Comparison of Diagnosis of Early Retinal Lesions of Diabetic Retinopathy Between a Computer System and Human Experts

Abstract

Objective: To investigate whether a computer vision system is comparable with humans in detecting early retinal lesions of diabetic retinopathy using color fundus photographs.Methods: A computer system has been developed using image processing and pattern recognition techniques to detect early lesions of diabetic retinopathy (hemorrhages and microaneurysms, hard exudates, and cotton-wool spots). Color fundus photographs obtained from American Indians in Oklahoma were used in developing and testing the system. A set of 369 color fundus slides were used to train the computer system using 3 diagnostic categories: lesions present, questionable, or absent (Y/Q/N). A different set of 428 slides were used to test and evaluate the system, and its diagnostic results were compared with those of 2 human experts-the grader at the University of Wisconsin Fundus Photograph Reading Center (Madison) and a general ophthalmologist. The experiments included comparisons using 3 (Y/Q/N) and 2 diagnostic categories (Y/N) (questionable cases excluded in the latter).Results: In the training phase, the agreement rates, sensitivity, and specificity in detecting the 3 lesions between the retinal specialist and the computer system were all above 90%. The statistics were high (0.75-0.97), indicating excellent agreement between the specialist and the computer system. In the testing phase, the results obtained between the computer system and human experts were consistent with those of the training phase, and they were comparable with those between the human experts. Conclusions:The performance of the computer vision system in diagnosing early retinal lesions was comparable with that of human experts. Therefore, this mobile, electronically easily accessible, and noninvasive computer system, could become a mass screening tool and a clinical aid in diagnosing early lesions of diabetic retinopathy.

Feasibility Study on Computer-Aided Screening for Diabetic Retinopathy

“…Automated detection of retinal exudates, haemorrhage, and microaneurysm can be used in screening for diabetic retinopathy. [26][27][28][29][30][31][32][33][34] The automated screening program in this study was developed by obtaining images of normal Asian fundi and fundi with nonproliferative diabetic retinopathy. The computer program was then taught to recognize the normal structures of the fundus, such as the optic disc, blood vessels, and fovea, and to distinguish them from abnormal features of diabetic retinopathy, such as exudates, microaneurysms, and haemorrhages, using these images.…”

Automatic Detection of Microaneurysms and Hemorrhages in Color Eye Fundus Images

“…Thus, DR affects adults in working age, being a disease that is strongly associated with inability to work, causing significant costs to institutions and governments. It is estimated that the U.S. government has an annual cost of 500 million dollars in the treatment of visual impairments originated by diabetes [4].…”

“…Fundus photography is a noninvasive technique for photographing the fundus eye and is commonly used in current methods for detection of microaneurysms and hemorrhages, such as [2,4,5,9]. Fluorescein angiography is an invasive technique based on intravenous injection of a fluorescent substance, which produces images with enhanced contrast.…”

Detection of Fundus Lesions Using Classifier Selection

“…In this decade, the research for a CAD system to detect diabetic retinopathy has been ongoing. Lee et al examined the CAD system's reliability by comparing its results to the ones by human specialists [3]. In their research, targets were hemorrhages, microaneurysms, hard exudates, and cotton-wool spots.…”