Journal
TRANSLATIONAL VISION SCIENCE & TECHNOLOGY
Volume 4, Issue 6, Pages -Publisher
ASSOC RESEARCH VISION OPHTHALMOLOGY INC
DOI: 10.1167/tvst.4.6.5
Keywords
computer-based image analysis; retinopathy of prematurity; machine learning
Categories
Funding
- National Institutes of Health, Bethesda, MD [EY19474, P30 EY010572, EY22387]
- Research to Prevent Blindness (New York, NY)
- St. Giles Foundation
- Bernadotte Foundation for Children's Eyecare
- Novartis Excellence in Ophthalmic Vision Award - XOVA
- iNsight Foundation
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Purpose: We developed and evaluated the performance of a novel computer-based image analysis system for grading plus disease in retinopathy of prematurity (ROP), and identified the image features, shapes, and sizes that best correlate with expert diagnosis. Methods: A dataset of 77 wide-angle retinal images from infants screened for ROP was collected. A reference standard diagnosis was determined for each image by combining image grading from 3 experts with the clinical diagnosis from ophthalmoscopic examination. Manually segmented images were cropped into a range of shapes and sizes, and a computer algorithm was developed to extract tortuosity and dilation features from arteries and veins. Each feature was fed into our system to identify the set of characteristics that yielded the highest-performing system compared to the reference standard, which we refer to as the i-ROP'' system. Results: Among the tested crop shapes, sizes, and measured features, point-based measurements of arterial and venous tortuosity (combined), and a large circular cropped image (with radius 6 times the disc diameter), provided the highest diagnostic accuracy. The i-ROP system achieved 95% accuracy for classifying preplus and plus disease compared to the reference standard. This was comparable to the performance of the 3 individual experts (96%, 94%, 92%), and significantly higher than the mean performance of 31 nonexperts (81%). Conclusions: This comprehensive analysis of computer-based plus disease suggests that it may be feasible to develop a fully-automated system based on wide-angle retinal images that performs comparably to expert graders at three-level plus disease discrimination.
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