RESUMEN
Retinal imaging is a non-invasive technique used to scan the back of the eye, enabling the extraction of potential biomarkers like the artery and vein ratio (AVR). This ratio is known for its association with various diseases, such as hypertensive retinopathy (HR) or diabetic retinopathy, and is crucial in assessing retinal health. HR refers to the morphological changes in retinal vessels caused by persistent high blood pressure. Timely identification of these alterations is crucial for preventing blindness and reducing the risk of stroke-related fatalities. The main objective of this paper is to propose a new method for assessing one of the morphological changes in the fundus through morphometric analysis of retinal images. The proposed method in this paper introduces a novel approach called the arteriovenous length ratio (AVLR), which has not been utilized in previous studies. Unlike commonly used measures such as the arteriovenous width ratio or tortuosity, AVLR focuses on assessing the relative length of arteries and veins in the retinal vasculature. The initial step involves segmenting the retinal blood vessels and distinguishing between arteries and veins; AVLR is calculated based on artery and vein caliber measurements for both eyes. Nine equations are used, and the length of both arteries and veins is measured in the region of interest (ROI) covering the optic disc for each eye. Using the AV-Classification dataset, the efficiency of the iterative AVLR assessment is evalutaed. The results show that the proposed approach performs better than the existing methods. By introducing AVLR as a diagnostic feature, this paper contributes to advancing retinal imaging analysis. It provides a valuable tool for the timely diagnosis of HR and other eye-related conditions and represents a novel diagnostic-feature-based method that can be integrated to serve as a clinical decision support system.
RESUMEN
Hypertensive retinopathy severity classification is proportionally related to tortuosity severity grading. No tortuosity severity scale enables a computer-aided system to classify the tortuosity severity of a retinal image. This work aimed to introduce a machine learning model that can identify the severity of a retinal image automatically and hence contribute to developing a hypertensive retinopathy or diabetic retinopathy automated grading system. First, the tortuosity is quantified using fourteen tortuosity measurement formulas for the retinal images of the AV-Classification dataset to create the tortuosity feature set. Secondly, a manual labeling is performed and reviewed by two ophthalmologists to construct a tortuosity severity ground truth grading for each image in the AV classification dataset. Finally, the feature set is used to train and validate the machine learning models (J48 decision tree, ensemble rotation forest, and distributed random forest). The best performance learned model is used as the tortuosity severity classifier to identify the tortuosity severity (normal, mild, moderate, and severe) for any given retinal image. The distributed random forest model has reported the highest accuracy (99.4%) compared to the J48 Decision tree model and the rotation forest model with minimal least root mean square error (0.0000192) and the least mean average error (0.0000182). The proposed tortuosity severity grading matched the ophthalmologist's judgment. Moreover, detecting the tortuosity severity of the retinal vessels', optimizing vessel segmentation, the vessel segment extraction, and the created feature set have increased the accuracy of the automatic tortuosity severity detection model.
RESUMEN
Hypertensive retinopathy (HR) refers to changes in the morphological diameter of the retinal vessels due to persistent high blood pressure. Early detection of such changes helps in preventing blindness or even death due to stroke. These changes can be quantified by computing the arteriovenous ratio and the tortuosity severity in the retinal vasculature. This paper presents a decision support system for detecting and grading HR using morphometric analysis of retinal vasculature, particularly measuring the arteriovenous ratio (AVR) and retinal vessel tortuosity. In the first step, the retinal blood vessels are segmented and classified as arteries and veins. Then, the width of arteries and veins is measured within the region of interest around the optic disk. Next, a new iterative method is proposed to compute the AVR from the caliber measurements of arteries and veins using Parr-Hubbard and Knudtson methods. Moreover, the retinal vessel tortuosity severity index is computed for each image using 14 tortuosity severity metrics. In the end, a hybrid decision support system is proposed for the detection and grading of HR using AVR and tortuosity severity index. Furthermore, we present a new publicly available retinal vessel morphometry (RVM) dataset to evaluate the proposed methodology. The RVM dataset contains 504 retinal images with pixel-level annotations for vessel segmentation, artery/vein classification, and optic disk localization. The image-level labels for vessel tortuosity index and HR grade are also available. The proposed methods of iterative AVR measurement, tortuosity index, and HR grading are evaluated using the new RVM dataset. The results indicate that the proposed method gives superior performance than existing methods. The presented methodology is a novel advancement in automated detection and grading of HR, which can potentially be used as a clinical decision support system.
