Bruch's membrane (BM) segmentation on optical coherence tomography (OCT) is a pivotal step for the diagnosis and follow-up of age-related macular degeneration (AMD), one of the leading causes of blindness in the developed world. Automated BM segmentation methods exist, but they usually do not account for the anatomical coherence of the results, neither provide feedback on the confidence of the prediction. These factors limit the applicability of these systems in real-world scenarios. With this in mind, we propose an end-to-end deep learning method for automated BM segmentation in AMD patients. An Attention U-Net is trained to output a probability density function of the BM position, while taking into account the natural curvature of the surface. Besides the surface position, the method also estimates an A-scan wise uncertainty measure of the segmentation output. Subsequently, the A-scans with high uncertainty are interpolated using thin plate splines (TPS). We tested our method with ablation studies on an internal dataset with 138 patients covering all three AMD stages, and achieved a mean absolute localization error of 4.10 um. In addition, the proposed segmentation method was compared against the state-of-the-art methods and showed a superior performance on an external publicly available dataset from a different patient cohort and OCT device, demonstrating strong generalization ability.
The presence of drusen is the main hallmark of early/intermediate age-related macular degeneration (AMD). Therefore, automated drusen segmentation is an important step in image-guided management of AMD. There are two common approaches to drusen segmentation. In the first, the drusen are segmented directly as a binary classification task. In the second approach, the surrounding retinal layers (outer boundary retinal pigment epithelium (OBRPE) and Bruch's membrane (BM)) are segmented and the remaining space between these two layers is extracted as drusen. In this work, we extend the standard U-N…
Automated drusen segmentation in retinal optical coherence tomography (OCT) scans is relevant for understanding age-related macular degeneration (AMD) risk and progression. This task is usually performed by segmenting the top/bottom anatomical interfaces that define drusen, the outer boundary of the retinal pigment epithelium (OBRPE) and the Bruch's membrane (BM), respectively. In this paper we propose a novel multi-decoder architecture that tackles drusen segmentation as a multitask problem. Instead of training a multiclass model for OBRPE/BM segmentation, we use one decoder per target class …
Deep Learning-assisted AMD Staging based on OCT and OCT Angiography
Casey Eye Institute, Oregon Health & Science University（奥勒冈健康与科学大学凯斯眼科研究所）；Department of Biomedical Engineering, Oregon Health & Science University（奥勒冈健康与科学大学生物医学工程系）；Department of Ophthalmology, Mackay Memorial Hospital（Mackay纪念医院眼科部）
University of Tehran（德黑兰大学）；Noor Ophthalmology Research Center, Noor Eye Hospital（努尔眼科研究中心，努尔眼科医院）；Henry Ford Health System（亨利·福特医疗系统）
Age-related macular degeneration (AMD) is the most common cause of blindness in developed countries, especially in people over 60 years of age. The workload of specialists and the healthcare system in this field has increased in recent years mainly due to the prevalence of population aging worldwide and the chronic nature of AMD. Recent developments in deep learning have provided a unique opportunity to develop fully automated diagnosis frameworks. Considering the presence of AMD-related retinal pathologies in varying sizes in OCT images, our objective was to propose a multi-scale convolutiona…
Renmin University of China（中国人民大学）；Visionary Intelligence Ltd.（远景智能有限公司）；Peking Union Medical College Hospital（北京协和医院）；Chinese Academy of Medical Sciences（中国医学科学院）
This paper studies automated categorization of age-related macular degeneration (AMD) given a multi-modal input, which consists of a color fundus image and an optical coherence tomography (OCT) image from a specific eye. Previous work uses a traditional method, comprised of feature extraction and classifier training that cannot be optimized jointly. By contrast, we propose a two-stream convolutional neural network (CNN) that is end-to-end. The CNN's fusion layer is tailored to the need of fusing information from the fundus and OCT streams. For generating more multi-modal training instances, we…
Simultaneous column-based deep learning progression analysis of atrophy associated with AMD in longitudinal OCT studies
School of Computer Science and Engineering, The Hebrew University of Jerusalem（耶路撒冷希伯来大学计算机科学与工程学院）；The Alexander Grass Center for Bioengineering, The Hebrew University of Jerusalem（耶路撒冷希伯来大学亚历山大·格拉斯生物工程中心）；Hadassah Medical Center（哈达萨医疗中心）
University of Bern（伯尔尼大学）；Lausanne University（洛桑大学）；University Hospital, Lausanne（洛桑大学医院）；Ecole Polytechnique Federale de Lausanne（洛桑联邦理工学院）；Bern University Hospital（伯尔尼大学医院）
Optical Coherence Tomography (OCT) provides a unique ability to image the eye retina in 3D at micrometer resolution and gives ophthalmologist the ability to visualize retinal diseases such as Age-Related Macular Degeneration (AMD). While visual inspection of OCT volumes remains the main method for AMD identification, doing so is time consuming as each cross-section within the volume must be inspected individually by the clinician. In much the same way, acquiring ground truth information for each cross-section is expensive and time consuming. This fact heavily limits the ability to acquire larg…
Morph-SSL: Self-Supervision with Longitudinal Morphing to Predict AMD Progression from OCT
Medical University of Vienna（维也纳医科大学）；Imperial College London（伦敦帝国学院）；Technical University Munich（慕尼黑工业大学）；Moorfields Eye Hospital NHS Foundation Trust（摩尔菲尔兹眼科医院NHS基金会信托）；University of Basel（巴塞尔大学）；University of Southampton（南安普顿大学）
School of Advanced Technologies in Medicine（医学先进技术学院）；Isfahan University of Medical Sciences（伊斯法罕医科大学）
Age-related Macular Degeneration (AMD) and Diabetic Macular Edema (DME) are the major causes of vision loss in developed countries. Alteration of retinal layer structure and appearance of exudate are the most significant signs of these diseases. With the aim of automatic classification of DME, AMD and normal subjects from Optical Coherence Tomography (OCT) images, we proposed a classification algorithm. The two important issues intended in this approach are, not utilizing retinal layer segmentation which by itself is a challenging task and attempting to identify diseases in their early stages,…
University of Washington School of Medicine（华盛顿大学医学院）
Objective: The advent of Electronic Medical Records (EMR) with large electronic imaging databases along with advances in deep neural networks with machine learning has provided a unique opportunity to achieve milestones in automated image analysis. Optical coherence tomography (OCT) is the most commonly obtained imaging modality in ophthalmology and represents a dense and rich dataset when combined with labels derived from the EMR. We sought to determine if deep learning could be utilized to distinguish normal OCT images from images from patients with Age-related Macular Degeneration (AMD). Me…
The identification and quantification of markers in medical images is critical for diagnosis, prognosis, and disease management. Supervised machine learning enables the detection and exploitation of findings that are known a priori after annotation of training examples by experts. However, supervision does not scale well, due to the amount of necessary training examples, and the limitation of the marker vocabulary to known entities. In this proof-of-concept study, we propose unsupervised identification of anomalies as candidates for markers in retinal Optical Coherence Tomography (OCT) imaging…
Optical coherence tomography (OCT) is a non-invasive 3D modality widely used in ophthalmology for imaging the retina. Achieving automated, anatomically coherent retinal layer segmentation on OCT is important for the detection and monitoring of different retinal diseases, like Age-related Macular Disease (AMD) or Diabetic Retinopathy. However, the majority of state-of-the-art layer segmentation methods are based on purely supervised deep-learning, requiring a large amount of pixel-level annotated data that is expensive and hard to obtain. With this in mind, we introduce a semi-supervised paradi…
Visulytix Ltd（Visulytix有限公司）；King’s College Hospital NHS Foundation Trust（国王学院医院NHS基金会信托）；Cardiff University（卡迪夫大学）；Ophthalmica, Ophthalmology and Microsurgery Institute（Ophthalmica眼科与显微外科研究所）
Purpose: To evaluate Pegasus-OCT, a clinical decision support software for the identification of features of retinal disease from macula OCT scans, across heterogenous populations involving varying patient demographics, device manufacturers, acquisition sites and operators. Methods: 5,588 normal and anomalous macular OCT volumes (162,721 B-scans), acquired at independent centres in five countries, were processed using the software. Results were evaluated against ground truth provided by the dataset owners. Results: Pegasus-OCT performed with AUROCs of at least 98% for all datasets in the detec…
Multiple-surface segmentation in Optical Coherence Tomography (OCT) images is a challenge problem, further complicated by the frequent presence of weak image boundaries. Recently, many deep learning (DL) based methods have been developed for this task and yield remarkable performance. Unfortunately, due to the scarcity of training data in medical imaging, it is challenging for DL networks to learn the global structure of the target surfaces, including surface smoothness. To bridge this gap, this study proposes to seamlessly unify a U-Net for feature learning with a constrained differentiable d…
Segmentation of Retinal Low-Cost Optical Coherence Tomography Images using Deep Learning
Institute of Medical Informatics, University of Lübeck（吕贝克大学医学信息学研究所）；University of Lübeck（吕贝克大学）；Graduate School for Computing in Medicine and Life Sciences, University of Lübeck（医学与生命科学计算研究生学院，吕贝克大学）；Medical Laser Center Lübeck（吕贝克医疗激光中心）；Department of Ophthalmology, University of Kiel（基尔大学眼科部门）；Institute of Biomedical Optics, University of Lübeck（吕贝克大学生物医学光学研究所）
Recent contrastive learning methods achieved state-of-the-art in low label regimes. However, the training requires large batch sizes and heavy augmentations to create multiple views of an image. With non-contrastive methods, the negatives are implicitly incorporated in the loss, allowing different images and modalities as pairs. Although the meta-information (i.e., age, sex) in medical imaging is abundant, the annotations are noisy and prone to class imbalance. In this work, we exploited already existing temporal information (different visits from a patient) in a longitudinal optical coherence…
Patch Progression Masked Autoencoder with Fusion CNN Network for Classifying Evolution Between Two Pairs of 2D OCT Slices
LaTIM UMR 1101, Inserm（LaTIM UMR 1101，Inserm）；University of Western Brittany（西部布列塔尼大学）；Evolucare Technologies（Evolucare技术公司）；College of Computer Science, Sichuan University（四川大学计算机学院）；United Imaging Healthcare（联合影像医疗）；University of Electronic Science and Technology of China（电子科技大学）；Northwestern University（西北大学）；ShanghaiTech University（上海科技大学）；Wuhan University（武汉大学）；MD Anderson Cancer Center（MD安德森癌症中心）；Guangdong General Hospital（广东人民医院）
University of Bern（伯尔尼大学）；RetinAI Medical GmbH（RetinAI Medical 公司）；Bern University Hospital（伯尔尼大学医院）
The automatic segmentation of retinal layer structures enables clinically-relevant quantification and monitoring of eye disorders over time in OCT imaging. Eyes with late-stage diseases are particularly challenging to segment, as their shape is highly warped due to pathological biomarkers. In this context, we propose a novel fully Convolutional Neural Network (CNN) architecture which combines dilated residual blocks in an asymmetric U-shape configuration, and can segment multiple layers of highly pathological eyes in one shot. We validate our approach on a dataset of late-stage AMD patients an…
Multiscale Color Guided Attention Ensemble Classifier for Age-Related Macular Degeneration using Concurrent Fundus and Optical Coherence Tomography Images
Indian Institute of Technology Kharagpur（印度理工学院卡拉格普尔分校）；School of Medical Science and Technology, Indian Institute of Technology Kharagpur（印度理工学院卡拉格普尔分校医学科学与技术学院）；Department of Mathematics, Indian Institute of Technology Kharagpur（印度理工学院卡拉格普尔分校数学系）
Medical University Vienna（维也纳医科大学）；University of Vienna（维也纳大学）；NVIDIA Corporation（英伟达公司）
Diagnosis and treatment guidance are aided by detecting relevant biomarkers in medical images. Although supervised deep learning can perform accurate segmentation of pathological areas, it is limited by requiring a-priori definitions of these regions, large-scale annotations, and a representative patient cohort in the training set. In contrast, anomaly detection is not limited to specific definitions of pathologies and allows for training on healthy samples without annotation. Anomalous regions can then serve as candidates for biomarker discovery. Knowledge about normal anatomical structure br…
University of Coimbra（科英布拉大学）；Erasmus MC（伊拉斯姆斯大学医学中心）；KU Leuven（鲁汶大学）；University of Porto（波尔图大学）；Centro Hospitalar e Universitário São João（圣若昂大学医院中心）；University Hospitals UZ Leuven（鲁汶大学医院）
The optic nerve head represents the intraocular section of the optic nerve (ONH), which is prone to damage by intraocular pressure. The advent of optical coherence tomography (OCT) has enabled the evaluation of novel optic nerve head parameters, namely the depth and curvature of the lamina cribrosa (LC). Together with the Bruch's membrane opening minimum-rim-width, these seem to be promising optic nerve head parameters for diagnosis and monitoring of retinal diseases such as glaucoma. Nonetheless, these optical coherence tomography derived biomarkers are mostly extracted through manual segment…
Optical coherence tomography (OCT) is a non-invasive imaging modality which is widely used in clinical ophthalmology. OCT images are capable of visualizing deep retinal layers which is crucial for early diagnosis of retinal diseases. In this paper, we describe a comprehensive open-access database containing more than 500 highresolution images categorized into different pathological conditions. The image classes include Normal (NO), Macular Hole (MH), Age-related Macular Degeneration (AMD), Central Serous Retinopathy (CSR), and Diabetic Retinopathy (DR). The images were obtained from a raster s…
OCTDL: Optical Coherence Tomography Dataset for Image-Based Deep Learning Methods
Friedrich-Alexander-Universität Erlangen-Nürnberg（弗里德里希-亚历山大-埃尔朗根-纽伦堡大学）；Ural Federal University Named after the First President of Russia B. N. Yeltsin（俄罗斯首任总统B.N.叶利钦命名的乌拉尔联邦大学）；Ophthalmosurgery Clinic "Professorskaya Plus"（“Professorskaya Plus”眼科诊所）；Ural State Medical University（乌拉尔国立医科大学）
Segmentation of retinal layers from Optical Coherence Tomography (OCT) volumes is a fundamental problem for any computer aided diagnostic algorithm development. This requires preprocessing steps such as denoising, region of interest extraction, flattening and edge detection all of which involve separate parameter tuning. In this paper, we explore deep learning techniques to automate all these steps and handle the presence/absence of pathologies. A model is proposed consisting of a combination of Convolutional Neural Network (CNN) and Long Short Term Memory (LSTM). The CNN is used to extract la…
FaraAI Company（法拉人工智能公司）；University of Tehran（德黑兰大学）
Optical coherence tomography (OCT) imaging is a well-known technology for visualizing retinal layers and helps ophthalmologists to detect possible diseases. Accurate and early diagnosis of common retinal diseases can prevent the patients from suffering critical damages to their vision. Computer-aided diagnosis (CAD) systems can significantly assist ophthalmologists in improving their examinations. This paper presents a new enhanced deep ensemble convolutional neural network for detecting retinal diseases from OCT images. Our model generates rich and multi-resolution features by employing the l…
The task of automatically segmenting 3-D surfaces representing boundaries of objects is important for quantitative analysis of volumetric images, and plays a vital role in biomedical image analysis. Recently, graph-based methods with a global optimization property have been developed and optimized for various medical imaging applications. Despite their widespread use, these require human experts to design transformations, image features, surface smoothness priors, and re-design for a different tissue, organ or imaging modality. Here, we propose a Deep Learning based approach for segmentation o…
SD-RetinaNet: Topologically Constrained Semi-Supervised Retinal Lesion and Layer Segmentation in OCT
Christian Doppler Laboratory for Artificial Intelligence in Retina（基督教多普勒人工智能视网膜实验室）；Institute of Artificial Intelligence（人工智能研究所）；Center for Medical Data Science（医学数据科学中心）；Medical University of Vienna（维也纳医学大学）；Computational Imaging Research Lab（计算成像研究实验室）；Department of Biomedical Imaging and Image-Guided Therapy（生物医学成像与影像引导治疗部门）；Department of Ophthalmology and Optometry（眼科与视光学部门）
Pretrained Deep 2.5D Models for Efficient Predictive Modeling from Retinal OCT
University of Basel（巴塞尔大学）；Technical University Munich（慕尼黑工业大学）；Medical University of Vienna（维也纳医科大学）；Moorfields Eye Hospital NHS Foundation Trust（摩尔菲尔斯眼科医院NHS基金会信托）；Imperial College London（帝国理工学院）；Institute of Molecular and Clinical Ophthalmology Basel（巴塞尔分子与临床眼科研究所）；University of Southampton（南安普顿大学）
Forecasting Disease Progression with Parallel Hyperplanes in Longitudinal Retinal OCT
Medical University of Vienna（维也纳医科大学）；University of Basel（巴塞尔大学）；University of Michigan（密歇根大学）；NIHR Moorfields Biomedical Research Centre（NIHR穆尔菲尔德生物医学研究中心）；Technical University Munich（慕尼黑工业大学）；University of Southampton（南安普顿大学）
Iran University Of Science and Technology（伊朗科学技术大学）；Lorestan University（洛雷斯坦大学）；Yasouj University（亚苏季大学）
Optical coherence tomography (OCT) as retina imaging technology is currently used by ophthalmologist as a non-invasive and non-contact method for diagnosis of agerelated degeneration (AMD) and diabetic macular edema (DME) diseases. Fluid regions in OCT images reveal the main signs of AMD and DME. In this paper, an efficient and fast clustering in neutrosophic (NS) domain referred as neutrosophic C-means is adapted for fluid segmentation. For this task, a NCM cost function in NS domain is adapted for fluid segmentation and then optimized by gradient descend methods which leads to binary segment…
Patch-Based and Non-Patch-Based inputs Comparison into Deep Neural Models: Application for the Segmentation of Retinal Diseases on Optical Coherence Tomography Volumes
Laboratoire LIMOS, CNRS UMR 6158（利摩日大学实验室，法国国家科研中心UMR 6158联合研究单位）；Université Clermont-Auvergne（克莱蒙奥弗涅大学）；AL Mansour University College（曼苏尔大学学院）
Accurate choroid segmentation in optical coherence tomography (OCT) image is vital because the choroid thickness is a major quantitative biomarker of many ocular diseases. Deep learning has shown its superiority in the segmentation of the choroid region but subjects to the performance degeneration caused by the domain discrepancies (e.g., noise level and distribution) among datasets obtained from the OCT devices of different manufacturers. In this paper, we present an unsupervised perceptual-assisted adversarial adaptation (PAAA) framework for efficiently segmenting the choroid area by narrowi…
Metadata-enhanced contrastive learning from retinal optical coherence tomography images
Imperial College London（帝国理工学院）；Medical University of Vienna（维也纳医科大学）；University of Michigan（密歇根大学）；King’s College London（伦敦国王学院）；Institute of Molecular and Clinical Ophthalmology Basel（巴塞尔分子与临床眼科研究所）；Universitat Basel（巴塞尔大学）；University College London（伦敦大学学院）；Moorfields Eye Hospital（摩尔菲尔兹眼科医院）；University of Southampton（南安普顿大学）
Deep-learning-based clustering of OCT images for biomarker discovery in age-related macular degeneration (Pinnacle study report 4)
BioMedIA, Imperial College London（伦敦帝国理工学院BioMedIA）；University of Southampton（南安普顿大学）；University College London（伦敦大学学院）；Moorfields Eye Hospital（摩尔菲尔德眼科医院）；Medical University of Vienna（维也纳医科大学）；Christian Doppler Forschungsgesellschaft（克里斯蒂安多普勒研究协会）；University of Basel（巴塞尔大学）；Technical University Munich（慕尼黑工业大学）
Test-Time Adaptation in Optical Coherence Tomography Using Trajectory-Aligned Time-Independent Flow
Institute of Artificial Intelligence, Center for Medical Data Science, Medical University of Vienna, Austria（人工智能研究所、医学数据科学中心、维也纳医学大学，奥地利）；Comprehensive Center for Artificial Intelligence in Medicine, Medical University of Vienna, Austria（医学人工智能综合中心、维也纳医学大学，奥地利）；Department of Ophthalmology and Optometry, Medical University of Vienna, Austria（眼科与视光学部、维也纳医学大学，奥地利）；Laboratory for Ophthalmic Image Analysis, Medical University of Vienna, Austria（眼科图像分析实验室、维也纳医学大学，奥地利）
Many eye diseases like Diabetic Macular Edema (DME), Age-related Macular Degeneration (AMD), and Glaucoma manifest in the retina, can cause irreversible blindness or severely impair the central version. The Optical Coherence Tomography (OCT), a 3D scan of the retina with high qualitative information about the retinal morphology, can be used to diagnose and monitor changes in the retinal anatomy. Many Deep Learning (DL) methods have shared the success of developing an automated tool to monitor pathological changes in the retina. However, the success of these methods depend mainly on large datas…
Deep learning methods for ophthalmic diagnosis have shown considerable success in tasks like segmentation and classification. However, their widespread application is limited due to the models being opaque and vulnerable to making a wrong decision in complicated cases. Explainability methods show the features that a system used to make prediction while uncertainty awareness is the ability of a system to highlight when it is not sure about the decision. This is one of the first studies using uncertainty and explanations for informed clinical decision making. We perform uncertainty analysis of a…
Simon Fraser University（西蒙弗雷泽大学）；Wake Forest University School of Medicine（维克森林大学医学院）；Wake Forest School of Medicine（维克森林大学医学院）；University of Nottingham（诺丁汉大学）；Tencent Jarvis Lab（腾讯Jarvis实验室）；Memorial University of Newfoundland（纽芬兰纪念大学）；University of British Columbia（不列颠哥伦比亚大学）；The University of British Columbia（不列颠哥伦比亚大学）；University College London（伦敦大学学院）
Optical Coherence Tomography(OCT) is a non-invasive technique capturing cross-sectional area of the retina in micro-meter resolutions. It has been widely used as a auxiliary imaging reference to detect eye-related pathology and predict longitudinal progression of the disease characteristics. Retina layer segmentation is one of the crucial feature extraction techniques, where the variations of retinal layer thicknesses and the retinal layer deformation due to the presence of the fluid are highly correlated with multiple epidemic eye diseases like Diabetic Retinopathy(DR) and Age-related Macular…
