment errors are minimized by subpixel accuracy registration using a 12-parameter transformation that accounts for unknown retinal curvature and camera parameters. Bayesian detection and classification algorithms are used to generate a color-coded output that is readily inspected. A multiobserver validation on 43 image pairs from 22 eyes involving nonproliferative and proliferative diabetic retinopathies, showed a 97% change detection rate, a 3% miss rate, and a 10% false alarm rate. The performance in correctly classifying the changes was 99.3%. A self-consistency metric, and an error factor were developed to measure performance over more than two periods. The average self consistency was 94% and the error factor was 0.06%. Although this study focuses on diabetic changes, the proposed techniques have broader applicability in ophthalmology. Index Terms--Bayesian classification, change analysis, change detection, diabetic retinopathy, illumination correction, retinal image analysis.

New clinical studies suggest that narrowing of the retinal blood vessels may be an early indicator of cardiovascular diseases. One measure to quantify the severity of retinal arteriolar narrowing is the arteriolar-to-venular diameter ratio (AVR). The manual computation of AVR is a tedious process involving repeated measurements of the diameters of all arterioles and venules in the retinal images by human graders. Consistency and reproducibility are concerns. To facilitate large-scale clinical use in the general population, it is essential to have a precise, efficient and automatic system to compute this AVR. This paper describes a new approach to obtain AVR. The starting points of vessels are detected using a matched Gaussian filter. The detected vessels are traced with the help of a combined Kalman filter and Gaussian filter. A modified Gaussian model that takes into account the central light reflection of arterioles is proposed to describe the vessel profile. The width of a vessel is obtained by data fitting. Experimental results indicate a 97.1% success rate in the identification of vessel starting points, and a 99.2% success rate in the tracking of retinal vessels. The accuracy of the AVR computation is well within the acceptable range of deviation among the human graders, with a mean relative AVR error of 4.4%. The system has interested clinical research groups worldwide and will be tested in clinical studies. Index Terms--AVR, cardiovascular disease, retinal image, vessel measurement, vessel modeling.

This paper proposes a multimodal approach for vessel segmentation of macular optical coherence tomography (OCT) slices along with the fundus image. The method is comprised of two separate stages; the first step is 2-D segmentation of blood vessels in curvelet domain, enhanced by taking advantage of vessel information in crossing OCT slices (named feedback procedure), and improved by suppressing the false positives around the optic nerve head. The proposed method for vessel localization of OCT slices is also enhanced utilizing the fact that retinal nerve fiber layer becomes thicker in the presence of the blood vessels. The second stage of this method is axial localization of the vessels in OCT slices and 3-D reconstruction of the blood vessels. Twenty-four macular spectral 3-D OCT scans of 16 normal subjects were acquired using a Heidelberg HRA OCT scanner. Each dataset consisted of a scanning laser ophthalmoscopy (SLO) image and limited number of OCT scans with size of 496 × 512 (namely, for a data with 19 selected OCT slices, the whole data size was 496 × 512 × 19). The method is developed with least complicated algorithms and the results show considerable improvement in accuracy of vessel segmentation over similar methods to produce a local accuracy of 0.9632 in area of SLO, covered with OCT slices, and the overall accuracy of 0.9467 in the whole SLO image. The results are also demonstrative of a direct relation between the overall accuracy and percentage of SLO coverage by OCT slices. [ABSTRACT FROM PUBLISHER]

A novel algorithm for detection of saccades and postsaccadic oscillations in the presence of smooth pursuit movements is proposed. The method combines saccade detection in the acceleration domain with specialized on- and offset criteria for saccades and postsaccadic oscillations. The performance of the algorithm is evaluated by comparing the detection results to those of an existing velocity-based adaptive algorithm and a manually annotated database. The results show that there is a good agreement between the events detected by the proposed algorithm and those in the annotated database with Cohen’s kappa around 0.8 for both a development and a test database. In conclusion, the proposed algorithm accurately detects saccades and postsaccadic oscillations as well as intervals of disturbances. [ABSTRACT FROM PUBLISHER]

Motivated by the goals of automatically extracting vessel segments and constructing retinal vascular trees with anatomical realism, this paper presents and analyses an algorithm that combines vessel segmentation and grouping of the extracted vessel segments. The proposed method aims to restore the topology of the vascular trees with anatomical realism for clinical studies and diagnosis of retinal vascular diseases, which manifest abnormalities in either venous and/or arterial vascular systems. Vessel segments are grouped using extended Kalman filter which takes into account continuities in curvature, width, and intensity changes at the bifurcation or crossover point. At a junction, the proposed method applies the minimum-cost matching algorithm to resolve the conflict in grouping due to error in tracing. The system was trained with 20 images from the DRIVE dataset, and tested using the remaining 20 images. The dataset contained a mixture of normal and pathological images. In addition, six pathological fluorescein angiogram sequences were also included in this study. The results were compared against the groundtruth images provided by a physician, achieving average success rates of 88.79% and 90.09%, respectively. [ABSTRACT FROM PUBLISHER]

In retinal surgery, surgeons face difficulties such as indirect visualization of surgical targets, physiological tremor, and lack of tactile feedback, which increase the risk of retinal damage caused by incorrect surgical gestures. In this context, intraocular proximity sensing has the potential to overcome current technical limitations and increase surgical safety. In this paper, we present a system for detecting unintentional collisions between surgical tools and the retina using the visual feedback provided by the opthalmic stereo microscope. Using stereo images, proximity between surgical tools and the retinal surface can be detected when their relative stereo disparity is small. For this purpose, we developed a system comprised of two modules. The first is a module for tracking the surgical tool position on both stereo images. The second is a disparity tracking module for estimating a stereo disparity map of the retinal surface. Both modules were specially tailored for coping with the challenging visualization conditions in retinal surgery. The potential clinical value of the proposed method is demonstrated by extensive testing using a silicon phantom eye and recorded rabbit in vivo data. [ABSTRACT FROM PUBLISHER]

In this paper, we present an algorithm to detect the presence of diabetic retinopathy (DR)-related lesions from fundus images based on a common analytical approach that is capable of identifying both red and bright lesions without requiring specific pre- or postprocessing. Our solution constructs a visual word dictionary representing points of interest (PoIs) located within regions marked by specialists that contain lesions associated with DR and classifies the fundus images based on the presence or absence of these PoIs as normal or DR-related pathology. The novelty of our approach is in locating DR lesions in the optic fundus images using visual words that combines feature information contained within the images in a framework easily extendible to different types of retinal lesions or pathologies and builds a specific projection space for each class of interest (e.g., white lesions such as exudates or normal regions) instead of a common dictionary for all classes. The visual words dictionary was applied to classifying bright and red lesions with classical cross validation and cross dataset validation to indicate the robustness of this approach. We obtained an area under the curve (AUC) of 95.3% for white lesion detection and an AUC of 93.3% for red lesion detection using fivefold cross validation and our own data consisting of 687 images of normal retinae, 245 images with bright lesions, 191 with red lesions, and 109 with signs of both bright and red lesions. For cross dataset analysis, the visual dictionary also achieves compelling results using our images as the training set and the RetiDB and Messidor images as test sets. In this case, the image classification resulted in an AUC of 88.1% when classifying the RetiDB dataset and in an AUC of 89.3% when classifying the Messidor dataset, both cases for bright lesion detection. The results indicate the potential for training with different acquisition images under different setup conditions with a high accuracy of referral based on the presence of either red or bright lesions or both. The robustness of the visual dictionary against image quality (blurring), resolution, and retinal background, makes it a strong candidate for DR screening of large, diverse communities with varying cameras and settings and levels of expertise for image capture. [ABSTRACT FROM PUBLISHER]

Reliable microaneurysm detection in digital fundus images is still an open issue in medical image processing. We propose an ensemble-based framework to improve microaneurysm detection. Unlike the well-known approach of considering the output of multiple classifiers, we propose a combination of internal components of microaneurysm detectors, namely preprocessing methods and candidate extractors. We have evaluated our approach for microaneurysm detection in an online competition, where this algorithm is currently ranked as first, and also on two other databases. Since microaneurysm detection is decisive in diabetic retinopathy (DR) grading, we also tested the proposed method for this task on the publicly available Messidor database, where a promising AUC 0.90 \pm 0.01 is achieved in a “DR/non-DR”-type classification based on the presence or absence of the microaneurysms. [ABSTRACT FROM PUBLISHER]

Accurate segmentation of the cup region from retinal images is needed to derive relevant measurements for glaucoma assessment. A novel, depth discontinuity (in the retinal surface)-based approach to estimate the cup boundary is proposed in this paper. The proposed approach shifts focus from the cup region used by existing approaches to cup boundary. The given set of images, acquired sequentially, are related via a relative motion model and the depth discontinuity at the cup boundary is determined from cues such as motion boundary and partial occlusion. The information encoded by these cues is used to approximate the cup boundary with a set of best-fitting circles. The final boundary is found by considering points on these circles at different sectors using a confidence measure. Four different kinds of data sets ranging from synthetic to real image pairs, covering different multiview scenarios, have been used to evaluate the proposed method. The proposed method was found to yield an error reduction of 16% for cup-to-disk vertical diameter ratio (CDR) and 13% for cup-to-disk area ratio (CAR) estimation, over an existing monocular image-based cup segmentation method. The error reduction increased to 33% in CDR and 18% in CAR with the addition of a third view (image) which indicates the potential of the proposed approach. [ABSTRACT FROM PUBLISHER]

In an effort toward standardization, this paper evaluates the performance of five eye-movement classification algorithms in terms of their assessment of oculomotor fixation and saccadic behavior. The results indicate that performance of these five commonly used algorithms vary dramatically, even in the case of a simple stimulus-evoked task using a single, common threshold value. The important contributions of this paper are: evaluation and comparison of performance of five algorithms to classify specific oculomotor behavior; introduction and comparison of new standardized scores to provide more reliable classification performance; logic for a reasonable threshold-value selection for any eye-movement classification algorithm based on the standardized scores; and logic for establishing a criterion-based baseline for performance comparison between any eye-movement classification algorithms. Proposed techniques enable efficient and objective clinical applications providing means to assure meaningful automated eye-movement classification. [ABSTRACT FROM PUBLISHER]