Abstract
The fractal dimension has been employed as a useful parameter in the diagnosis of retinal disease. Avakian et al. (Curr Eye Res 2002; 24: 274-280), comparing the vascular pattern of normal patients with mild to moderate non-proliferative diabetic retinopathy (NPDR), found a significant difference between them only in the macular region. This significant difference in the box-counting fractal dimension of the macular region between normal and mild NPDR patients has been proposed as a method of precocious diagnosis of NPDR. The aim of the present study was to determine if fractal dimensions can really be used as a parameter for the early diagnosis of NPDR. Box-counting and information fractal dimensions were used to parameterize the vascular pattern of the human retina. The two methods were applied to the whole retina and to nine anatomical regions of the retina in 5 individuals with mild NPDR and in 28 diabetic but opthalmically normal individuals (controls), with age between 31 and 86 years. All images of retina were obtained from the Digital Retinal Images for Vessel Extraction (DRIVE) database. The results showed that the fractal dimension parameter was not sensitive enough to be of use for an early diagnosis of NPDR.
Highlights
The retina captures and propagates images to the brain through receptor and neural cells
A geometric description of this retinal vascularization is of great interest for the early diagnosis of some diseases that attack the vessels of the retina [4,5,6]
The main objective of the present study was to answer the following question: is the fractal dimension a sufficiently sensitive parameter to be used for an early diagnosis of non-proliferative diabetic retinopathy (NPDR)? A strategy developed in the present study to answer this question was to use a large sample for the control condition (28 diabetic but ophthalmically normal individuals) in order to reach consistent statistical conclusions
Summary
The retina captures and propagates images to the brain through receptor (cones and rods) and neural cells. Because of the high demand for oxygen due to elevated cellular activity, this tissue is highly vascularized, with a consequent complex vessel distribution [1,2,3]. A geometric description of this retinal vascularization is of great interest for the early diagnosis of some diseases that attack the vessels of the retina [4,5,6]. Complex geometric patterns similar to those formed by the retinal vessels can be described by fractal geometry. Squares can completely cover a two-dimensional space and their fractal dimension is two. Retinal vessels span the two-dimensional space less completely, and their fractal dimension is less than two, but greater than one [8,9]
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