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Al-Absi HRH, Pai A, Naeem U, Mohamed FK, Arya S, Sbeit RA, Bashir M, El Shafei MM, El Hajj N, Alam T. DiaNet v2 deep learning based method for diabetes diagnosis using retinal images. Sci Rep 2024; 14:1595. [PMID: 38238377 PMCID: PMC10796402 DOI: 10.1038/s41598-023-49677-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 12/11/2023] [Indexed: 01/22/2024] Open
Abstract
Diabetes mellitus (DM) is a prevalent chronic metabolic disorder linked to increased morbidity and mortality. With a significant portion of cases remaining undiagnosed, particularly in the Middle East North Africa (MENA) region, more accurate and accessible diagnostic methods are essential. Current diagnostic tests like fasting plasma glucose (FPG), oral glucose tolerance tests (OGTT), random plasma glucose (RPG), and hemoglobin A1c (HbA1c) have limitations, leading to misclassifications and discomfort for patients. The aim of this study is to enhance diabetes diagnosis accuracy by developing an improved predictive model using retinal images from the Qatari population, addressing the limitations of current diagnostic methods. This study explores an alternative approach involving retinal images, building upon the DiaNet model, the first deep learning model for diabetes detection based solely on retinal images. The newly proposed DiaNet v2 model is developed using a large dataset from Qatar Biobank (QBB) and Hamad Medical Corporation (HMC) covering wide range of pathologies in the the retinal images. Utilizing the most extensive collection of retinal images from the 5545 participants (2540 diabetic patients and 3005 control), DiaNet v2 is developed for diabetes diagnosis. DiaNet v2 achieves an impressive accuracy of over 92%, 93% sensitivity, and 91% specificity in distinguishing diabetic patients from the control group. Given the high prevalence of diabetes and the limitations of existing diagnostic methods in clinical setup, this study proposes an innovative solution. By leveraging a comprehensive retinal image dataset and applying advanced deep learning techniques, DiaNet v2 demonstrates a remarkable accuracy in diabetes diagnosis. This approach has the potential to revolutionize diabetes detection, providing a more accessible, non-invasive and accurate method for early intervention and treatment planning, particularly in regions with high diabetes rates like MENA.
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Affiliation(s)
- Hamada R H Al-Absi
- College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar
| | - Anant Pai
- Ophthalmology Section, Department of Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Usman Naeem
- Ophthalmology Section, Department of Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Fatma Kassem Mohamed
- Ophthalmology Section, Department of Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Saket Arya
- Ophthalmology Section, Department of Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Rami Abu Sbeit
- Ophthalmology Section, Department of Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Mohammed Bashir
- Endocrine Section, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar
| | | | - Nady El Hajj
- College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Tanvir Alam
- College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar.
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Selvachandran G, Quek SG, Paramesran R, Ding W, Son LH. Developments in the detection of diabetic retinopathy: a state-of-the-art review of computer-aided diagnosis and machine learning methods. Artif Intell Rev 2023; 56:915-964. [PMID: 35498558 PMCID: PMC9038999 DOI: 10.1007/s10462-022-10185-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2022] [Indexed: 02/02/2023]
Abstract
The exponential increase in the number of diabetics around the world has led to an equally large increase in the number of diabetic retinopathy (DR) cases which is one of the major complications caused by diabetes. Left unattended, DR worsens the vision and would lead to partial or complete blindness. As the number of diabetics continue to increase exponentially in the coming years, the number of qualified ophthalmologists need to increase in tandem in order to meet the demand for screening of the growing number of diabetic patients. This makes it pertinent to develop ways to automate the detection process of DR. A computer aided diagnosis system has the potential to significantly reduce the burden currently placed on the ophthalmologists. Hence, this review paper is presented with the aim of summarizing, classifying, and analyzing all the recent development on automated DR detection using fundus images from 2015 up to this date. Such work offers an unprecedentedly thorough review of all the recent works on DR, which will potentially increase the understanding of all the recent studies on automated DR detection, particularly on those that deploys machine learning algorithms. Firstly, in this paper, a comprehensive state-of-the-art review of the methods that have been introduced in the detection of DR is presented, with a focus on machine learning models such as convolutional neural networks (CNN) and artificial neural networks (ANN) and various hybrid models. Each AI will then be classified according to its type (e.g. CNN, ANN, SVM), its specific task(s) in performing DR detection. In particular, the models that deploy CNN will be further analyzed and classified according to some important properties of the respective CNN architectures of each model. A total of 150 research articles related to the aforementioned areas that were published in the recent 5 years have been utilized in this review to provide a comprehensive overview of the latest developments in the detection of DR. Supplementary Information The online version contains supplementary material available at 10.1007/s10462-022-10185-6.
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Affiliation(s)
- Ganeshsree Selvachandran
- Department of Actuarial Science and Applied Statistics, Faculty of Business & Management, UCSI University, Jalan Menara Gading, Cheras, 56000 Kuala Lumpur, Malaysia
| | - Shio Gai Quek
- Department of Actuarial Science and Applied Statistics, Faculty of Business & Management, UCSI University, Jalan Menara Gading, Cheras, 56000 Kuala Lumpur, Malaysia
| | - Raveendran Paramesran
- Institute of Computer Science and Digital Innovation, UCSI University, Jalan Menara Gading, Cheras, 56000 Kuala Lumpur, Malaysia
| | - Weiping Ding
- School of Information Science and Technology, Nantong University, Nantong, 226019 People’s Republic of China
| | - Le Hoang Son
- VNU Information Technology Institute, Vietnam National University, Hanoi, Vietnam
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Jena M, Mishra D, Mishra SP, Mallick PK. A Tailored Complex Medical Decision Analysis Model for Diabetic Retinopathy Classification Based on Optimized Un-Supervised Feature Learning Approach. ARABIAN JOURNAL FOR SCIENCE AND ENGINEERING 2022. [DOI: 10.1007/s13369-022-07057-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Maslinic Acid Protects against Streptozotocin-Induced Diabetic Retinopathy by Activating Nrf2 and Suppressing NF-κB. J Ophthalmol 2022; 2022:3044202. [PMID: 35265366 PMCID: PMC8901311 DOI: 10.1155/2022/3044202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/15/2022] [Accepted: 01/19/2022] [Indexed: 12/17/2022] Open
Abstract
This study tested the protective effect of maslinic acid (MA) against diabetic retinopathy (DR) in rats with type 1 diabetes mellitus (T1DM) and investigated possible mechanisms of action. DM was introduced by streptozotocin (STZ) (65 mg/kg, i.p.). Control and STZ (T1DM) were divided into 2 subgroups, which received either the vehicle or MA (80 mg/kg). Serum, pancreases, and retinas were collected for further use. MA significantly reduced fasting glucose levels in the control and T1DM rats but enhanced fasting insulin levels and partially increased the size of the islets of Langerhans and the number of β-cells in T1DM rats. In addition, MA significantly improved the retina structure by preventing the reduction in the area between the inner and outer limiting membranes (ILM and OLM, respectively) and increasing the number of cells forming the ganglion cell layer (GCL), inner nuclear layer (INL), and outer nuclear layer (ONL). Associated with these effects, MA significantly reduced the total levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6), as well as the nuclear levels of NF-κB p65, mRNA levels of Bax, and protein levels of cleaved caspase-3 in the retinas of T1DM rats. However, MA significantly lowered levels of reactive oxygen species (ROS) and malondialdehyde (MDA) but significantly increased the nuclear levels of Nrf2, protein levels of Bcl2, and total levels of superoxide dismutase (SOD) and reduced glutathione (GSH) in the retinas of the control and T1DM rats. In conclusion, MA prevents DR by antioxidant potential mediated by the activation of Nrf2.
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Yao F, Jiang X, Qiu L, Peng Z, Zheng W, Ding L, Xia X. Long-Term Oral Administration of Salidroside Alleviates Diabetic Retinopathy in db/db Mice. Front Endocrinol (Lausanne) 2022; 13:861452. [PMID: 35370972 PMCID: PMC8966089 DOI: 10.3389/fendo.2022.861452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
Diabetic retinopathy (DR), a microvascular complication of diabetes mellitus, is the leading cause of vision loss in the working-age population worldwide. Unfortunately, current clinical treatments cannot completely prevent the occurrence and development of DR. Salidroside (Sal) is a medicinal supplement that has antioxidative and cytoprotective properties. This study aimed to investigate the therapeutic effect of Sal on DR. Briefly, Sal treatment was applied to wide-type mice and db/db mice (a widely used diabetic mice) at 25 mg/kg by oral gavage once daily from 8 weeks to 20 weeks. Mice's bodyweight, blood glucose, total cholesterol, triglyceride, high density lipoprotein and low density lipoprotein were recorded and analyzed. Retinal trypsin digestion and evans blue dye assay were used to detect retinal microvessel changes and function. Retinal glutathione and malondialdehyde content measurements were applied to assess retinal oxidative stress. Full-length transcriptome analysis was performed to explore the underlying mechanisms of Sal protection. Our results found that Sal treatment could successfully relieve blood glucose and blood lipid abnormalities, and reduce retinal oxidative stress level in diabetic mice. Also, Sal treatment repaired the abnormal transcriptome caused by diabetes, alleviated the microvascular lesion of the fundus in diabetic mice, and protected retinal normal barrier function. This study enriches the indications of Sal in the treatment of diabetic diseases, providing practical research ideas for the comprehensive preventions and treatments of DR.
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Affiliation(s)
- Fei Yao
- Eye Center of Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Ophthalmology, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Xinyi Jiang
- Bio-Manufacturing Engineering Laboratory, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, China
| | - Ling Qiu
- Eye Center of Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Zixuan Peng
- Eye Center of Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Ophthalmology, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Wei Zheng
- Eye Center of Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Ophthalmology, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
- *Correspondence: Xiaobo Xia, ; Lexi Ding, ; Wei Zheng,
| | - Lexi Ding
- Eye Center of Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Ophthalmology, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
- *Correspondence: Xiaobo Xia, ; Lexi Ding, ; Wei Zheng,
| | - Xiaobo Xia
- Eye Center of Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Ophthalmology, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
- *Correspondence: Xiaobo Xia, ; Lexi Ding, ; Wei Zheng,
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Choudhury A, Renjilian E, Asan O. Use of machine learning in geriatric clinical care for chronic diseases: a systematic literature review. JAMIA Open 2020; 3:459-471. [PMID: 33215079 PMCID: PMC7660963 DOI: 10.1093/jamiaopen/ooaa034] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/26/2020] [Accepted: 07/11/2020] [Indexed: 12/13/2022] Open
Abstract
Objectives Geriatric clinical care is a multidisciplinary assessment designed to evaluate older patients’ (age 65 years and above) functional ability, physical health, and cognitive well-being. The majority of these patients suffer from multiple chronic conditions and require special attention. Recently, hospitals utilize various artificial intelligence (AI) systems to improve care for elderly patients. The purpose of this systematic literature review is to understand the current use of AI systems, particularly machine learning (ML), in geriatric clinical care for chronic diseases. Materials and Methods We restricted our search to eight databases, namely PubMed, WorldCat, MEDLINE, ProQuest, ScienceDirect, SpringerLink, Wiley, and ERIC, to analyze research articles published in English between January 2010 and June 2019. We focused on studies that used ML algorithms in the care of geriatrics patients with chronic conditions. Results We identified 35 eligible studies and classified in three groups: psychological disorder (n = 22), eye diseases (n = 6), and others (n = 7). This review identified the lack of standardized ML evaluation metrics and the need for data governance specific to health care applications. Conclusion More studies and ML standardization tailored to health care applications are required to confirm whether ML could aid in improving geriatric clinical care.
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Affiliation(s)
- Avishek Choudhury
- School of Systems and Enterprises, Stevens Institute of Technology, Hoboken, New Jersey, USA
| | - Emily Renjilian
- School of Systems and Enterprises, Stevens Institute of Technology, Hoboken, New Jersey, USA
| | - Onur Asan
- School of Systems and Enterprises, Stevens Institute of Technology, Hoboken, New Jersey, USA
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Abstract
OBJECTIVES This survey analyses the latest literature contributions to clinical decision support systems (DSSs) on a two-year period (2017-2018), focusing on the approaches that adopt Artificial Intelligence (AI) techniques in a broad sense. The goal is to analyse the distribution of data-driven AI approaches with respect to "classical" knowledge-based ones, and to consider the issues raised and their possible solutions. METHODS We included PubMed and Web of ScienceTM publications, focusing on contributions describing clinical DSSs that adopted one or more AI methodologies. RESULTS We selected 75 papers, 49 of which describe approaches in the data-driven AI area, 20 present purely knowledge-based DSSs, and 6 adopt hybrid approaches relying on both formalized knowledge and data. CONCLUSIONS Recent studies in the clinical DSS area demonstrate a prevalence of data-driven AI, which can be adopted autonomously in purely data-driven systems, or in cooperation with domain knowledge in hybrid systems. Such hybrid approaches, able to conjugate all available knowledge sources through proper knowledge integration steps, represent an interesting example of synergy between the two AI categories. This synergy can lead to the resolution of some existing issues, such as the need for transparency and explainability, nowadays recognized as central themes to be addressed by both AI and medical informatics research.
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Affiliation(s)
- Stefania Montani
- DISIT, Computer Science Institute, University of Piemonte Orientale, Alessandria, Italy
| | - Manuel Striani
- DISIT, Computer Science Institute, University of Piemonte Orientale, Alessandria, Italy
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Hogarty DT, Mackey DA, Hewitt AW. Current state and future prospects of artificial intelligence in ophthalmology: a review. Clin Exp Ophthalmol 2018; 47:128-139. [DOI: 10.1111/ceo.13381] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 08/25/2018] [Indexed: 12/23/2022]
Affiliation(s)
- Daniel T Hogarty
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne; Melbourne Victoria Australia
| | - David A Mackey
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne; Melbourne Victoria Australia
- Lions Eye Institute, Centre for Vision Sciences, University of Western Australia; Perth Western Australia Australia
- Menzies Institute for Medical Research, University of Tasmania; Hobart Tasmania Australia
| | - Alex W Hewitt
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne; Melbourne Victoria Australia
- Lions Eye Institute, Centre for Vision Sciences, University of Western Australia; Perth Western Australia Australia
- Menzies Institute for Medical Research, University of Tasmania; Hobart Tasmania Australia
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Kaur J, Mittal D. Estimation of severity level of non-proliferative diabetic retinopathy for clinical aid. Biocybern Biomed Eng 2018. [DOI: 10.1016/j.bbe.2018.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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