title: A fully automatic nerve segmentation and morphometric parameter quantification system for early diagnosis of diabetic neuropathy in corneal images.
abstract: Diabetic Peripheral Neuropathy (DPN) is one of the most common types of diabetes that can affect the cornea. An accurate analysis of the nerve structures can assist the early diagnosis of this disease. This paper proposes a robust, fast and fully automatic nerve segmentation and morphometric parameter quantification system for corneal confocal microscope images. The segmentation part consists of three main steps. First, a preprocessing step is applied to enhance the visibility of the nerves and remove noise using anisotropic diffusion filtering, specifically a Coherence filter followed by Gaussian filtering. Second, morphological operations are applied to remove unwanted objects in the input image such as epithelial cells and small nerve segments. Finally, an edge detection step is applied to detect all the nerves in the input image. In this step, an efficient algorithm for connecting discontinuous nerves is proposed. In the morphometric parameters quantification part, a number of features are extracted, including thickness, tortuosity and length of nerve, which may be used for the early diagnosis of diabetic polyneuropathy and when planning Laser-Assisted in situ Keratomileusis (LASIK) or Photorefractive keratectomy (PRK). The performance of the proposed segmentation system is evaluated against manually traced ground-truth images based on a database consisting of 498 corneal sub-basal nerve images (238 are normal and 260 are abnormal). In addition, the robustness and efficiency of the proposed system in extracting morphometric features with clinical utility was evaluated in 919 images taken from healthy subjects and diabetic patients with and without neuropathy. We demonstrate rapid (13 seconds/image), robust and effective automated corneal nerve quantification. The proposed system will be deployed as a useful clinical tool to support the expertise of ophthalmologists and save the clinician time in a busy clinical setting.
authors: School of Electrical Engineering and Computer Science, University of Bradford, Bradford, UK. Electronic address: sun_algold@yahoo.com.
authors: Shumoos
authors: S
authors: Al-Fahdawi
authors: School of Electrical Engineering and Computer Science, University of Bradford, Bradford, UK.
authors: Rami
authors: R
authors: Qahwaji
authors: School of Electrical Engineering and Computer Science, University of Bradford, Bradford, UK.
authors: Alaa S
authors: AS
authors: Al-Waisy
authors: School of Electrical Engineering and Computer Science, University of Bradford, Bradford, UK.
authors: Stanley
authors: S
authors: Ipson
authors: Division of Medicine, Weill Cornell Medical College in Qatar, Doha, Qatar; Centre for Endocrinology and Diabetes, Institute of Human Development, University of Manchester and the Manchester Royal Infirmary, Central Manchester Hospital Foundation Trust, Manchester, UK.
authors: Rayaz A
authors: RA
authors: Malik
authors: Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M13 9WL, UK.
authors: Arun
authors: A
authors: Brahma
authors: Centre for Imaging Sciences, Institute of Population Health, University of Manchester, Manchester, UK.
authors: Xin
authors: X
authors: Chen
mesh_terms: D001341:Autonomic Nervous System / Q000033:anatomy & histology*; D016022:Case-Control Studies; D003315:Cornea / Q000294:innervation*; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000473:pathology*; D006801:Humans
keywords: Anisotropic diffusion filtering; Automatic nerve segmentation; Corneal confocal microscopy; Corneal subbasal epithelium; Diabetes; Diabetic peripheral neuropathy