Computer aided quantification for retinal lesions in patients with moderate and severe non-proliferative diabetic retinopathy: a retrospective cohort study.

Huiqun Wu,Guomin Zhou,Xiaofeng Zhang,Jiancheng Dong,Xingyun Geng

doi:10.1186/1471-2415-14-126

Abstract

BackgroundDetection of retinal lesions like micro-aneurysms and exudates are important for the clinical diagnosis of diabetes retinopathy. The traditional subjective judgments by clinicians are dependent on their experience and can be subject to lack of consistency and therefore a quantification method is worthwhile.MethodsIn this study, 10 moderate non-proliferative diabetes retinopathy (NPDR) patients and 10 severe NPDR ones were retrospectively selected as a cohort. Mathematical morphological methods were used for automatic segmentation of lesions. For exudates detection, images were pre-processed with adaptive histogram equalization to enhance contrast, then binary images for area calculation were obtained by threshold classification. For micro-aneurysms detection, the images were pre-processed by top-hat and bottom-hat transformation, then Otsu method and Hough transform were used to classify micro-aneurysms. Post-processing morphological methods were used to preclude the false positive noise.ResultsAfter segmentation, the area of exuduates divided by optic disk area (exudates/disk ratio) and counts of microaneurysms were quantified and compared between the moderate and severe non-proliferative diabetic retinopathy groups, which had significant difference(P < 0.05).ConclusionsIn conclusion, morphological features of lesion might be an image marker for NPDR grading and computer aided quantification of retinal lesion could be a practical way for clinicians to better investigates diabetic retinopathy.

Highlights

Detection of retinal lesions like micro-aneurysms and exudates are important for the clinical diagnosis of diabetes retinopathy
We proposed a computerized framework for automatic detection of exudate and microaneurysms and compared the morphological features in moderate and severe nonproliferative diabetic retinopathy
10 patients (7 males and 3 females, mean age: 60.8 ± 11.0 years old) were graded as moderate non-proliferative diabetes retinopathy (NPDR), and another 10 ones (6 males and 4 females, mean age: 63.2 ± 12.1) were graded as severe NPDR according to the international classification for NPDR [3]

Summary

Introduction

Detection of retinal lesions like micro-aneurysms and exudates are important for the clinical diagnosis of diabetes retinopathy. The traditional subjective judgments by clinicians are dependent on their experience and can be subject to lack of consistency and a quantification method is worthwhile. Detection of eye disease due to diabetes, glaucoma, and age-related macular degeneration has a significant impact on the prevention of blindness. It’s estimated that nearly one million patients would be screened every day worldwide for diabetic retinopathy(DR) by 2025. Detecting and counting lesions in the human retina like microaneurysms and exudates is important for clinical diagnosis of DR [1,2], but is a time-consuming task

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Discussion

Conclusion