title: Combined Methods for Diabetic Retinopathy Screening, Using Retina Photographs and Tear Fluid Proteomics Biomarkers.
abstract: Background. It is estimated that 347 million people suffer from diabetes mellitus (DM), and almost 5 million are blind due to diabetic retinopathy (DR). The progression of DR can be slowed down with early diagnosis and treatment. Therefore our aim was to develop a novel automated method for DR screening. Methods. 52 patients with diabetes mellitus were enrolled into the project. Of all patients, 39 had signs of DR. Digital retina images and tear fluid samples were taken from each eye. The results from the tear fluid proteomics analysis and from digital microaneurysm (MA) detection on fundus images were used as the input of a machine learning system. Results. MA detection method alone resulted in 0.84 sensitivity and 0.81 specificity. Using the proteomics data for analysis 0.87 sensitivity and 0.68 specificity values were achieved. The combined data analysis integrated the features of the proteomics data along with the number of detected MAs in the associated image and achieved sensitivity/specificity values of 0.93/0.78. Conclusions. As the two different types of data represent independent and complementary information on the outcome, the combined model resulted in a reliable screening method that is comparable to the requirements of DR screening programs applied in clinical routine.
authors.affiliation: Department of Computer Graphics and Image Processing, Bioinformatics Research Group, Faculty of Informatics, University of Debrecen, Egyetem tér 1, Debrecen 4032, Hungary ; Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Egyetem tér 1, Debrecen 4032, Hungary ; Astridbio Technologies Inc., 439 University Avenue, Toronto, ON, Canada M5G 1Y8.
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Torok
authors.affiliation: NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, 162 City Road, London EC1V 2PD, UK.
authors.forename: Tunde
authors.initials: T
authors.lastname: Peto
authors.affiliation: Department of Biochemistry and Molecular Biology, Proteomics Core Facility, Faculty of Medicine, University of Debrecen, Egyetem tér 1, Debrecen 4032, Hungary.
authors.forename: Eva
authors.initials: E
authors.lastname: Csosz
authors.affiliation: Department of Computer Graphics and Image Processing, Bioinformatics Research Group, Faculty of Informatics, University of Debrecen, Egyetem tér 1, Debrecen 4032, Hungary ; Astridbio Technologies Inc., 439 University Avenue, Toronto, ON, Canada M5G 1Y8.
authors.forename: Edit
authors.initials: E
authors.lastname: Tukacs
authors.affiliation: Centre for Research on Inner City Health, Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, 30 Bond Street, Toronto, ON, Canada M5B 1W8.
authors.forename: Agnes M
authors.initials: AM
authors.lastname: Molnar
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Egyetem tér 1, Debrecen 4032, Hungary ; InnoTears Ltd., Szent Anna Utca 37/1. 2. em. 1, Debrecen 4024, Hungary.
authors.forename: Andras
authors.initials: A
authors.lastname: Berta
authors.affiliation: Department of Biochemistry and Molecular Biology, Proteomics Core Facility, Faculty of Medicine, University of Debrecen, Egyetem tér 1, Debrecen 4032, Hungary ; InnoTears Ltd., Szent Anna Utca 37/1. 2. em. 1, Debrecen 4024, Hungary.
authors.forename: Jozsef
authors.initials: J
authors.lastname: Tozser
authors.affiliation: Department of Computer Graphics and Image Processing, Bioinformatics Research Group, Faculty of Informatics, University of Debrecen, Egyetem tér 1, Debrecen 4032, Hungary.
authors.forename: Andras
authors.initials: A
authors.lastname: Hajdu
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Egyetem tér 1, Debrecen 4032, Hungary.
authors.forename: Valeria
authors.initials: V
authors.lastname: Nagy
authors.affiliation: Astridbio Technologies Inc., 439 University Avenue, Toronto, ON, Canada M5G 1Y8.
authors.forename: Balint
authors.initials: B
authors.lastname: Domokos
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Egyetem tér 1, Debrecen 4032, Hungary ; InnoTears Ltd., Szent Anna Utca 37/1. 2. em. 1, Debrecen 4024, Hungary.
authors.forename: Adrienne
authors.initials: A
authors.lastname: Csutak
mesh_terms: D000368:Aged; D000783:Aneurysm / Q000175:diagnosis*; D015415:Biomarkers / Q000378:metabolism; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000378:metabolism*; D003930:Diabetic Retinopathy / Q000175:diagnosis*; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D007091:Image Processing, Computer-Assisted; D000069550:Machine Learning; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010781:Photography; D020543:Proteome / Q000378:metabolism*; D040901:Proteomics; D012160:Retina; D012171:Retinal Vessels; D012680:Sensitivity and Specificity; D013666:Tears / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D020543:Proteome