Characterization of the retinal vasculature in fundus photos using the PanOptic iExaminer system
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RESEARCH
Open Access
Characterization of the retinal vasculature in fundus photos using the PanOptic iExaminer system Huiling Hu1,2, Haicheng Wei3,4, Mingxia Xiao3,4, Liqiong Jiang1, Huijuan Wang2,5, Hong Jiang2,6, Tatjana Rundek6 and Jianhua Wang2*
Abstract Background: The goal was to characterize retinal vasculature by quantitative analysis of arteriole-to-venule (A/V) ratio and vessel density in fundus photos taken with the PanOptic iExaminer System. Methods: The PanOptic ophthalmoscope equipped with a smartphone was used to acquire fundus photos centered on the optic nerve head. Two fundus photos of a total of 19 eyes from 10 subjects were imaged. Retinal vessels were analyzed to obtain the A/V ratio. In addition, the vessel tree was extracted using deep learning U-NET, and vessel density was processed by the percentage of pixels within vessels over the entire image. Results: All images were successfully processed for the A/V ratio and vessel density. There was no significant difference of averaged A/V ratio between the first (0.77 ± 0.09) and second (0.77 ± 0.10) measurements (P = 0.53). There was no significant difference of averaged vessel density (%) between the first (6.11 ± 1.39) and second (6.12 ± 1.40) measurements (P = 0.85). Conclusions: Quantitative analysis of the retinal vasculature was feasible in fundus photos taken using the PanOptic ophthalmoscope. The device appears to provide sufficient image quality for analyzing A/V ratio and vessel density with the benefit of portability, easy data transferring, and low cost of the device, which could be used for pre-clinical screening of systemic, cerebral and ocular diseases. Keywords: Smartphone ophthalmoscope, Image analysis, Deep learning, Arteriovenous ratio, Vessel density, Retina
Background The retina provides a direct, non-invasive, and easily accessible window for observing the microvascular system. The vasculature of the retina and brain are anatomically and physiologically similar [1]. Fundus photography is a useful tool to observe and monitor changes in the retinal vasculature. Large-scale epidemiology studies based on fundus photography reported that the changes of retinal * Correspondence: [email protected] 2 Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 1638 NW 10th Avenue, McKnight Building Room 202A, Miami, FL 33136, USA Full list of author information is available at the end of the article
vessels are associated with the risk of retinal and systemic diseases, including diabetic retinopathy [2], stroke [3], cardiovascular mortality [4] and dementia [5]. While the traditional fundus camera offers goodquality images for analysis of large retinal vessels, these fundus camera systems are based in hospitals and research facilities. The office-based systems require skillful technicians and are limited to the subjectivity of the clinician’s interpretation. These systems are also bulky and costly, which limits their use in community screening efforts, especially in remote areas [6
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