Glaucoma is a serious ocular disorder for which the screening and diagnosis are carried out by the examination of the optic nerve head (ONH). The color fundus image (CFI) is the most common modality used for ocular screening. In CFI, the central region which is the optic disc and the optic cup region within the disc are examined to determine one of the important cues for glaucoma diagnosis called the optic cup-to-disc ratio (CDR). CDR calculation requires accurate segmentation of optic disc and cup. Another important cue for glaucoma progression is the variation of depth in ONH region. In this paper, we first propose a deep learning framework to estimate depth from a single fundus image. For the case of monocular retinal depth estimation, we are also plagued by the labeled data insufficiency. To overcome this problem we adopt the technique of pretraining the deep network where, instead of using a denoising autoencoder, we propose a new pretraining scheme called pseudo-depth reconstruction, which serves as a proxy task for retinal depth estimation. Empirically, we show pseudo-depth reconstruction to be a better proxy task than denoising. Our results outperform the existing techniques for depth estimation on the INSPIRE dataset. To extend the use of depth map for optic disc and cup segmentation, we propose a novel fully convolutional guided network, where, along with the color fundus image the network uses the depth map as a guide. We propose a convolutional block called multimodal feature extraction block to extract and fuse the features of the color image and the guide image. We extensively evaluate the proposed segmentation scheme on three datasets- ORIGA, RIMONEr3, and DRISHTI-GS. The performance of the method is comparable and in many cases, outperforms the most recent state of the art.
Automatic retinal image analysis is emerging as an important screening tool for early detection of eye diseases. Glaucoma is one of the most common causes of blindness. The manual examination of optic disk (OD) is a standard procedure used for detecting glaucoma. In this paper, we present an automatic OD parameterization technique based on segmented OD and cup regions obtained from monocular retinal images. A novel OD segmentation method is proposed which integrates the local image information around each point of interest in multidimensional feature space to provide robustness against variations found in and around the OD region. We also propose a novel cup segmentation method which is based on anatomical evidence such as vessel bends at the cup boundary, considered relevant by glaucoma experts. Bends in a vessel are robustly detected using a region of support concept, which automatically selects the right scale for analysis. A multi-stage strategy is employed to derive a reliable subset of vessel bends called r-bends followed by a local spline fitting to derive the desired cup boundary. The method has been evaluated on 138 images comprising 33 normal and 105 glaucomatous images against three glaucoma experts. The obtained segmentation results show consistency in handling various geometric and photometric variations found across the dataset. The estimation error of the method for vertical cup-to-disk diameter ratio is 0.09 0.08 (mean standard deviation) while for cup-to-disk area ratio it is 0.12 0.10. Overall, the obtained qualitative and quantitative results show effectiveness in both segmentation and subsequent OD parameterization for glaucoma assessment. Glaucoma is a leading cause of permanent blindness. However, disease progression can be limited if detected early. The optic cup-to-disc ratio (CDR) is one of the main clinical indicators of glaucoma, and is currently determined manually, limiting its potential in mass screening. In this paper, we propose an automatic CDR determination method using a variational level-set approach to segment the optic disc and cup from retinal fundus images. The method is a core component of ARGALI, a system for automated glaucoma risk assessment. Threshold analysis is used in pre-processing to estimate the initial contour. Due to the presence of retinal vasculature traversing the disc and cup boundaries which can cause inaccuracies in the detected contours, an ellipse-fitting post-processing step is also introduced. The method was tested on 104 images from the Singapore Malay Eye Study, and it was found the results produced a clinically acceptable variation of up to 0.2 CDR units from the manually graded samples, with potential use in mass screening.