Deep learning based early stage diabetic retinopathy detection using optical coherence tomography

Abstract Diabetic retinopathy (DR) is one of the leading causes of preventable blindness globally. Performing retinal examinations on all diabetic patients is an unmet need, and detection at an early stage can provide better control of the disease. The objective of this study is to provide an optical coherence tomography (OCT) image based diagnostic technology for automated early DR diagnosis, including at both grades 0 and 1. This work can help ophthalmologists with evaluation and treatment, reducing the rate of vision loss, and enabling timely and accurate diagnosis. In this work, we developed and evaluated a novel deep network – OCTD_Net, for early-stage DR detection. While one of the networks extracted features from the original OCT image, the other extracted retinal layer information. The accuracy, sensitivity and specificity was 0.92, 0.90 and 0.95, respectively. Our analysis of retinal layers and the features learned by the proposed network suggests that grade 1 DR patients present with significant changes in the thickness and reflection of certain retinal layers. However, grade 0 DR patients do not have such significant changes. The heatmaps of the trained network also suggest that patients with early DR showed different textures around the myoid and ellipsoid zones, inner nuclear layers, and photoreceptor outer segments, which should all receive dedicated attention for early DR diagnosis.

[1]  F. Mériaudeau,et al.  Classification of SD-OCT Volumes Using Local Binary Patterns: Experimental Validation for DME Detection , 2016, Journal of ophthalmology.

[2]  Rajiv Raman,et al.  Prevalence of diabetic retinopathy in India: Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study report 2. , 2009, Ophthalmology.

[3]  Rao Tatavarti,et al.  Automated diagnosis of diabetic retinopathy and glaucoma using fundus and OCT images , 2012, Lipids in Health and Disease.

[4]  Xinbo Gao,et al.  Graphical Representation for Heterogeneous Face Recognition , 2017, IEEE Transactions on Pattern Analysis and Machine Intelligence.

[5]  Chong Wang,et al.  Automatic segmentation of nine retinal layer boundaries in OCT images of non-exudative AMD patients using deep learning and graph search. , 2017, Biomedical optics express.

[6]  C. Day The rising tide of type 2 diabetes , 2001 .

[7]  Chong Wang,et al.  Attention to Lesion: Lesion-Aware Convolutional Neural Network for Retinal Optical Coherence Tomography Image Classification , 2019, IEEE Transactions on Medical Imaging.

[8]  Rui Bernardes,et al.  Optical coherence tomography: automatic retina classification through support vector machines , 2012 .

[9]  James M. Rehg,et al.  Automated macular pathology diagnosis in retinal OCT images using multi-scale spatial pyramid and local binary patterns in texture and shape encoding , 2011, Medical Image Anal..

[10]  Gwénolé Quellec,et al.  Deep image mining for diabetic retinopathy screening , 2016, Medical Image Anal..

[11]  Ayman El-Baz,et al.  A computer‐aided diagnostic system for detecting diabetic retinopathy in optical coherence tomography images , 2017, Medical physics.

[12]  R V North,et al.  Incidence of diabetic retinopathy in people with type 2 diabetes mellitus attending the Diabetic Retinopathy Screening Service for Wales: retrospective analysis , 2012, BMJ : British Medical Journal.

[13]  C. Sinthanayothin,et al.  Automated detection of diabetic retinopathy on digital fundus images , 2002, Diabetic medicine : a journal of the British Diabetic Association.

[14]  C. Bunce,et al.  Anti-vascular endothelial growth factor for macular oedema secondary to branch retinal vein occlusion. , 2013, The Cochrane database of systematic reviews.

[15]  Vasile Palade,et al.  Automatic screening and classification of diabetic retinopathy and maculopathy using fuzzy image processing , 2016, Brain Informatics.

[16]  F. Lu,et al.  Repeatability and Reproducibility of Eight Macular Intra-Retinal Layer Thicknesses Determined by an Automated Segmentation Algorithm Using Two SD-OCT Instruments , 2014, PloS one.

[17]  M. Abràmoff,et al.  Improved Automated Detection of Diabetic Retinopathy on a Publicly Available Dataset Through Integration of Deep Learning. , 2016, Investigative ophthalmology & visual science.

[18]  R. Ansari,et al.  Thickness profiles of retinal layers by optical coherence tomography image segmentation. , 2008, American journal of ophthalmology.

[19]  U. Rajendra Acharya,et al.  Automated Identification of Diabetic Retinopathy Stages Using Digital Fundus Images , 2008, Journal of Medical Systems.

[20]  Bálint Antal,et al.  An Ensemble-Based System for Microaneurysm Detection and Diabetic Retinopathy Grading , 2012, IEEE Transactions on Biomedical Engineering.

[21]  C. M. Lim,et al.  Computer-based detection of diabetes retinopathy stages using digital fundus images , 2009, Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine.

[22]  B. Klein,et al.  Global Prevalence and Major Risk Factors of Diabetic Retinopathy , 2012, Diabetes Care.

[23]  Sina Farsiu,et al.  Fully automated detection of diabetic macular edema and dry age-related macular degeneration from optical coherence tomography images. , 2014, Biomedical optics express.

[24]  Sven Loncaric,et al.  Segmentation of the foveal microvasculature using deep learning networks , 2016, Journal of biomedical optics.

[25]  Tien Yin Wong,et al.  Artificial Intelligence With Deep Learning Technology Looks Into Diabetic Retinopathy Screening. , 2016, JAMA.

[26]  Geoffrey E. Hinton,et al.  Deep Learning , 2015, Nature.

[27]  J. Shaw,et al.  Global estimates of the prevalence of diabetes for 2010 and 2030. , 2010, Diabetes research and clinical practice.

[28]  Qaisar Abbas,et al.  Automatic recognition of severity level for diagnosis of diabetic retinopathy using deep visual features , 2017, Medical & Biological Engineering & Computing.

[29]  Rishab Gargeya,et al.  Automated Identification of Diabetic Retinopathy Using Deep Learning. , 2017, Ophthalmology.

[30]  Frans Coenen,et al.  Convolutional Neural Networks for Diabetic Retinopathy , 2016, MIUA.

[31]  Nassir Navab,et al.  ReLayNet: Retinal Layer and Fluid Segmentation of Macular Optical Coherence Tomography using Fully Convolutional Network , 2017, Biomedical optics express.

[32]  Pascale Massin,et al.  A contribution of image processing to the diagnosis of diabetic retinopathy-detection of exudates in color fundus images of the human retina , 2002, IEEE Transactions on Medical Imaging.

[33]  Daniel S. Kermany,et al.  Identifying Medical Diagnoses and Treatable Diseases by Image-Based Deep Learning , 2018, Cell.

[34]  U. Rajendra Acharya,et al.  Algorithms for the Automated Detection of Diabetic Retinopathy Using Digital Fundus Images: A Review , 2012, Journal of Medical Systems.

[35]  D. Ting,et al.  Diabetic retinopathy: global prevalence, major risk factors, screening practices and public health challenges: a review , 2016, Clinical & experimental ophthalmology.

[36]  S. Wild,et al.  Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. , 2004, Diabetes care.

[37]  Kilian Q. Weinberger,et al.  Densely Connected Convolutional Networks , 2016, 2017 IEEE Conference on Computer Vision and Pattern Recognition (CVPR).

[38]  Aliaa A. A. Youssif,et al.  Optic Disc Detection From Normalized Digital Fundus Images by Means of a Vessels' Direction Matched Filter , 2008, IEEE Transactions on Medical Imaging.

[39]  Hiroshi Murata,et al.  Detecting Preperimetric Glaucoma with Standard Automated Perimetry Using a Deep Learning Classifier. , 2016, Ophthalmology.

[40]  Michael J. Pencina,et al.  Trends in the Incidence of Type 2 Diabetes Mellitus From the 1970s to the 1990s: The Framingham Heart Study , 2006, Circulation.

[41]  J. Duker,et al.  Optical coherence tomography of age-related macular degeneration and choroidal neovascularization. , 1996, Ophthalmology.

[42]  Freddy T. Nguyen,et al.  Optical coherence tomography: a review of clinical development from bench to bedside. , 2007, Journal of biomedical optics.

[43]  Subhashini Venugopalan,et al.  Development and Validation of a Deep Learning Algorithm for Detection of Diabetic Retinopathy in Retinal Fundus Photographs. , 2016, JAMA.

[44]  Adnan Tufail,et al.  Evaluation of age-related macular degeneration with optical coherence tomography. , 2012, Survey of ophthalmology.

[45]  Xuelong Li,et al.  Multiple Representations-Based Face Sketch–Photo Synthesis , 2016, IEEE Transactions on Neural Networks and Learning Systems.

[46]  Jie Li,et al.  DLFace: Deep local descriptor for cross-modality face recognition , 2019, Pattern Recognit..

[47]  Geraint Rees,et al.  Clinically applicable deep learning for diagnosis and referral in retinal disease , 2018, Nature Medicine.