PubMed Health⌕ Search

Biomedical subjects

Stephen R Fransen

Publications and source records attributed to Stephen R Fransen.

2 recordsLinked to original sources

Hybrid retinal image registration.

This work studies retinal image registration in the context of the National Institutes of Health (NIH) Early Treatment Diabetic Retinopathy Study (ETDRS) standard. The ETDRS imaging protocol specifies seven fields of each retina and presents three major challenges for the image registration task. First, small overlaps between adjacent fields lead to inadequate landmark points for feature-based methods. Second, the non-uniform contrast/intensity distributions due to imperfect data acquisition will deteriorate the performance of area-based techniques. Third, high-resolution images contain large homogeneous nonvascular/texureless regions that weaken the capabilities of both feature-based and area-based techniques. In this work, we propose a hybrid retinal image registration approach for ETDRS images that effectively combines both area-based and feature-based methods. Four major steps are involved. First, the vascular tree is extracted by using an efficient local entropy-based thresholding technique. Next, zeroth-order translation is estimated by maximizing mutual information based on the binary image pair (area-based). Then image quality assessment regarding the ETDRS field definition is performed based on the translation model. If the image pair is accepted, higher-order transformations will be involved. Specifically, we use two types of features, landmark points and sampling points, for affine/quadratic model estimation. Three empirical conditions are derived experimentally to control the algorithm progress, so that we can achieve the lowest registration error and the highest success rate. Simulation results on 504 pairs of ETDRS images show the effectiveness and robustness of the proposed algorithm.

Algorithms↗

Clinical evaluation of patients with diabetic retinopathy: accuracy of the Inoveon diabetic retinopathy-3DT system.

PURPOSE: This study analyzed the accuracy of the Inoveon Diabetic Retinopathy (DR-3DT) system (Inoveon Corp., Oklahoma City, OK), a scalable evaluation method for the management of diabetic retinopathy using high-quality digital retinal imaging. DESIGN: An independent, masked, cross-sectional, clinical validation study. PARTICIPANTS: Two hundred ninety adult patients with diabetes from the Chickasaw Nation's Carl Albert Indian Health Facility in Ada, Oklahoma. METHODS: All participants underwent DRS7 imaging using a Zeiss FF450 fundus camera with images recorded on 35-mm film and a Kodak DCS520 digital camera back. Masked double grading with independent third reader adjudication yielded an Early Treatment Diabetic Retinopathy Study (ETDRS) Final Retinopathy Severity Scale Level (ETDRS Level) and macular edema stage for each eye. The presence of greater-than-or-equal ETDRS Level 53, questionable or definite clinically significant macular edema in either eye, or ungradeable images was defined as a threshold event requiring referral. MAIN OUTCOME MEASURES: Accuracy (sensitivity, specificity, predictive values) of the digital system relative to the film "gold standard" on the threshold referral criteria per patient. RESULTS: All patients with gradeable 35-mm slides from at least one eye were included in this per patient analysis (n = 290). The prevalence of threshold events was 19.3%. The sensitivity of the digital system in detecting threshold events was 98.2% (95% confidence interval [CI], 90.5%-100.0%) and specificity 89.7% (95% CI, 85.1%-93.3%). The positive predictive value was 69.5% and negative predictive value 99.5% for this sample. CONCLUSIONS: When compared with the "gold standard," Inoveon's DR-3DT system provides highly accurate diabetic retinopathy referral decisions. Given their inherent advantages, high-quality digital imaging systems could replace the film "gold standard" as the basis for scalable, accessible, diabetic retinopathy evaluation.

Adult↗