Abstract
The retinal vascular tortuosity presents a valuable potential as a clinical biomarker of many relevant vascular and systemic diseases. Commonly, the existent approaches face the tortuosity quantification by means of fully mathematical representations of the vessel segments. However, the specialists, based on their diagnostic experience, commonly analyze additional domain-related information that is not represented in these mathematical metrics of reference. In this work, we propose a novel computational tortuosity metric that outperforms the mathematical metrics of reference also incorporating anatomical properties of the fundus image such as the distinction between arteries and veins, the distance to the optic disc, the distance to the fovea, and the vessel caliber. The evaluation of its prognostic performance shows that the integration of the anatomical factors provides an accurate tortuosity assessment that is more adjusted to the specialists’ perception.
Highlights
The retinal vascular tortuosity presents a valuable potential as a clinical biomarker of many relevant vascular and systemic diseases
Bhuiyan et al.[12] introduced some changes considering numerical derivatives for the calculus of the total curvature, whereas Trucco et al.[13] generalized the measurement of the vessel skeleton curvature proposed by Hart et al.[11]. Another approach proposed by Grisan et al.[14] incorporated the times that a vessel curves by splitting each vessel in n segments of constant-sign curvature, 1University of A Coruña, Department of Computer Science and Information Technology, A Coruña, Spain. 2CITICResearch Center of Information and Communication Technologies, University of A Coruña, A Coruña, Spain. 3Grupo VARPA, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade da Coruña (UDC), As Xubias, 15006, A Coruña, Spain. 4Servizo de Oftalmoloxía, Complexo Hospitalario Universitario de Ferrol, Ferrol, A Coruña, Spain. *email: l.ramos@udc.es www.nature.com/scientificreports/
ROC curves can be built from the reciprocal relation between sensitivity and specificity calculated for all the possible threshold values in the computational metrics
Summary
The retinal vascular tortuosity presents a valuable potential as a clinical biomarker of many relevant vascular and systemic diseases. Subsequent works were conducted in[18,19] with the aim of advancing in the standardization of the vascular tortuosity as a clinical biomarker with diagnostic potential In these works, a complete and exhaustive multi-expert validation was performed in order to establish a consistent clinical criteria to validate the effectiveness of the objective computational metrics of reference. Among the metrics of reference, the proposal of Grisan et al.[14] provided the closest results to the specialists performance As indicated, these metrics are exclusively based in mathematical properties of the vessel segments, stating the tortuosity degree on the basis of one or two factors such as the curvature, the amplitude, or the number of turns and twists, depending on each case. A computational metric that provides a tortuosity characterization more useful and reliable to support the clinical decision-making process should incorporate additional anatomical properties of the fundus image that better represent the clinical analysis
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