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Driban M, Yan A, Selvam A, Ong J, Vupparaboina KK, Chhablani J. Artificial intelligence in chorioretinal pathology through fundoscopy: a comprehensive review. Int J Retina Vitreous 2024; 10:36. [PMID: 38654344 PMCID: PMC11036694 DOI: 10.1186/s40942-024-00554-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Applications for artificial intelligence (AI) in ophthalmology are continually evolving. Fundoscopy is one of the oldest ocular imaging techniques but remains a mainstay in posterior segment imaging due to its prevalence, ease of use, and ongoing technological advancement. AI has been leveraged for fundoscopy to accomplish core tasks including segmentation, classification, and prediction. MAIN BODY In this article we provide a review of AI in fundoscopy applied to representative chorioretinal pathologies, including diabetic retinopathy and age-related macular degeneration, among others. We conclude with a discussion of future directions and current limitations. SHORT CONCLUSION As AI evolves, it will become increasingly essential for the modern ophthalmologist to understand its applications and limitations to improve patient outcomes and continue to innovate.
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Affiliation(s)
- Matthew Driban
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Audrey Yan
- Department of Medicine, West Virginia School of Osteopathic Medicine, Lewisburg, WV, USA
| | - Amrish Selvam
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Joshua Ong
- Michigan Medicine, University of Michigan, Ann Arbor, USA
| | | | - Jay Chhablani
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
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Fea AM, Ricardi F, Novarese C, Cimorosi F, Vallino V, Boscia G. Precision Medicine in Glaucoma: Artificial Intelligence, Biomarkers, Genetics and Redox State. Int J Mol Sci 2023; 24:2814. [PMID: 36769127 PMCID: PMC9917798 DOI: 10.3390/ijms24032814] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/07/2023] [Accepted: 01/18/2023] [Indexed: 02/05/2023] Open
Abstract
Glaucoma is a multifactorial neurodegenerative illness requiring early diagnosis and strict monitoring of the disease progression. Current exams for diagnosis and prognosis are based on clinical examination, intraocular pressure (IOP) measurements, visual field tests, and optical coherence tomography (OCT). In this scenario, there is a critical unmet demand for glaucoma-related biomarkers to enhance clinical testing for early diagnosis and tracking of the disease's development. The introduction of validated biomarkers would allow for prompt intervention in the clinic to help with prognosis prediction and treatment response monitoring. This review aims to report the latest acquisitions on biomarkers in glaucoma, from imaging analysis to genetics and metabolic markers.
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An Image Examination System for Retinal Optic Disc mining and Analysis with Social Group Optimization Algorithm. INTERNATIONAL JOURNAL OF SWARM INTELLIGENCE RESEARCH 2022. [DOI: 10.4018/ijsir.300370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This work aims to develop a hybrid image examination system to extract and evaluate the Optic Disc (OD) from the Age-related Macular Degeneration (AMD) and Non-AMD class Digital Fundus Retinal Image (DFRI). This work implements an image pre-processing through Shannon’s Entropy and Social Group Optimization (SE+SGO) based thresholding and image post-processing with Level Set Segmentation (LSS). A relative study among the extracted OD and the ground-truth is then executed to compute the vital Picture Similarity Parameters (PSP). This study also presents a detailed pixel level data analysis practice on the extracted OD. Finally, the performance of the LSS is then validated against the existing segmentation techniques, such as Chan-Vese, Active-Contour and k-means clustering. The proposed work is executed on the iChallenge-AMD-2018 DFRI (400 images) and the results confirm that, proposed hybrid tool helps to achieve better values of Jaccard (86.82%), Dice (91.78%), Accuracy (98.94%), Precision (92.86%), Sensitivity (94.06%), and Specificity (99.46%).
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Accurate Diagnosis of Diabetic Retinopathy and Glaucoma Using Retinal Fundus Images Based on Hybrid Features and Genetic Algorithm. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11136178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Diabetic retinopathy (DR) and glaucoma can both be incurable if they are not detected early enough. Therefore, ophthalmologists worldwide are striving to detect them by personally screening retinal fundus images. However, this procedure is not only tedious, subjective, and labor-intensive, but also error-prone. Worse yet, it may not even be attainable in some countries where ophthalmologists are in short supply. A practical solution to this complicated problem is a computer-aided diagnosis (CAD) system—the objective of this work. We propose an accurate system to detect at once any of the two diseases from retinal fundus images. The accuracy stems from two factors. First, we calculate a large set of hybrid features belonging to three groups: first-order statistics (FOS), higher-order statistics (HOS), and histogram of oriented gradient (HOG). Then, these features are skillfully reduced using a genetic algorithm scheme that selects only the most relevant and significant of them. Finally, the selected features are fed to a classifier to detect one of three classes: DR, glaucoma, or normal. Four classifiers are tested for this job: decision tree (DT), naive Bayes (NB), k-nearest neighbor (kNN), and linear discriminant analysis (LDA). The experimental work, conducted on three publicly available datasets, two of them merged into one, shows impressive performance in terms of four standard classification metrics, each computed using k-fold crossvalidation for added credibility. The highest accuracy has been provided by DT—96.67% for DR, 100% for glaucoma, and 96.67% for normal.
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Barros DMS, Moura JCC, Freire CR, Taleb AC, Valentim RAM, Morais PSG. Machine learning applied to retinal image processing for glaucoma detection: review and perspective. Biomed Eng Online 2020; 19:20. [PMID: 32293466 PMCID: PMC7160894 DOI: 10.1186/s12938-020-00767-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 04/06/2020] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION This is a systematic review on the main algorithms using machine learning (ML) in retinal image processing for glaucoma diagnosis and detection. ML has proven to be a significant tool for the development of computer aided technology. Furthermore, secondary research has been widely conducted over the years for ophthalmologists. Such aspects indicate the importance of ML in the context of retinal image processing. METHODS The publications that were chosen to compose this review were gathered from Scopus, PubMed, IEEEXplore and Science Direct databases. Then, the papers published between 2014 and 2019 were selected . Researches that used the segmented optic disc method were excluded. Moreover, only the methods which applied the classification process were considered. The systematic analysis was performed in such studies and, thereupon, the results were summarized. DISCUSSION Based on architectures used for ML in retinal image processing, some studies applied feature extraction and dimensionality reduction to detect and isolate important parts of the analyzed image. Differently, other works utilized a deep convolutional network. Based on the evaluated researches, the main difference between the architectures is the number of images demanded for processing and the high computational cost required to use deep learning techniques. CONCLUSIONS All the analyzed publications indicated it was possible to develop an automated system for glaucoma diagnosis. The disease severity and its high occurrence rates justify the researches which have been carried out. Recent computational techniques, such as deep learning, have shown to be promising technologies in fundus imaging. Although such a technique requires an extensive database and high computational costs, the studies show that the data augmentation and transfer learning techniques have been applied as an alternative way to optimize and reduce networks training.
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Affiliation(s)
- Daniele M S Barros
- Laboratory of Technological Innovation in Health, Federal University of Rio Grande do Norte, Natal, Brazil.
| | - Julio C C Moura
- Laboratory of Technological Innovation in Health, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Cefas R Freire
- Laboratory of Technological Innovation in Health, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | - Ricardo A M Valentim
- Laboratory of Technological Innovation in Health, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Philippi S G Morais
- Laboratory of Technological Innovation in Health, Federal University of Rio Grande do Norte, Natal, Brazil
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Leaf Counting with Multi-Scale Convolutional Neural Network Features and Fisher Vector Coding. Symmetry (Basel) 2019. [DOI: 10.3390/sym11040516] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The number of leaves in maize plant is one of the key traits describing its growth conditions. It is directly related to plant development and leaf counts also give insight into changing plant development stages. Compared with the traditional solutions which need excessive human interventions, the methods of computer vision and machine learning are more efficient. However, leaf counting with computer vision remains a challenging problem. More and more researchers are trying to improve accuracy. To this end, an automated, deep learning based approach for counting leaves in maize plants is developed in this paper. A Convolution Neural Network(CNN) is used to extract leaf features. The CNN model in this paper is inspired by Google Inception Net V3, which using multi-scale convolution kernels in one convolution layer. To compress feature maps generated from some middle layers in CNN, the Fisher Vector (FV) is used to reduce redundant information. Finally, these encoded feature maps are used to regress the leaf numbers by using Random Forests. To boost the related research, a relatively single maize image dataset (Different growth stage with 2845 samples, which 80% for train and 20% for test) is constructed by our team. The proposed algorithm in single maize data set achieves Mean Square Error (MSE) of 0.32.
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de Souza LA, Afonso LCS, Ebigbo A, Probst A, Messmann H, Mendel R, Hook C, Palm C, Papa JP. Learning visual representations with optimum-path forest and its applications to Barrett’s esophagus and adenocarcinoma diagnosis. Neural Comput Appl 2019. [DOI: 10.1007/s00521-018-03982-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Li F, Chen H, Liu Z, Zhang X, Wu Z. Fully automated detection of retinal disorders by image-based deep learning. Graefes Arch Clin Exp Ophthalmol 2019; 257:495-505. [PMID: 30610422 DOI: 10.1007/s00417-018-04224-8] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 12/10/2018] [Accepted: 12/18/2018] [Indexed: 12/12/2022] Open
Abstract
PURPOSE With the aging population and the global diabetes epidemic, the prevalence of age-related macular degeneration (AMD) and diabetic macular edema (DME) diseases which are the leading causes of blindness is further increasing. Intravitreal injections with anti-vascular endothelial growth factor (anti-VEGF) medications are the standard of care for their indications. Optical coherence tomography (OCT), as a noninvasive imaging modality, plays a major part in guiding the administration of anti-VEGF therapy by providing detailed cross-sectional scans of the retina pathology. Fully automating OCT image detection can significantly decrease the tedious clinician labor and obtain a faithful pre-diagnosis from the analysis of the structural elements of the retina. Thereby, we explore the use of deep transfer learning method based on the visual geometry group 16 (VGG-16) network for classifying AMD and DME in OCT images accurately and automatically. METHOD A total of 207,130 retinal OCT images between 2013 and 2017 were selected from retrospective cohorts of 5319 adult patients from the Shiley Eye Institute of the University of California San Diego, the California Retinal Research Foundation, Medical Center Ophthalmology Associates, the Shanghai First People's Hospital, and the Beijing Tongren Eye Center, with 109,312 images (37,456 with choroidal neovascularization, 11,599 with diabetic macular edema, 8867 with drusen, and 51,390 normal) for the experiment. After images preprocessing, 1000 images (250 images from each category) from 633 patients were selected as validation dataset while the rest images from another 4686 patients were used as training dataset. We used deep transfer learning method to fine-tune the VGG-16 network pre-trained on the ImageNet dataset, and evaluated its performance on the validation dataset. Then, prediction accuracy, sensitivity, specificity, and receiver-operating characteristic (ROC) were calculated. RESULTS Experimental results proved that the proposed approach had manifested superior performance in retinal OCT images detection, which achieved a prediction accuracy of 98.6%, with a sensitivity of 97.8%, a specificity of 99.4%, and introduced an area under the ROC curve of 100%. CONCLUSION Deep transfer learning method based on the VGG-16 network shows significant effectiveness on classification of retinal OCT images with a relatively small dataset, which can provide assistant support for medical decision-making. Moreover, the performance of the proposed approach is comparable to that of human experts with significant clinical experience. Thereby, it will find promising applications in an automatic diagnosis and classification of common retinal diseases.
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Affiliation(s)
- Feng Li
- School of Optical-Electrical and Computer Engineering, University of Shanghai for Science and Technology, Shanghai, 200093, China
| | - Hua Chen
- School of Optical-Electrical and Computer Engineering, University of Shanghai for Science and Technology, Shanghai, 200093, China.
| | - Zheng Liu
- School of Optical-Electrical and Computer Engineering, University of Shanghai for Science and Technology, Shanghai, 200093, China
| | - Xuedian Zhang
- School of Optical-Electrical and Computer Engineering, University of Shanghai for Science and Technology, Shanghai, 200093, China
| | - Zhizheng Wu
- Department of Precision Mechanical Engineering, Shanghai University, Shanghai, 200072, China
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Hagiwara Y, Koh JEW, Tan JH, Bhandary SV, Laude A, Ciaccio EJ, Tong L, Acharya UR. Computer-aided diagnosis of glaucoma using fundus images: A review. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2018; 165:1-12. [PMID: 30337064 DOI: 10.1016/j.cmpb.2018.07.012] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 07/02/2018] [Accepted: 07/25/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND AND OBJECTIVES Glaucoma is an eye condition which leads to permanent blindness when the disease progresses to an advanced stage. It occurs due to inappropriate intraocular pressure within the eye, resulting in damage to the optic nerve. Glaucoma does not exhibit any symptoms in its nascent stage and thus, it is important to diagnose early to prevent blindness. Fundus photography is widely used by ophthalmologists to assist in diagnosis of glaucoma and is cost-effective. METHODS The morphological features of the disc that is characteristic of glaucoma are clearly seen in the fundus images. However, manual inspection of the acquired fundus images may be prone to inter-observer variation. Therefore, a computer-aided detection (CAD) system is proposed to make an accurate, reliable and fast diagnosis of glaucoma based on the optic nerve features of fundus imaging. In this paper, we reviewed existing techniques to automatically diagnose glaucoma. RESULTS The use of CAD is very effective in the diagnosis of glaucoma and can assist the clinicians to alleviate their workload significantly. We have also discussed the advantages of employing state-of-art techniques, including deep learning (DL), when developing the automated system. The DL methods are effective in glaucoma diagnosis. CONCLUSIONS Novel DL algorithms with big data availability are required to develop a reliable CAD system. Such techniques can be employed to diagnose other eye diseases accurately.
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Affiliation(s)
- Yuki Hagiwara
- Department of Electronics and Computer Engineering, Ngee Ann Polytechnic, 599489, Singapore
| | - Joel En Wei Koh
- Department of Electronics and Computer Engineering, Ngee Ann Polytechnic, 599489, Singapore
| | - Jen Hong Tan
- National University of Singapore, Institute of System Science
| | | | - Augustinus Laude
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | | | - Louis Tong
- Ocular Surface Research Group, Singapore Eye Research Institute, Singapore; Cornea and External Eye Disease Service, Singapore National Eye Center, Singapore; Eye Academic Clinical Program, Duke-NUS Medical School, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - U Rajendra Acharya
- Department of Electronics and Computer Engineering, Ngee Ann Polytechnic, 599489, Singapore; Department of Biomedical Engineering, School of Science and Technology, Singapore School of Social Sciences, Singapore; School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia.
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