Differences in image quality, lighting conditions, and patient demographics pose challenges to automated glaucoma detection from color fundus photography. Brighteye, a method based on Vision Transformer, is proposed for glaucoma detection and glaucomatous feature classification. Brighteye learns long-range relationships among pixels within large fundus images using a self-attention mechanism. Prior to being input into Brighteye, the optic disc is localized using YOLOv8, and the region of interest (ROI) around the disc center is cropped to ensure alignment with clinical practice. Optic disc detection improves the sensitivity at 95% specificity from 79.20% to 85.70% for glaucoma detection and the Hamming distance from 0.2470 to 0.1250 for glaucomatous feature classification. In the developmental stage of the Justified Referral in AI Glaucoma Screening (JustRAIGS) challenge, the overall outcome secured the fifth position out of 226 entries.
Explainable Artificial Intelligence (AI) in the form of an interpretable and semiautomatic approach to stage grading ocular pathologies such as Diabetic retinopathy, Hypertensive retinopathy, and other retinopathies on the backdrop of major systemic diseases. The experimental study aims to evaluate an explainable staged grading process without using deep Convolutional Neural Networks (CNNs) directly. Many current CNN-based deep neural networks used for diagnosing retinal disorders might have appreciable performance but fail to pinpoint the basis driving their decisions. To improve these decisions' transparency, we have proposed a clinician-in-the-loop assisted intelligent workflow that performs a retinal vascular assessment on the fundus images to derive quantifiable and descriptive parameters. The retinal vessel parameters meta-data serve as hyper-parameters for better interpretation and explainability of decisions. The semiautomatic methodology aims to have a federated approach to AI in healthcare applications with more inputs and interpretations from clinicians. The baseline process involved in the machine learning pipeline through image processing techniques for optic disc detection, vessel segmentation, and arteriole/venule identification.
Fundus photography has routinely been used to document the presence and severity of retinal degenerative diseases such as age-related macular degeneration (AMD), glaucoma, and diabetic retinopathy (DR) in clinical practice, for which the fovea and optic disc (OD) are important retinal landmarks. However, the occurrence of lesions, drusen, and other retinal abnormalities during retinal degeneration severely complicates automatic landmark detection and segmentation. Here we propose HBA-U-Net: a U-Net backbone enriched with hierarchical bottleneck attention. The network consists of a novel bottleneck attention block that combines and refines self-attention, channel attention, and relative-position attention to highlight retinal abnormalities that may be important for fovea and OD segmentation in the degenerated retina. HBA-U-Net achieved state-of-the-art results on fovea detection across datasets and eye conditions (ADAM: Euclidean Distance (ED) of 25.4 pixels, REFUGE: 32.5 pixels, IDRiD: 32.1 pixels), on OD segmentation for AMD (ADAM: Dice Coefficient (DC) of 0.947), and on OD detection for DR (IDRiD: ED of 20.5 pixels). Our results suggest that HBA-U-Net may be well suited for landmark detection in the presence of a variety of retinal degenerative diseases.
With the advancement of powerful image processing and machine learning techniques, CAD has become ever more prevalent in all fields of medicine including ophthalmology. Since optic disc is the most important part of retinal fundus image for glaucoma detection, this paper proposes a two-stage framework that first detects and localizes optic disc and then classifies it into healthy or glaucomatous. The first stage is based on RCNN and is responsible for localizing and extracting optic disc from a retinal fundus image while the second stage uses Deep CNN to classify the extracted disc into healthy or glaucomatous. In addition to the proposed solution, we also developed a rule-based semi-automatic ground truth generation method that provides necessary annotations for training RCNN based model for automated disc localization. The proposed method is evaluated on seven publicly available datasets for disc localization and on ORIGA dataset, which is the largest publicly available dataset for glaucoma classification. The results of automatic localization mark new state-of-the-art on six datasets with accuracy reaching 100% on four of them. For glaucoma classification we achieved AUC equal to 0.874 which is 2.7% relative improvement over the state-of-the-art results previously obtained for classification on ORIGA. Once trained on carefully annotated data, Deep Learning based methods for optic disc detection and localization are not only robust, accurate and fully automated but also eliminates the need for dataset-dependent heuristic algorithms. Our empirical evaluation of glaucoma classification on ORIGA reveals that reporting only AUC, for datasets with class imbalance and without pre-defined train and test splits, does not portray true picture of the classifier's performance and calls for additional performance metrics to substantiate the results.