title: Automated detection of diabetic retinopathy on digital fundus images.
abstract: OBJECTIVE
  The aim was to develop an automated screening system to analyse digital colour retinal images for important features of non-proliferative diabetic retinopathy (NPDR).
  
  
  METHODS
  High performance pre-processing of the colour images was performed. Previously described automated image analysis systems were used to detect major landmarks of the retinal image (optic disc, blood vessels and fovea). Recursive region growing segmentation algorithms combined with the use of a new technique, termed a 'Moat Operator', were used to automatically detect features of NPDR. These features included haemorrhages and microaneurysms (HMA), which were treated as one group, and hard exudates as another group. Sensitivity and specificity data were calculated by comparison with an experienced fundoscopist.
  
  
  RESULTS
  The algorithm for exudate recognition was applied to 30 retinal images of which 21 contained exudates and nine were without pathology. The sensitivity and specificity for exudate detection were 88.5% and 99.7%, respectively, when compared with the ophthalmologist. HMA were present in 14 retinal images. The algorithm achieved a sensitivity of 77.5% and specificity of 88.7% for detection of HMA.
  
  
  CONCLUSIONS
  Fully automated computer algorithms were able to detect hard exudates and HMA. This paper presents encouraging results in automatic identification of important features of NPDR.
authors.affiliation: Image Processing Group, Department of Physics, King's College London , UK.
authors.forename: C
authors.initials: C
authors.lastname: Sinthanayothin
authors.forename: J F
authors.initials: JF
authors.lastname: Boyce
authors.forename: T H
authors.initials: TH
authors.lastname: Williamson
authors.forename: H L
authors.initials: HL
authors.lastname: Cook
authors.forename: E
authors.initials: E
authors.lastname: Mensah
authors.forename: S
authors.initials: S
authors.lastname: Lal
authors.forename: D
authors.initials: D
authors.lastname: Usher
mesh_terms: D000465:Algorithms; D001331:Automation; D003930:Diabetic Retinopathy / Q000175:diagnosis*; D005451:Fluorescein Angiography / Q000379:methods*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D015203:Reproducibility of Results; D012160:Retina / Q000033:anatomy & histology / Q000473:pathology*