Robust Retinal Vessel Segmentation via Locally Adaptive Derivative Frames in Orientation Scores

An accurate unsupervised extraction of retinal vasculature using curvelet transform and classical morphological operators

BACKGROUND

Many ophthalmic disorders such as diabetic retinopathy and hypertension can be early diagnosed by analyzing changes related to the vascular structure of the retina. Accuracy and efficiency of the segmentation of retinal blood vessels are important parameters that can help the ophthalmologist to better characterize the targeted anomalies.

METHOD

In this work, we propose a new method for accurate unsupervised automatic segmentation of retinal blood vessels based on a simple and adequate combination of classical filters. Initially, contrast of vessels in retinal image is significantly improved by adding the Curvelet Transform to commonly used Contrast-Limited Adaptive Histogram Equalization technique. Afterwards, a morphological operator using Top Hat is applied to highlight vascular network. Then, a global threshold-based Otsu technique using minimum of intra-class variance is applied for vessel detection. Finally, a cleanup operation based on Match Filter and First Derivative Order Gaussian with fixed parameters is used to remove unwanted or isolated segments. We test the proposed method on images from two publicly available STARE and DRIVE databases.

RESULTS

We achieve in terms of sensitivity, specificity and accuracy the respective average performances of 0.7407, 0.9878 and 0.9667 on the DRIVE database, then 0.7028, 0.9755 and 0.9507 on the STARE database.

CONCLUSIONS

Compared to some recent similar work, the obtained results are quite promising and can thus contribute to the optimization of automatic tools to aid in the diagnosis of eye disorders.

Partial class activation mapping guided graph convolution cascaded U-Net for retinal vessel segmentation

Accurate segmentation of retinal vessels in fundus images is of great importance for the diagnosis of numerous ocular diseases. However, due to the complex characteristics of fundus images, such as various lesions, image noise and complex background, the pixel features of some vessels have significant differences, which makes it easy for the segmentation networks to misjudge these vessels as noise, thus affecting the accuracy of the overall segmentation. Therefore, accurately segment retinal vessels in complex situations is still a great challenge. To address the problem, a partial class activation mapping guided graph convolution cascaded U-Net for retinal vessel segmentation is proposed. The core idea of the proposed network is first to use the partial class activation mapping guided graph convolutional network to eliminate the differences of local vessels and generate feature maps with global consistency, and subsequently these feature maps are further refined by segmentation network U-Net to achieve better segmentation results. Specifically, a new neural network block, called EdgeConv, is stacked multiple layers to form a graph convolutional network to realize the transfer an update of information from local to global, so as gradually enhance the feature consistency of graph nodes. Simultaneously, in an effort to suppress the noise information that may be transferred in graph convolution and thus reduce adverse effects of noise on segmentation results, the partial class activation mapping is introduced. The partial class activation mapping can guide the information transmission between graph nodes and effectively activate vessel feature through classification labels, thereby improving the accuracy of segmentation. The performance of the proposed method is validated on four different fundus image datasets. Compared with existing state-of-the-art methods, the proposed method can improve the integrity of vessel to a certain extent when the pixel features of local vessels are significantly different, caused by objective factors such as inappropriate illumination and exudates. Moreover, the proposed method shows robustness when segmenting complex retinal vessels.

Enhancing stroke risk and prognostic timeframe assessment with deep learning and a broad range of retinal biomarkers

Stroke stands as a major global health issue, causing high death and disability rates and significant social and economic burdens. The effectiveness of existing stroke risk assessment methods is questionable due to their use of inconsistent and varying biomarkers, which may lead to unpredictable risk evaluations. This study introduces an automatic deep learning-based system for predicting stroke risk (both ischemic and hemorrhagic) and estimating the time frame of its occurrence, utilizing a comprehensive set of known retinal biomarkers from fundus images. Our system, tested on the UK Biobank and DRSSW datasets, achieved AUROC scores of 0.83 (95% CI: 0.79-0.85) and 0.93 (95% CI: 0.9-0.95), respectively. These results not only highlight our system's advantage over established benchmarks but also underscore the predictive power of retinal biomarkers in assessing stroke risk and the unique effectiveness of each biomarker. Additionally, the correlation between retinal biomarkers and cardiovascular diseases broadens the potential application of our system, making it a versatile tool for predicting a wide range of cardiovascular conditions.

CS-UNet: Cross-scale U-Net with Semantic-position dependencies for retinal vessel segmentation

Accurate retinal vessel segmentation is the prerequisite for early recognition and treatment of retina-related diseases. However, segmenting retinal vessels is still challenging due to the intricate vessel tree in fundus images, which has a significant number of tiny vessels, low contrast, and lesion interference. For this task, the u-shaped architecture (U-Net) has become the de-facto standard and has achieved considerable success. However, U-Net is a pure convolutional network, which usually shows limitations in global modelling. In this paper, we propose a novel Cross-scale U-Net with Semantic-position Dependencies (CS-UNet) for retinal vessel segmentation. In particular, we first designed a Semantic-position Dependencies Aggregator (SPDA) and incorporate it into each layer of the encoder to better focus on global contextual information by integrating the relationship of semantic and position. To endow the model with the capability of cross-scale interaction, the Cross-scale Relation Refine Module (CSRR) is designed to dynamically select the information associated with the vessels, which helps guide the up-sampling operation. Finally, we have evaluated CS-UNet on three public datasets: DRIVE, CHASE_DB1, and STARE. Compared to most existing state-of-the-art methods, CS-UNet demonstrated better performance.

Cross-modality Labeling Enables Noninvasive Capillary Quantification as a Sensitive Biomarker for Assessing Cardiovascular Risk

Purpose

We aim to use fundus fluorescein angiography (FFA) to label the capillaries on color fundus (CF) photographs and train a deep learning model to quantify retinal capillaries noninvasively from CF and apply it to cardiovascular disease (CVD) risk assessment.

Design

Cross-sectional and longitudinal study.

Participants

A total of 90732 pairs of CF-FFA images from 3893 participants for segmentation model development, and 49229 participants in the UK Biobank for association analysis.

Methods

We matched the vessels extracted from FFA and CF, and used vessels from FFA as labels to train a deep learning model (RMHAS-FA) to segment retinal capillaries using CF. We tested the model's accuracy on a manually labeled internal test set (FundusCapi). For external validation, we tested the segmentation model on 7 vessel segmentation datasets, and investigated the clinical value of the segmented vessels in predicting CVD events in the UK Biobank.

Main Outcome Measures

Area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity for segmentation. Hazard ratio (HR; 95% confidence interval [CI]) for Cox regression analysis.

Results

On the FundusCapi dataset, the segmentation performance was AUC = 0.95, accuracy = 0.94, sensitivity = 0.90, and specificity = 0.93. Smaller vessel skeleton density had a stronger correlation with CVD risk factors and incidence (P < 0.01). Reduced density of small vessel skeletons was strongly associated with an increased risk of CVD incidence and mortality for women (HR [95% CI] = 0.91 [0.84-0.98] and 0.68 [0.54-0.86], respectively).

Conclusions

Using paired CF-FFA images, we automated the laborious manual labeling process and enabled noninvasive capillary quantification from CF, supporting its potential as a sensitive screening method for identifying individuals at high risk of future CVD events.

Financial Disclosures

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Automatic artery/vein classification methods for retinal blood vessel: A review

Automatic retinal arteriovenous classification can assist ophthalmologists in disease early diagnosis. Deep learning-based methods and topological graph-based methods have become the main solutions for retinal arteriovenous classification in recent years. This paper reviews the automatic retinal arteriovenous classification methods from 2003 to 2022. Firstly, we compare different methods and provide comparison tables of the summary results. Secondly, we complete the classification of the public arteriovenous classification datasets and provide the annotation development tables of different datasets. Finally, we sort out the challenges of evaluation methods and provide a comprehensive evaluation system. Quantitative and qualitative analysis shows the changes in research hotspots over time, Quantitative and qualitative analyses reveal the evolution of research hotspots over time, highlighting the significance of exploring the integration of deep learning with topological information in future research.

Segment anything model for medical images?

The Segment Anything Model (SAM) is the first foundation model for general image segmentation. It has achieved impressive results on various natural image segmentation tasks. However, medical image segmentation (MIS) is more challenging because of the complex modalities, fine anatomical structures, uncertain and complex object boundaries, and wide-range object scales. To fully validate SAM's performance on medical data, we collected and sorted 53 open-source datasets and built a large medical segmentation dataset with 18 modalities, 84 objects, 125 object-modality paired targets, 1050K 2D images, and 6033K masks. We comprehensively analyzed different models and strategies on the so-called COSMOS 1050K dataset. Our findings mainly include the following: (1) SAM showed remarkable performance in some specific objects but was unstable, imperfect, or even totally failed in other situations. (2) SAM with the large ViT-H showed better overall performance than that with the small ViT-B. (3) SAM performed better with manual hints, especially box, than the Everything mode. (4) SAM could help human annotation with high labeling quality and less time. (5) SAM was sensitive to the randomness in the center point and tight box prompts, and may suffer from a serious performance drop. (6) SAM performed better than interactive methods with one or a few points, but will be outpaced as the number of points increases. (7) SAM's performance correlated to different factors, including boundary complexity, intensity differences, etc. (8) Finetuning the SAM on specific medical tasks could improve its average DICE performance by 4.39% and 6.68% for ViT-B and ViT-H, respectively. Codes and models are available at: https://github.com/yuhoo0302/Segment-Anything-Model-for-Medical-Images. We hope that this comprehensive report can help researchers explore the potential of SAM applications in MIS, and guide how to appropriately use and develop SAM.

Artificial intelligence and hemodynamic studies in optical coherence tomography angiography for diabetic retinopathy evaluation: A review

Diabetic retinopathy (DR) is a rapidly emerging retinal abnormality worldwide, which can cause significant vision loss by disrupting the vascular structure in the retina. Recently, optical coherence tomography angiography (OCTA) has emerged as an effective imaging tool for diagnosing and monitoring DR. OCTA produces high-quality 3-dimensional images and provides deeper visualization of retinal vessel capillaries and plexuses. The clinical relevance of OCTA in detecting, classifying, and planning therapeutic procedures for DR patients has been highlighted in various studies. Quantitative indicators obtained from OCTA, such as blood vessel segmentation of the retina, foveal avascular zone (FAZ) extraction, retinal blood vessel density, blood velocity, flow rate, capillary vessel pressure, and retinal oxygen extraction, have been identified as crucial hemodynamic features for screening DR using computer-aided systems in artificial intelligence (AI). AI has the potential to assist physicians and ophthalmologists in developing new treatment options. In this review, we explore how OCTA has impacted the future of DR screening and early diagnosis. It also focuses on how analysis methods have evolved over time in clinical trials. The future of OCTA imaging and its continued use in AI-assisted analysis is promising and will undoubtedly enhance the clinical management of DR.

A Review on Retinal Blood Vessel Enhancement and Segmentation Techniques for Color Fundus Photography

The retinal image is a trusted modality in biomedical image-based diagnosis of many ophthalmologic and cardiovascular diseases. Periodic examination of the retina can help in spotting these abnormalities in the early stage. However, to deal with today's large population, computerized retinal image analysis is preferred over manual inspection. The precise extraction of the retinal vessel is the first and decisive step for clinical applications. Every year, many more articles are added to the literature that describe new algorithms for the problem at hand. The majority of the review article is restricted to a fairly small number of approaches, assessment indices, and databases. In this context, a comprehensive review of different vessel extraction methods is inevitable. It includes the development of a first-hand classification of these methods. A bibliometric analysis of these articles is also presented. The benefits and drawbacks of the most commonly used techniques are summarized. The primary challenges, as well as the scope of possible changes, are discussed. In order to make a fair comparison, numerous assessment indices are considered. The findings of this survey could provide a new path for researchers for further work in this domain.

TDCAU-Net: retinal vessel segmentation using transformer dilated convolutional attention-based U-Net method

Retinal vessel segmentation plays a vital role in the medical field, facilitating the identification of numerous chronic conditions based on retinal vessel images. These conditions include diabetic retinopathy, hypertensive retinopathy, glaucoma, and others. Although the U-Net model has shown promising results in retinal vessel segmentation, it tends to struggle with fine branching and dense vessel segmentation. To further enhance the precision of retinal vessel segmentation, we propose a novel approach called transformer dilated convolution attention U-Net (TDCAU-Net), which builds upon the U-Net architecture with improved Transformer-based dilated convolution attention mechanisms. The proposed model retains the three-layer architecture of the U-Net network. The Transformer component enables the learning of contextual information for each pixel in the image, while the dilated convolution attention prevents information loss. The algorithm efficiently addresses several challenges to optimize blood vessel detection. The process starts with five-step preprocessing of the images, followed by chunking them into segments. Subsequently, the retinal images are fed into the modified U-Net network introduced in this paper for segmentation. The study employs eye fundus images from the DRIVE and CHASEDB1 databases for both training and testing purposes. Evaluation metrics are utilized to compare the algorithm's results with state-of-the-art methods. The experimental analysis on both databases demonstrates that the algorithm achieves high values of sensitivity, specificity, accuracy, and AUC. Specifically, for the first database, the achieved values are 0.8187, 0.9756, 0.9556, and 0.9795, respectively. For the second database, the corresponding values are 0.8243, 0.9836, 0.9738, and 0.9878, respectively. These results demonstrate that the proposed approach outperforms state-of-the-art methods, achieving higher performance on both datasets. The TDCAU-Net model presented in this study exhibits substantial capabilities in accurately segmenting fine branching and dense vessels. The segmentation performance of the network surpasses that of the U-Net algorithm and several mainstream methods.

SURVS: A Swin-Unet and game theory-based unsupervised segmentation method for retinal vessel

Medical images, especially intricate vascular structures, are costly and time-consuming to annotate manually. It is beneficial to investigate an unsupervised method for vessel segmentation, one that circumvents the manual annotation yet remains valuable for disease detection. In this study, we design an unsupervised retinal vessel segmentation model based on the Swin-Unet framework and game theory. First, we construct two extreme pseudo-mapping functions by changing the contrast of the images and obtain their corresponding pseudo-masks based the on binary segmentation method and mathematical morphology, then we prove that there exists a mapping function between pseudo-mappings such that its corresponding mask is closest to the ground true mask. To acquire the best-predicted mask, based on which, we second develop a model based on the Swin-Unet frame to solve the optimal mapping function, and introduce an Image Colorization proxy task to assist the learning of pixel-level feature representations. Third, since to the instability of two pseudo-masks, the predicted mask will inevitably have errors, inspired by the two-player, non-zero-sum, non-cooperative Neighbor's Collision game in game theory, a game filter is proposed in this paper to reduce the errors in the final predicted mask. Finally, we verify the effectiveness of the presented unsupervised retinal vessel segmentation model on DRIVE, STARE and CHASE_DB1 datasets, and extensive experiments show that has obvious advantages over image segmentation and conventional unsupervised models.

Computer-aided diagnostic system for hypertensive retinopathy: A review

Hypertensive Retinopathy (HR) is a retinal disease caused by elevated blood pressure for a prolonged period. There are no obvious signs in the early stages of high blood pressure, but it affects various body parts over time, including the eyes. HR is a biomarker for several illnesses, including retinal diseases, atherosclerosis, strokes, kidney disease, and cardiovascular risks. Early microcirculation abnormalities in chronic diseases can be diagnosed through retinal examination prior to the onset of major clinical consequences. Computer-aided diagnosis (CAD) plays a vital role in the early identification of HR with improved diagnostic accuracy, which is time-efficient and demands fewer resources. Recently, numerous studies have been reported on the automatic identification of HR. This paper provides a comprehensive review of the automated tasks of Artery-Vein (A/V) classification, Arteriovenous ratio (AVR) computation, HR detection (Binary classification), and HR severity grading. The review is conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. The paper discusses the clinical features of HR, the availability of datasets, existing methods used for A/V classification, AVR computation, HR detection, and severity grading, and performance evaluation metrics. The reviewed articles are summarized with classifiers details, adoption of different kinds of methodologies, performance comparisons, datasets details, their pros and cons, and computational platform. For each task, a summary and critical in-depth analysis are provided, as well as common research issues and challenges in the existing studies. Finally, the paper proposes future research directions to overcome challenges associated with data set availability, HR detection, and severity grading.

Multi-scale Bottleneck Residual Network for Retinal Vessel Segmentation

Precise segmentation of retinal vessels is crucial for the prevention and diagnosis of ophthalmic diseases. In recent years, deep learning has shown outstanding performance in retinal vessel segmentation. Many scholars are dedicated to studying retinal vessel segmentation methods based on color fundus images, but the amount of research works on Scanning Laser Ophthalmoscopy (SLO) images is very scarce. In addition, existing SLO image segmentation methods still have difficulty in balancing accuracy and model parameters. This paper proposes a SLO image segmentation model based on lightweight U-Net architecture called MBRNet, which solves the problems in the current research through Multi-scale Bottleneck Residual (MBR) module and attention mechanism. Concretely speaking, the MBR module expands the receptive field of the model at a relatively low computational cost and retains more detailed information. Attention Gate (AG) module alleviates the disturbance of noise so that the network can concentrate on vascular characteristics. Experimental results on two public SLO datasets demonstrate that by comparison to existing methods, the MBRNet has better segmentation performance with relatively few parameters.

CCS-UNet: a cross-channel spatial attention model for accurate retinal vessel segmentation

Precise segmentation of retinal vessels plays an important role in computer-assisted diagnosis. Deep learning models have been applied to retinal vessel segmentation, but the efficacy is limited by the significant scale variation of vascular structures and the intricate background of retinal images. This paper supposes a cross-channel spatial attention U-Net (CCS-UNet) for accurate retinal vessel segmentation. In comparison to other models based on U-Net, our model employes a ResNeSt block for the encoder-decoder architecture. The block has a multi-branch structure that enables the model to extract more diverse vascular features. It facilitates weight distribution across channels through the incorporation of soft attention, which effectively aggregates contextual information in vascular images. Furthermore, we suppose an attention mechanism within the skip connection. This mechanism serves to enhance feature integration across various layers, thereby mitigating the degradation of effective information. It helps acquire cross-channel information and enhance the localization of regions of interest, ultimately leading to improved recognition of vascular structures. In addition, the feature fusion module (FFM) module is used to provide semantic information for a more refined vascular segmentation map. We evaluated CCS-UNet based on five benchmark retinal image datasets, DRIVE, CHASEDB1, STARE, IOSTAR and HRF. Our proposed method exhibits superior segmentation efficacy compared to other state-of-the-art techniques with a global accuracy of 0.9617/0.9806/0.9766/0.9786/0.9834 and AUC of 0.9863/0.9894/0.9938/0.9902/0.9855 on DRIVE, CHASEDB1, STARE, IOSTAR and HRF respectively. Ablation studies are also performed to evaluate the the relative contributions of different architectural components. Our proposed model is potential for diagnostic aid of retinal diseases.

Retinal vessel segmentation via a Multi-resolution Contextual Network and adversarial learning

Timely and affordable computer-aided diagnosis of retinal diseases is pivotal in precluding blindness. Accurate retinal vessel segmentation plays an important role in disease progression and diagnosis of such vision-threatening diseases. To this end, we propose a Multi-resolution Contextual Network (MRC-Net) that addresses these issues by extracting multi-scale features to learn contextual dependencies between semantically different features and using bi-directional recurrent learning to model former-latter and latter-former dependencies. Another key idea is training in adversarial settings for foreground segmentation improvement through optimization of the region-based scores. This novel strategy boosts the performance of the segmentation network in terms of the Dice score (and correspondingly Jaccard index) while keeping the number of trainable parameters comparatively low. We have evaluated our method on three benchmark datasets, including DRIVE, STARE, and CHASE, demonstrating its superior performance as compared with competitive approaches elsewhere in the literature.

Enhancing fine retinal vessel segmentation: Morphological reconstruction and double thresholds filtering strategy

Eye diseases such as diabetic retinopathy are progressive with various changes in the retinal vessels, and it is difficult to analyze the disease for future treatment. There are many computerized algorithms implemented for retinal vessel segmentation, but the tiny vessels drop off, impacting the performance of the overall algorithms. This research work contains the new image processing techniques such as enhancement filters, coherence filters and binary thresholding techniques to handle the different color retinal fundus image problems to achieve a vessel image that is well-segmented, and the proposed algorithm has improved performance over existing work. Our developed technique incorporates morphological techniques to address the center light reflex issue. Additionally, to effectively resolve the problem of insufficient and varying contrast, our developed technique employs homomorphic methods and Wiener filtering. Coherent filters are used to address the coherence issue of the retina vessels, and then a double thresholding technique is applied with image reconstruction to achieve a correctly segmented vessel image. The results of our developed technique were evaluated using the STARE and DRIVE datasets and it achieves an accuracy of about 0.96 and a sensitivity of 0.81. The performance obtained from our proposed method proved the capability of the method which can be used by ophthalmology experts to diagnose ocular abnormalities and recommended for further treatment.

Dual consistent pseudo label generation for multi-source domain adaptation without source data for medical image segmentation

Introduction

Unsupervised domain adaptation (UDA) aims to adapt a model learned from the source domain to the target domain. Thus, the model can obtain transferable knowledge even in target domain that does not have ground truth in this way. In medical image segmentation scenarios, there exist diverse data distributions caused by intensity in homogeneities and shape variabilities. But multi source data may not be freely accessible, especially medical images with patient identity information.

Methods

To tackle this issue, we propose a new multi-source and source-free (MSSF) application scenario and a novel domain adaptation framework where in the training stage, we only get access to the well-trained source domain segmentation models without source data. First, we propose a new dual consistency constraint which uses domain-intra and domain-inter consistency to filter those predictions agreed by each individual domain expert and all domain experts. It can serve as a high-quality pseudo label generation method and produce correct supervised signals for target domain supervised learning. Next, we design a progressive entropy loss minimization method to minimize the class-inter distance of features, which is beneficial to enhance domain-intra and domain-inter consistency in turn.

Results

Extensive experiments are performed for retinal vessel segmentation under MSSF condition and our approach produces impressive performance. The sensitivity metric of our approach is highest and it surpasses other methods with a large margin.

Discussion

It is the first attempt to conduct researches on the retinal vessel segmentation task under multi-source and source-free scenarios. In medical applications, such adaptation method can avoid the privacy issue. Furthermore, how to balance the high sensitivity and high accuracy need to be further considered.

A lightweight network guided with differential matched filtering for retinal vessel segmentation

The geometric morphology of retinal vessels reflects the state of cardiovascular health, and fundus images are important reference materials for ophthalmologists. Great progress has been made in automated vessel segmentation, but few studies have focused on thin vessel breakage and false-positives in areas with lesions or low contrast. In this work, we propose a new network, differential matched filtering guided attention UNet (DMF-AU), to address these issues, incorporating a differential matched filtering layer, feature anisotropic attention, and a multiscale consistency constrained backbone to perform thin vessel segmentation. The differential matched filtering is used for the early identification of locally linear vessels, and the resulting rough vessel map guides the backbone to learn vascular details. Feature anisotropic attention reinforces the vessel features of spatial linearity at each stage of the model. Multiscale constraints reduce the loss of vessel information while pooling within large receptive fields. In tests on multiple classical datasets, the proposed model performed well compared with other algorithms on several specially designed criteria for vessel segmentation. DMF-AU is a high-performance, lightweight vessel segmentation model. The source code is at https://github.com/tyb311/DMF-AU.

Retinal Disease Detection Using Deep Learning Techniques: A Comprehensive Review

Millions of people are affected by retinal abnormalities worldwide. Early detection and treatment of these abnormalities could arrest further progression, saving multitudes from avoidable blindness. Manual disease detection is time-consuming, tedious and lacks repeatability. There have been efforts to automate ocular disease detection, riding on the successes of the application of Deep Convolutional Neural Networks (DCNNs) and vision transformers (ViTs) for Computer-Aided Diagnosis (CAD). These models have performed well, however, there remain challenges owing to the complex nature of retinal lesions. This work reviews the most common retinal pathologies, provides an overview of prevalent imaging modalities and presents a critical evaluation of current deep-learning research for the detection and grading of glaucoma, diabetic retinopathy, Age-Related Macular Degeneration and multiple retinal diseases. The work concluded that CAD, through deep learning, will increasingly be vital as an assistive technology. As future work, there is a need to explore the potential impact of using ensemble CNN architectures in multiclass, multilabel tasks. Efforts should also be expended on the improvement of model explainability to win the trust of clinicians and patients.

LUVS-Net: A Lightweight U-Net Vessel Segmentor for Retinal Vasculature Detection in Fundus Images

This paper presents LUVS-Net, which is a lightweight convolutional network for retinal vessel segmentation in fundus images that is designed for resource-constrained devices that are typically unable to meet the computational requirements of large neural networks. The computational challenges arise due to low-quality retinal images, wide variance in image acquisition conditions and disparities in intensity. Consequently, the training of existing segmentation methods requires a multitude of trainable parameters for the training of networks, resulting in computational complexity. The proposed Lightweight U-Net for Vessel Segmentation Network (LUVS-Net) can achieve high segmentation performance with only a few trainable parameters. This network uses an encoder–decoder framework in which edge data are transposed from the first layers of the encoder to the last layer of the decoder, massively improving the convergence latency. Additionally, LUVS-Net’s design allows for a dual-stream information flow both inside as well as outside of the encoder–decoder pair. The network width is enhanced using group convolutions, which allow the network to learn a larger number of low- and intermediate-level features. Spatial information loss is minimized using skip connections, and class imbalances are mitigated using dice loss for pixel-wise classification. The performance of the proposed network is evaluated on the publicly available retinal blood vessel datasets DRIVE, CHASE_DB1 and STARE. LUVS-Net proves to be quite competitive, outperforming alternative state-of-the-art segmentation methods and achieving comparable accuracy using trainable parameters that are reduced by two to three orders of magnitude compared with those of comparative state-of-the-art methods.

Segmentation and Classification Approaches of Clinically Relevant Curvilinear Structures: A Review

Detection of curvilinear structures from microscopic images, which help the clinicians to make an unambiguous diagnosis is assuming paramount importance in recent clinical practice. Appearance and size of dermatophytic hyphae, keratitic fungi, corneal and retinal vessels vary widely making their automated detection cumbersome. Automated deep learning methods, endowed with superior self-learning capacity, have superseded the traditional machine learning methods, especially in complex images with challenging background. Automatic feature learning ability using large input data with better generalization and recognition capability, but devoid of human interference and excessive pre-processing, is highly beneficial in the above context. Varied attempts have been made by researchers to overcome challenges such as thin vessels, bifurcations and obstructive lesions in retinal vessel detection as revealed through several publications reviewed here. Revelations of diabetic neuropathic complications such as tortuosity, changes in the density and angles of the corneal fibers have been successfully sorted in many publications reviewed here. Since artifacts complicate the images and affect the quality of analysis, methods addressing these challenges have been described. Traditional and deep learning methods, that have been adapted and published between 2015 and 2021 covering retinal vessels, corneal nerves and filamentous fungi have been summarized in this review. We find several novel and meritorious ideas and techniques being put to use in the case of retinal vessel segmentation and classification, which by way of cross-domain adaptation can be utilized in the case of corneal and filamentous fungi also, making suitable adaptations to the challenges to be addressed.

Automatic vessel crossing and bifurcation detection based on multi-attention network vessel segmentation and directed graph search

Analysis of the vascular tree is the basic premise to automatically diagnose retinal biomarkers associated with ophthalmic and systemic diseases, among which accurate identification of intersection and bifurcation points is quite challenging but important for disentangling complex vascular network and tracking vessel morphology. In this paper, we present a novel directed graph search-based multi-attentive neural network approach to automatically segment the vascular network and separate intersections and bifurcations from color fundus images. Our approach uses multi-dimensional attention to adaptively integrate local features and their global dependencies while learning to focus on target structures at different scales to generate binary vascular maps. A directed graphical representation of the vascular network is constructed to represent the topology and spatial connectivity of the vascular structures. Using local geometric information including color difference, diameter, and angle, the complex vascular tree is decomposed into multiple sub-trees to finally classify and label vascular feature points. The proposed method has been tested on the DRIVE dataset and the IOSTAR dataset containing 40 images and 30 images, respectively, with 0.863 and 0.764 F¹-score of detection points and average accuracy of 0.914 and 0.854 for classification points. These results demonstrate the superiority of our proposed method outperforming state-of-the-art methods in feature point detection and classification.

Separable Paravector Orientation Tensors for Enhancing Retinal Vessels

Robust detection of retinal vessels remains an unsolved research problem, particularly in handling the intrinsic real-world challenges of highly imbalanced contrast between thick vessels and thin ones, inhomogeneous background regions, uneven illumination, and complex geometries of crossing/bifurcations. This paper presents a new separable paravector orientation tensor that addresses these difficulties by characterizing the enhancement of retinal vessels to be dependent on a nonlinear scale representation, invariant to changes in contrast and lighting, responsive for symmetric patterns, and fitted with elliptical cross-sections. The proposed method is built on projecting vessels as a 3D paravector valued function rotated in an alpha quarter domain, providing geometrical, structural, symmetric, and energetic features. We introduce an innovative symmetrical inhibitory scheme that incorporates paravector features for producing a set of directional contrast-independent elongated-like patterns reconstructing vessel tree in orientation tensors. By fitting constraint elliptical volumes via eigensystem analysis, the final vessel tree is produced with a strong and uniform response preserving various vessel features. The validation of proposed method on clinically relevant retinal images with high-quality results, shows its excellent performance compared to the state-of-the-art benchmarks and the second human observers.

Prompt Deep Light-Weight Vessel Segmentation Network (PLVS-Net)

Achieving accurate retinal vessel segmentation is critical in the progression and diagnosis of vision-threatening diseases such as diabetic retinopathy and age-related macular degeneration. Existing vessel segmentation methods are based on encoder-decoder architectures, which frequently fail to take into account the retinal vessel structure's context in their analysis. As a result, such methods have difficulty bridging the semantic gap between encoder and decoder characteristics. This paper proposes a Prompt Deep Light-weight Vessel Segmentation Network (PLVS-Net) to address these issues by using prompt blocks. Each prompt block use combination of asymmetric kernel convolutions, depth-wise separable convolutions, and ordinary convolutions to extract useful features. This novel strategy improves the performance of the segmentation network while simultaneously decreasing the number of trainable parameters. Our method outperformed competing approaches in the literature on three benchmark datasets, including DRIVE, STARE, and CHASE.

Retinal blood vessel segmentation by using the MS-LSDNet network and geometric skeleton reconnection method

Automatic retinal blood vessel segmentation is a key link in the diagnosis of ophthalmic diseases. Recent deep learning methods have achieved high accuracy in vessel segmentation but still face challenges in maintaining vascular structural connectivity. Therefore, this paper proposes a novel retinal blood vessel segmentation strategy that includes three stages: vessel structure detection, vessel branch extraction and broken vessel segment reconnection. First, we propose a multiscale linear structure detection network (MS-LSDNet), which improves the detection ability of fine blood vessels by learning the types of rich hierarchical features. In addition, to maintain the connectivity of the vascular structure in the process of binarization of the vascular probability map, an adaptive hysteresis threshold method for vascular extraction is proposed. Finally, we propose a vascular tree structure reconstruction algorithm based on a geometric skeleton to connect the broken vessel segments. Experimental results on three publicly available datasets show that compared with current state-of-the-art algorithms, our strategy effectively maintains the connectivity of retinal vascular tree structure.

Improved fully convolutional neuron networks on small retinal vessel segmentation using local phase as attention

Retinal images have been proven significant in diagnosing multiple diseases such as diabetes, glaucoma, and hypertension. Retinal vessel segmentation is crucial for the quantitative analysis of retinal images. However, current methods mainly concentrate on the segmentation performance of overall retinal vessel structures. The small vessels do not receive enough attention due to their small percentage in the full retinal images. Small retinal vessels are much more sensitive to the blood circulation system and have great significance in the early diagnosis and warning of various diseases. This paper combined two unsupervised methods, local phase congruency (LPC) and orientation scores (OS), with a deep learning network based on the U-Net as attention. And we proposed the U-Net using local phase congruency and orientation scores (UN-LPCOS), which showed a remarkable ability to identify and segment small retinal vessels. A new metric called sensitivity on a small ship (Se_sv ) was also proposed to evaluate the methods' performance on the small vessel segmentation. Our strategy was validated on both the DRIVE dataset and the data from Maastricht Study and achieved outstanding segmentation performance on both the overall vessel structure and small vessels.

Segmentation of retinal vessels based on MRANet

The segmentation of retinal vessel takes a crucial part in computer-aided diagnosis of diseases and eye disorders. However, the insufficient segmentation of the capillary vessels and weak anti-noise interference ability make such task more difficult. To solve this problem, we proposed a multi-scale residual attention network (MRANet) which is based on U-Net network. Firstly, to collect useful information about the blood vessels more effectively, we proposed a multi-level feature fusion block (MLF block). Then, different weights of each fused feature are learned by using attention blocks, which can retain more useful feature information while reducing the interference of redundant features. Thirdly, multi-scale residual connection block (MSR block) is constructed, which can better extract the image features. Finally, we use the DropBlock layer in the network to reduce the network parameters and alleviate network overfitting. Experiments show that based on DRIVE, the accuracy rate and the AUC performance value of our network are 0.9698 and 0.9899 respectively, and based on CHASE_DB1 dataset, they are 0.9755 and 0.9893 respectively. Our network has a better segmentation effect compared with other methods, which can ensure the continuity and completeness of blood vessel segmentation.

An efficient registration-based approach for retinal blood vessel segmentation using generalized Pareto and fatigue pdf

Segmentation of Retinal Blood Vessel (RBV) extraction in the retina images and Registration of segmented RBV structure is implemented to identify changes in vessel structure by ophthalmologists in diagnosis of various illnesses like Glaucoma, Diabetes, and Hypertension's. The Retinal Blood Vessel provides blood to the inner retinal neurons, RBV are located mainly in internal retina but it may partly in the ganglion cell layer, following network failure haven't been identified with past methods. Classifications of accurate RBV and Registration of segmented blood vessels are challenging tasks in the low intensity background of Retinal Image. So, we projected a novel approach of segmentation of RBV extraction used matched filter of Generalized Pareto Probability Distribution Function (pdf) and Registration approach on feature-based segmented retinal blood vessel of Binary Robust Invariant Scalable Key point (BRISK). The BRISK provides the predefined sampling pattern as compared to Pdf. The BRISK feature is implemented for attention point recognition & matching approach for change in vessel structure. The proposed approaches contain 3 levels: pre-processing, matched filter-based Generalized Pareto pdf as a source along with the novel approach of fatigue pdf as a target, and BRISK framework is used for Registration on segmented retinal images of supply & intention images. This implemented system's performance is estimated in experimental analysis by the Average accuracy, Normalized Cross-Correlation (NCC), and computation time process of the segmented retinal source and target image. The NCC is main element to give more statistical information about retinal image segmentation. The proposed approach of Generalized Pareto value pdf has Average Accuracy of 95.21%, NCC of both image pairs is 93%, and Average accuracy of Registration of segmented source images and the target image is 98.51% respectively. The proposed approach of average computational time taken is around 1.4 s, which has been identified on boundary condition of Pdf function.

Recent trends and advances in fundus image analysis: A review

Automated retinal image analysis holds prime significance in the accurate diagnosis of various critical eye diseases that include diabetic retinopathy (DR), age-related macular degeneration (AMD), atherosclerosis, and glaucoma. Manual diagnosis of retinal diseases by ophthalmologists takes time, effort, and financial resources, and is prone to error, in comparison to computer-aided diagnosis systems. In this context, robust classification and segmentation of retinal images are primary operations that aid clinicians in the early screening of patients to ensure the prevention and/or treatment of these diseases. This paper conducts an extensive review of the state-of-the-art methods for the detection and segmentation of retinal image features. Existing notable techniques for the detection of retinal features are categorized into essential groups and compared in depth. Additionally, a summary of quantifiable performance measures for various important stages of retinal image analysis, such as image acquisition and preprocessing, is provided. Finally, the widely used in the literature datasets for analyzing retinal images are described and their significance is emphasized.

BCR-UNet: Bi-directional ConvLSTM residual U-Net for retinal blood vessel segmentation

Background

High precision segmentation of retinal blood vessels from retinal images is a significant step for doctors to diagnose many diseases such as glaucoma and cardiovascular diseases. However, at the peripheral region of vessels, previous U-Net-based segmentation methods failed to significantly preserve the low-contrast tiny vessels.

Methods

For solving this challenge, we propose a novel network model called Bi-directional ConvLSTM Residual U-Net (BCR-UNet), which takes full advantage of U-Net, Dropblock, Residual convolution and Bi-directional ConvLSTM (BConvLSTM). In this proposed BCR-UNet model, we propose a novel Structured Dropout Residual Block (SDRB) instead of using the original U-Net convolutional block, to construct our network skeleton for improving the robustness of the network. Furthermore, to improve the discriminative ability of the network and preserve more original semantic information of tiny vessels, we adopt BConvLSTM to integrate the feature maps captured from the first residual block and the last up-convolutional layer in a nonlinear manner.

Results and discussion

We conduct experiments on four public retinal blood vessel datasets, and the results show that the proposed BCR-UNet can preserve more tiny blood vessels at the low-contrast peripheral regions, even outperforming previous state-of-the-art methods.

Do you need sharpened details? Asking MMDC-Net: Multi-layer multi-scale dilated convolution network for retinal vessel segmentation

Convolutional neural networks (CNN), especially numerous U-shaped models, have achieved great progress in retinal vessel segmentation. However, a great quantity of global information in fundus images has not been fully explored. And the class imbalance problem of background and blood vessels is still serious. To alleviate these issues, we design a novel multi-layer multi-scale dilated convolution network (MMDC-Net) based on U-Net. We propose an MMDC module to capture sufficient global information under diverse receptive fields through a cascaded mode. Then, we place a new multi-layer fusion (MLF) module behind the decoder, which can not only fuse complementary features but filter noisy information. This enables MMDC-Net to capture the blood vessel details after continuous up-sampling. Finally, we employ a recall loss to resolve the class imbalance problem. Extensive experiments have been done on diverse fundus color image datasets, including STARE, CHASEDB1, DRIVE, and HRF. HRF has a large resolution of 3504 × 2336 whereas others have a small resolution of slightly more than 512 × 512. Qualitative and quantitative results verify the superiority of MMDC-Net. Notably, satisfactory accuracy and sensitivity are acquired by our model. Hence, some key blood vessel details are sharpened. In addition, a large number of further validations and discussions prove the effectiveness and generalization of the proposed MMDC-Net.

An improved U-net based retinal vessel image segmentation method

Diabetic retinopathy is not just the most common complication of diabetes but also the leading cause of adult blindness. Currently, doctors determine the cause of diabetic retinopathy primarily by diagnosing fundus images. Large-scale manual screening is difficult to achieve for retinal health screen. In this paper, we proposed an improved U-net network for segmenting retinal vessels. Firstly, due to the lack of retinal data, pre-processing of the raw data is required. The data processed by grayscale transformation, normalization, CLAHE, gamma transformation. Data augmentation can prevent overfitting in the training process. Secondly, the basic network structure model U-net is built, and the Bi-FPN network is fused based on U-net. Datasets from a public challenge are used to evaluate the performance of the proposed method, which is able to detect vessel SP of 0.8604, SE of 0.9767, ACC of 0.9651, and AUC of 0.9787.

Local-Sensitive Connectivity Filter (LS-CF): A Post-Processing Unsupervised Improvement of the Frangi, Hessian and Vesselness Filters for Multimodal Vessel Segmentation

A retinal vessel analysis is a procedure that can be used as an assessment of risks to the eye. This work proposes an unsupervised multimodal approach that improves the response of the Frangi filter, enabling automatic vessel segmentation. We propose a filter that computes pixel-level vessel continuity while introducing a local tolerance heuristic to fill in vessel discontinuities produced by the Frangi response. This proposal, called the local-sensitive connectivity filter (LS-CF), is compared against a naive connectivity filter to the baseline thresholded Frangi filter response and to the naive connectivity filter response in combination with the morphological closing and to the current approaches in the literature. The proposal was able to achieve competitive results in a variety of multimodal datasets. It was robust enough to outperform all the state-of-the-art approaches in the literature for the OSIRIX angiographic dataset in terms of accuracy and 4 out of 5 works in the case of the IOSTAR dataset while also outperforming several works in the case of the DRIVE and STARE datasets and 6 out of 10 in the CHASE-DB dataset. For the CHASE-DB, it also outperformed all the state-of-the-art unsupervised methods.

Self-Supervised Rigid Registration for Multimodal Retinal Images

The ability to accurately overlay one modality retinal image to another is critical in ophthalmology. Our previous framework achieved the state-of-the-art results for multimodal retinal image registration. However, it requires human-annotated labels due to the supervised approach of the previous work. In this paper, we propose a self-supervised multimodal retina registration method to alleviate the burdens of time and expense to prepare for training data, that is, aiming to automatically register multimodal retinal images without any human annotations. Specially, we focus on registering color fundus images with infrared reflectance and fluorescein angiography images, and compare registration results with several conventional and supervised and unsupervised deep learning methods. From the experimental results, the proposed self-supervised framework achieves a comparable accuracy comparing to the state-of-the-art supervised learning method in terms of registration accuracy and Dice coefficient.

Retinal Vessel Segmentation With Skeletal Prior and Contrastive Loss

The morphology of retinal vessels is closely associated with many kinds of ophthalmic diseases. Although huge progress in retinal vessel segmentation has been achieved with the advancement of deep learning, some challenging issues remain. For example, vessels can be disturbed or covered by other components presented in the retina (such as optic disc or lesions). Moreover, some thin vessels are also easily missed by current methods. In addition, existing fundus image datasets are generally tiny, due to the difficulty of vessel labeling. In this work, a new network called SkelCon is proposed to deal with these problems by introducing skeletal prior and contrastive loss. A skeleton fitting module is developed to preserve the morphology of the vessels and improve the completeness and continuity of thin vessels. A contrastive loss is employed to enhance the discrimination between vessels and background. In addition, a new data augmentation method is proposed to enrich the training samples and improve the robustness of the proposed model. Extensive validations were performed on several popular datasets (DRIVE, STARE, CHASE, and HRF), recently developed datasets (UoA-DR, IOSTAR, and RC-SLO), and some challenging clinical images (from RFMiD and JSIEC39 datasets). In addition, some specially designed metrics for vessel segmentation, including connectivity, overlapping area, consistency of vessel length, revised sensitivity, specificity, and accuracy were used for quantitative evaluation. The experimental results show that, the proposed model achieves state-of-the-art performance and significantly outperforms compared methods when extracting thin vessels in the regions of lesions or optic disc. Source code is available at https://www.github.com/tyb311/SkelCon.

SlypNet: Spikelet-based yield prediction of wheat using advanced plant phenotyping and computer vision techniques

The application of computer vision in agriculture has already contributed immensely to restructuring the existing field practices starting from the sowing to the harvesting. Among the different plant parts, the economic part, the yield, has the highest importance and becomes the ultimate goal for the farming community. It depends on many genetic and environmental factors, so this curiosity about knowing the yield brought several precise pre-harvest prediction methods using different ways. Out of those techniques, non-invasive yield prediction techniques using computer vision have been proved to be the most efficient and trusted platform. This study developed a novel methodology, called SlypNet, using advanced deep learning networks, i.e., Mask R-CNN and U-Net, which can extract various plant morphological features like spike and spikelet from the visual image of the wheat plant and provide a high-throughput yield estimate with great precision. Mask R-CNN outperformed previous networks in spike detection by its precise detection performance with a mean average precision (mAP) of 97.57%, a F1 score of 0.67, and an MCC of 0.91 by overcoming several natural field constraints like overlapping and background interference, variable resolution, and high bushiness of plants. The spikelet detection module's accuracy and consistency were tested with about 99% validation accuracy of the model and the least error, i.e., a mean square error of 1.3 from a set of typical and complex views of wheat spikes. Spikelet yield cumulatively showed the probable production capability of each plant. Our method presents an integrated deep learning platform of spikelet-based yield prediction comprising spike and spikelet detection, leading to higher precision over the existing methods.

Dual Encoder-Based Dynamic-Channel Graph Convolutional Network With Edge Enhancement for Retinal Vessel Segmentation

Retinal vessel segmentation with deep learning technology is a crucial auxiliary method for clinicians to diagnose fundus diseases. However, the deep learning approaches inevitably lose the edge information, which contains spatial features of vessels while performing down-sampling, leading to the limited segmentation performance of fine blood vessels. Furthermore, the existing methods ignore the dynamic topological correlations among feature maps in the deep learning framework, resulting in the inefficient capture of the channel characterization. To address these limitations, we propose a novel dual encoder-based dynamic-channel graph convolutional network with edge enhancement (DE-DCGCN-EE) for retinal vessel segmentation. Specifically, we first design an edge detection-based dual encoder to preserve the edge of vessels in down-sampling. Secondly, we investigate a dynamic-channel graph convolutional network to map the image channels to the topological space and synthesize the features of each channel on the topological map, which solves the limitation of insufficient channel information utilization. Finally, we study an edge enhancement block, aiming to fuse the edge and spatial features in the dual encoder, which is beneficial to improve the accuracy of fine blood vessel segmentation. Competitive experimental results on five retinal image datasets validate the efficacy of the proposed DE-DCGCN-EE, which achieves more remarkable segmentation results against the other state-of-the-art methods, indicating its potential clinical application.

AutoMorph: Automated Retinal Vascular Morphology Quantification Via a Deep Learning Pipeline

Purpose

To externally validate a deep learning pipeline (AutoMorph) for automated analysis of retinal vascular morphology on fundus photographs. AutoMorph has been made publicly available, facilitating widespread research in ophthalmic and systemic diseases.

Methods

AutoMorph consists of four functional modules: image preprocessing, image quality grading, anatomical segmentation (including binary vessel, artery/vein, and optic disc/cup segmentation), and vascular morphology feature measurement. Image quality grading and anatomical segmentation use the most recent deep learning techniques. We employ a model ensemble strategy to achieve robust results and analyze the prediction confidence to rectify false gradable cases in image quality grading. We externally validate the performance of each module on several independent publicly available datasets.

Results

The EfficientNet-b4 architecture used in the image grading module achieves performance comparable to that of the state of the art for EyePACS-Q, with an F1-score of 0.86. The confidence analysis reduces the number of images incorrectly assessed as gradable by 76%. Binary vessel segmentation achieves an F1-score of 0.73 on AV-WIDE and 0.78 on DR HAGIS. Artery/vein scores are 0.66 on IOSTAR-AV, and disc segmentation achieves 0.94 in IDRID. Vascular morphology features measured from the AutoMorph segmentation map and expert annotation show good to excellent agreement.

Conclusions

AutoMorph modules perform well even when external validation data show domain differences from training data (e.g., with different imaging devices). This fully automated pipeline can thus allow detailed, efficient, and comprehensive analysis of retinal vascular morphology on color fundus photographs.

Translational Relevance

By making AutoMorph publicly available and open source, we hope to facilitate ophthalmic and systemic disease research, particularly in the emerging field of oculomics.

Stacked Ensemble Network to Assess the Structural Variations in Retina: A Bio-marker for Early Disease Diagnosis

The retina is a unique tissue that extends the human brain in transmitting the incoming light into neural spikes. Researchers collaborating with domain experts proposed numerous deep networks to extract vessels from the retina; however, these techniques have the least response for micro-vessels. The proposed method has developed a stacked ensemble network approach with deep neural architectures for precise vessel extraction. Our method has used bi-directional LSTM for filling gaps in dis-joint vessels and applied W-Net for boundary refinement and emphasizing local regions to achieve better results for micro-vessels extraction. The platform has combined the strength of various networks to improve the automated screening process and has shown promising results on benchmark datasets.

MFI-Net: Multiscale Feature Interaction Network for Retinal Vessel Segmentation

Segmentation of retinal vessels on fundus images plays a critical role in the diagnosis of micro-vascular and ophthalmological diseases. Although being extensively studied, this task remains challenging due to many factors including the highly variable vessel width and poor vessel-background contrast. In this paper, we propose a multiscale feature interaction network (MFI-Net) for retinal vessel segmentation, which is a U-shaped convolutional neural network equipped with the pyramid squeeze-and-excitation (PSE) module, coarse-to-fine (C2F) module, deep supervision, and feature fusion. We extend the SE operator to multiscale features, resulting in the PSE module, which uses the channel attention learned at multiple scales to enhance multiscale features and enables the network to handle the vessels with variable width. We further design the C2F module to generate and re-process the residual feature maps, aiming to preserve more vessel details during the decoding process. The proposed MFI-Net has been evaluated against several public models on the DRIVE, STARE, CHASE_DB1, and HRF datasets. Our results suggest that both PSE and C2F modules are effective in improving the accuracy of MFI-Net, and also indicate that our model has superior segmentation performance and generalization ability over existing models on four public datasets.

Predicting CT-Based Coronary Artery Disease Using Vascular Biomarkers Derived from Fundus Photographs with a Graph Convolutional Neural Network

The study population contains 145 patients who were prospectively recruited for coronary CT angiography (CCTA) and fundoscopy. This study first examined the association between retinal vascular changes and the Coronary Artery Disease Reporting and Data System (CAD-RADS) as assessed on CCTA. Then, we developed a graph neural network (GNN) model for predicting the CAD-RADS as a proxy for coronary artery disease. The CCTA scans were stratified by CAD-RADS scores by expert readers, and the vascular biomarkers were extracted from their fundus images. Association analyses of CAD-RADS scores were performed with patient characteristics, retinal diseases, and quantitative vascular biomarkers. Finally, a GNN model was constructed for the task of predicting the CAD-RADS score compared to traditional machine learning (ML) models. The experimental results showed that a few retinal vascular biomarkers were significantly associated with adverse CAD-RADS scores, which were mainly pertaining to arterial width, arterial angle, venous angle, and fractal dimensions. Additionally, the GNN model achieved a sensitivity, specificity, accuracy and area under the curve of 0.711, 0.697, 0.704 and 0.739, respectively. This performance outperformed the same evaluation metrics obtained from the traditional ML models (p < 0.05). The data suggested that retinal vasculature could be a potential biomarker for atherosclerosis in the coronary artery and that the GNN model could be utilized for accurate prediction.

State-of-the-art retinal vessel segmentation with minimalistic models

The segmentation of retinal vasculature from eye fundus images is a fundamental task in retinal image analysis. Over recent years, increasingly complex approaches based on sophisticated Convolutional Neural Network architectures have been pushing performance on well-established benchmark datasets. In this paper, we take a step back and analyze the real need of such complexity. We first compile and review the performance of 20 different techniques on some popular databases, and we demonstrate that a minimalistic version of a standard U-Net with several orders of magnitude less parameters, carefully trained and rigorously evaluated, closely approximates the performance of current best techniques. We then show that a cascaded extension (W-Net) reaches outstanding performance on several popular datasets, still using orders of magnitude less learnable weights than any previously published work. Furthermore, we provide the most comprehensive cross-dataset performance analysis to date, involving up to 10 different databases. Our analysis demonstrates that the retinal vessel segmentation is far from solved when considering test images that differ substantially from the training data, and that this task represents an ideal scenario for the exploration of domain adaptation techniques. In this context, we experiment with a simple self-labeling strategy that enables moderate enhancement of cross-dataset performance, indicating that there is still much room for improvement in this area. Finally, we test our approach on Artery/Vein and vessel segmentation from OCTA imaging problems, where we again achieve results well-aligned with the state-of-the-art, at a fraction of the model complexity available in recent literature. Code to reproduce the results in this paper is released.