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Feasibility Study on Computer-Aided Screening for Diabetic Retinopathy

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Abstract

Purpose

To conduct a feasibility study of computer-aided screening for diabetic retinopathy by developing a computerized program to automatically detect retinal changes from digital retinal images.

Methods

The study was carried out in three steps. Step 1 was to collect baseline retinal image data of 600 eyes of normal subjects with normal fundi and data of 300 eyes of diabetic patients with diabetic retinopathy. All data were recorded by digital fundus camera. Step 2 was to analyse all retinal images for normal and abnormal features. By this method, the automated computerized screening program was developed. The program preprocesses colour retinal images and recognizes the main retinal components (optic disc, fovea, and blood vessels) and diabetic features such as exudates, haemorrhages, and microaneurysms. All of the accumulated information is interpreted as normal, abnormal, or unknown. Step 3 was to evaluate the sensitivity and specificity of the computerized screening program by testing the program on diabetic patients and comparing the program's results with the results of screening by retinal specialists.

Results

Diabetic patients (182 patients, 336 eyes) were examined by retinal specialists; 221 eyes had a normal fundus and 115 eyes had nonproliferative diabetic retinopathy. Digital retinal images were taken of these 336 eyes and interpreted by the automated screening program. The program had a sensitivity and specificity of 74.8% and 82.7%, respectively.

Conclusions

The automated screening program was able to differentiate between the normal fundus and the diabetic retinopathy fundus. The program may be beneficial for use in screening for diabetic retinopathy. Further development of the program may provide higher sensitivity. Jpn J Ophthalmol 2006;50:361–366 © Japanese Ophthalmological Society 2006

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References

  1. JC Javitt JK Canner A Sommer (1989) ArticleTitleCost effectiveness of current approaches to the control of retinopathy in type I diabetes Ophthalmology 96 255–264 Occurrence Handle2495499 Occurrence Handle1:STN:280:BiaB3c7otlA%3D

    PubMed  CAS  Google Scholar 

  2. EJ Sussman WG Tsiaras KA Soper (1982) ArticleTitleDiagnosis of diabetic eye disease JAMA 247 3231–3234 Occurrence Handle7087063 Occurrence Handle1:STN:280:Bi2B3MjitVQ%3D Occurrence Handle10.1001/jama.247.23.3231

    Article  PubMed  CAS  Google Scholar 

  3. SE Moss R Klein SD Kessler KA Richie (1985) ArticleTitleComparison between ophthalmoscopy and fundus photography in determining severity of diabetic retinopathy Ophthalmology 92 62–67 Occurrence Handle2579361 Occurrence Handle1:STN:280:DyaL2M7jvFWjtA%3D%3D

    PubMed  CAS  Google Scholar 

  4. RE Ryder S Young JP Vora et al. (1985) ArticleTitleScreening for the diabetic retinopathy using polaroid retinal photography through undilated pupils Pract Diabetes 2 34–39

    Google Scholar 

  5. DR Owen RL Gibbins PA Lewis et al. (1998) ArticleTitleScreening for diabetic retinopathy Diabet Med 15 170–175 Occurrence Handle10.1002/(SICI)1096-9136(199802)15:2<170::AID-DIA518>3.0.CO;2-H

    Article  Google Scholar 

  6. SP Harding DM Broadbent C Neoh MC White J Vora (1995) ArticleTitleSensitivity and specificity of photography and direct ophthalmoscopy in screening for sight-threatening eye disease: the Liverpool diabetic eye study Br Med J 311 1131–1135 Occurrence Handle1:STN:280:BymD2cfosFc%3D

    CAS  Google Scholar 

  7. R Klein BEK Klein MW Neider LD Hubbard SM Meuer RJ Brothers (1985) ArticleTitleDiabetic retinopathy as detected using ophthalmoscopy, a nonmydriatic camera and a standard fundus camera Ophthalmology 92 485–491 Occurrence Handle4000642 Occurrence Handle1:STN:280:DyaL2M3hsV2jtg%3D%3D

    PubMed  CAS  Google Scholar 

  8. JP O'Hare A Hopper C Madhaven et al. (1996) ArticleTitleAdding retinal photography to screening for diabetic retinopathy: a prospective study in primary care Br Med J 312 679–682

    Google Scholar 

  9. JA Pugh JM Jacobson WA Van Heuven et al. (1993) ArticleTitleScreening for diabetic retinopathy. The wide-angle retinal camera Diabetes Care 16 889–895 Occurrence Handle8100761 Occurrence Handle1:STN:280:ByyA3Mvlt1U%3D

    PubMed  CAS  Google Scholar 

  10. VS Lee RM Kingsley ET Lee et al. (1993) ArticleTitleThe diagnosis of diabetic retinopathy. Ophthalmoscopy versus fundus photography Ophthalmology 100 1504–1512 Occurrence Handle8414411 Occurrence Handle1:STN:280:ByuD38%2FntFE%3D

    PubMed  CAS  Google Scholar 

  11. C Clements (2002) ArticleTitleNational screening programme for diabetic retinopathy. Digital image may be better for screening Br Med J 324 849–850

    Google Scholar 

  12. M Henricsson C Karlsson C Ekholm et al. (2000) ArticleTitleColour slides or digital photography in diabetes screening—a comparison Acta Ophthalmol Scand 78 164–168 Occurrence Handle10794249 Occurrence Handle1:STN:280:DC%2BD3c3lt1ahsQ%3D%3D Occurrence Handle10.1034/j.1600-0420.2000.078002164.x

    Article  PubMed  CAS  Google Scholar 

  13. DJ Taylor J Fisher J Jacob JE Tooke (1999) ArticleTitleThe use of digital camera in a mobile retinal screening environment Diabet Med 16 680–686 Occurrence Handle10477214 Occurrence Handle1:STN:280:DyaK1MvgsVyltg%3D%3D Occurrence Handle10.1046/j.1464-5491.1999.00139.x

    Article  PubMed  CAS  Google Scholar 

  14. TH Williamson D Keating (1998) ArticleTitleTelemedicine and computers in diabetic retinopathy screening Br J Ophthalmol 82 5–6 Occurrence Handle9536870 Occurrence Handle1:STN:280:DyaK1c7psl2gug%3D%3D Occurrence Handle10.1136/bjo.82.1.5

    Article  PubMed  CAS  Google Scholar 

  15. P Massin A Erginay A Ben Mehidi et al. (2003) ArticleTitleEvaluation of a new non-mydriatic digital camera for detection of diabetic retinopathy Diabet Med 20 635–641 Occurrence Handle12873290 Occurrence Handle1:STN:280:DC%2BD3szosVemtA%3D%3D Occurrence Handle10.1046/j.1464-5491.2003.01002.x

    Article  PubMed  CAS  Google Scholar 

  16. RSB Newsom C Sinthanayothin JF Boyce AG Casswell TH Williamson (2000) ArticleTitleClinical evaluation of local contrast enhancement for oral fluorescein angiograms Eye 14 318–323 Occurrence Handle11026992

    PubMed  Google Scholar 

  17. C Sinthanayothin JF Boyce HL Cook TH Williamson (1999) ArticleTitleAutomated localisation of the optic disc, fovea and retinal blood vessels from digital colour fundus images Br J Ophthalmol 83 902–910 Occurrence Handle10413690 Occurrence Handle1:STN:280:DC%2BD3c%2Fgt1SqsA%3D%3D

    PubMed  CAS  Google Scholar 

  18. DL Toulson JF Boyce (1992) ArticleTitleSegmentation of MR images using neural nets Image and Vision Computing 10 324–328 Occurrence Handle10.1016/0262-8856(92)90050-D

    Article  Google Scholar 

  19. C Sinthanayothin JF Boyce TH Williamson et al. (2002) ArticleTitleAutomated detection of diabetic retinopathy on digital fundus images Diabet Med 19 105–112 Occurrence Handle11874425 Occurrence Handle1:STN:280:DC%2BD387jvVGlsg%3D%3D Occurrence Handle10.1046/j.1464-5491.2002.00613.x

    Article  PubMed  CAS  Google Scholar 

  20. JL Fleiss (1981) Statistical methods for rates and proportion EditionNumber2nd ed Wiley New York 212–225

    Google Scholar 

  21. InstitutionalAuthorNameDiabetic Retinopathy Study Research Group (1981) ArticleTitleReport No. 7: a modification of the Airlie House classification of diabetic retinopathy Invest Ophthalmol Vis Sci 21 210–226

    Google Scholar 

  22. SE Moss SM Meuer R Klein LD Hubbard RJ Brothers BEK Klein (1989) ArticleTitleAre seven standard photographic fields necessary for classification of diabetic retinopathy? Invest Ophthalmol Vis Sci 30 823–828 Occurrence Handle2656572 Occurrence Handle1:STN:280:BiaB2MvjsFM%3D

    PubMed  CAS  Google Scholar 

  23. JO O'Hare A Hopper C Madhaven et al. (1996) ArticleTitleAdding retinal photography to screening for diabetic retinopathy: a prospective study in the primary care Br Med J 312 679–682

    Google Scholar 

  24. JA Olson FM Strachan JH Hipwell et al. (2003) ArticleTitleA comparative evaluation of digital imaging, retinal photography and optometrist examination in screening for diabetic retinopathy Diabet Med 20 528–534 Occurrence Handle12823232 Occurrence Handle1:STN:280:DC%2BD3s3ps1Wqtw%3D%3D Occurrence Handle10.1046/j.1464-5491.2003.00969.x

    Article  PubMed  CAS  Google Scholar 

  25. PH Scanlon R Malhotra G Thomas et al. (2003) ArticleTitleThe effectiveness of screening for diabetic retinopathy by digital imaging photography and technician ophthalmoscopy Diabet Med 20 467–474 Occurrence Handle12786681 Occurrence Handle1:STN:280:DC%2BD3s3mtFCrug%3D%3D Occurrence Handle10.1046/j.1464-5491.2003.00954.x

    Article  PubMed  CAS  Google Scholar 

  26. RP Phillips T Spencer PG Ross PF Sharp JV Forrester (1991) ArticleTitleQuantification of diabetic maculopathy by digital imaging of the fundus Eye 5 130–137 Occurrence Handle2060662

    PubMed  Google Scholar 

  27. GG Gardner D Keating TH Williamson AT Elliot (1996) ArticleTitleAutomatic detection of diabetic retinopathy using an artificial neural network: a screening tool Br J Ophthalmol 80 940–943 Occurrence Handle8976718 Occurrence Handle1:STN:280:ByiC3s7gs1I%3D

    PubMed  CAS  Google Scholar 

  28. MJ Cree JA Olson KC McHardy PF Sharp JV Forrester (1997) ArticleTitleA fully automated comparative microaneurysm digital detection system Eye 11 622–628 Occurrence Handle9474307

    PubMed  Google Scholar 

  29. JH Hipwell F Strachan JA Olson KC McHardy PF Sharp JV Forrester (2000) ArticleTitleAutomated detection of microaneurysms in digital red-free photographs: a diabetic retinopathy screening tool Diabet Med 17 588–594 Occurrence Handle11073180 Occurrence Handle1:STN:280:DC%2BD3crhsVahug%3D%3D Occurrence Handle10.1046/j.1464-5491.2000.00338.x

    Article  PubMed  CAS  Google Scholar 

  30. S Lee E Lee R Kingsley et al. (2001) ArticleTitleComparison of diagnosis of early retinal lesions of diabetic retinopathy between a computer and human experts Arch Ophthalmol 119 509–515 Occurrence Handle11296016 Occurrence Handle1:STN:280:DC%2BD3M3jslKisw%3D%3D

    PubMed  CAS  Google Scholar 

  31. D Usher M Dumskyj M Himaga TH Williamson S Nussey J Boyce (2004) ArticleTitleAutomated detection of diabetic retinopathy in digital retinal images: a tool for diabetic retinopathy screening Diabet Med 21 84–90 Occurrence Handle14706060 Occurrence Handle1:STN:280:DC%2BD2c%2FmsVWguw%3D%3D Occurrence Handle10.1046/j.1464-5491.2003.01085.x

    Article  PubMed  CAS  Google Scholar 

  32. JC Javitt LP Aiello LJ Bassi YP Chiang JK Canner (1991) ArticleTitleDetecting and treating retinopathy in patients with type I diabetes mellitus. Savings associated with improved implementation of current guidelines Ophthalmology 98 1565–1573 Occurrence Handle1961646 Occurrence Handle1:STN:280:By2D2szhsF0%3D

    PubMed  CAS  Google Scholar 

  33. M Larsen J Godt N Larsen et al. (2003) ArticleTitleAutomated detection of fundus photographic red lesions in diabetic retinopathy Invest Ophthalmol Vis Sci 44 761–766 Occurrence Handle12556411 Occurrence Handle10.1167/iovs.02-0418

    Article  PubMed  Google Scholar 

  34. AB Hansen NV Hartvig MS Jensen et al. (2004) ArticleTitleDiabetic retinopathy screening using digital non-mydriatic fundus photography and automated image analysis Acta Ophthalmol Scand 82 666–672 Occurrence Handle15606461 Occurrence Handle10.1111/j.1600-0420.2004.00350.x

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand

    Apichart Singalavanija, Jirayuth Supokavej & Parapan Bamroongsuk

  2. National Electronics and Computer Technology Center, Bangkok, Thailand

    Chanjira Sinthanayothin, Suthee Phoojaruenchanachai & Viravud Kongbunkiat

Authors
  1. Apichart Singalavanija
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  2. Jirayuth Supokavej
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  3. Parapan Bamroongsuk
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  4. Chanjira Sinthanayothin
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  6. Viravud Kongbunkiat
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Singalavanija, A., Supokavej, J., Bamroongsuk, P. et al. Feasibility Study on Computer-Aided Screening for Diabetic Retinopathy. Jpn J Ophthalmol 50, 361–366 (2006). https://doi.org/10.1007/s10384-005-0328-3

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  • DOI: https://doi.org/10.1007/s10384-005-0328-3

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