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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]

Detection of vascular bifurcations is a challenging task in multimodal retinal image registration. Existing algorithms based on bifurcations usually fail in correctly aligning poor quality retinal image pairs. To solve this problem, we propose a novel highly distinctive local feature descriptor named partial intensity invariant feature descriptor (PIIFD) and describe a robust automatic retinal image registration framework named Harris-PIIFD. PIIFD is invariant to image rotation, partially invariant to image intensity, affine transformation, and viewpoint/perspective change. Our Harris-PIIFD framework consists of four steps. First, corner points are used as control point candidates instead of bifurcations since corner points are sufficient and uniformly distributed across the image domain. Second, PIIFDs are extracted for all corner points, and a bilateral matching technique is applied to identify corresponding PIIFDs matches between image pairs. Third, incorrect matches are removed and inaccurate matches are refined. Finally, an adaptive transformation is used to register the image pairs. PIIFD is so distinctive that it can be correctly identified even in nonvascular areas. When tested on 168 pairs of multimodal retinal images, the Harris-PIIFD far outperforms existing algorithms in terms of robustness, accuracy, and computational efficiency. [ABSTRACT FROM AUTHOR]

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]

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 × 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. [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 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]

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]

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]

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]

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]

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]

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]

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.

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]

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]

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]

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. [ABSTRACT FROM AUTHOR]

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) outliers in the training data; 4) segmentation and alignment errors. Robustness to illumination variation is achieved by a novel iterative 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. [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]