The present invention relates to the design and implementation of a
three stage computer-aided screening
system that analyzes fundus images with varying illumination and fields of view, and generates a severity grade for
diabetic retinopathy (DR) using
machine learning. In the first stage, bright and red regions are extracted from the
fundus image. An
optic disc has similar structural appearance as bright lesions, and the
blood vessel regions have similar
pixel intensity properties as the red lesions. Hence, the region corresponding to the
optic disc is removed from the bright regions and the regions corresponding to the blood vessels are removed from the red regions. This leads to an image containing bright candidate regions and another image containing red candidate regions. In the second stage, the bright and red candidate regions are subjected to two-step hierarchical classification. In the first step, bright and red
lesion regions are separated from non-
lesion regions. In the second step, the classified bright
lesion regions are further classified as hard exudates or cotton-
wool spots, while the classified red lesion regions are further classified as hemorrhages and micro-aneurysms. In the third stage, the numbers of bright and red lesions per image are combined to generate a DR severity grade. Such a
system will help in reducing the number of patients requiring manual assessment, and will be critical in prioritizing eye-care delivery measures for patients with highest DR severity.