Deep Learning Methods for Retinal Disease Diagnosis: History
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Subjects: Ophthalmology | Computer Science, Artificial Intelligence
Contributor:
Mohan Bhandari
,
Tej Bahadur Shahi
,
Arjun Neupane

The advancement of digital medical imaging has brought about a significant change in ophthalmology as it has introduced effective technologies that help in the detection of such diseases. By improving early detection through image analysis and identifying minuscule anomalies, Artificial Intelligence (AI) has considerably coped with retinal diseases. Different Machine Learning (ML) and Convolutional Neural Networks (CNNs) are efficient at analyzing images and are particularly incredible at recognizing complex patterns in medical images.

  • adversarial attacks
  • deep learning
  • health informatics
  • retinal image classification

1. Introduction

The retina, situated at the posterior aspect of the ocular globe, comprises photoreceptor cells adept at transducing luminous stimuli into intricate electrical signals, subsequently dispatched to the cerebral cortex via the optic nerve. This intricate process serves as the foundation for human visual perception, wherein the brain deciphers these electrical transmissions as coherent visual representations. Retinal diseases can seriously affect vision and in some cases, can lead to permanent blindness [1] which is a big problem for the general health of the public. Getting a prompt and accurate diagnosis with the help of automated tools is a great assist for medical specialists in making wise medical decisions. The advancement of digital medical imaging has brought about a significant change in ophthalmology as it has introduced effective technologies that help in the detection of such diseases. By improving early detection through image analysis and identifying minuscule anomalies, Artificial Intelligence (AI) has considerably coped with retinal diseases. AI has also enhanced treatment planning by analyzing patient data and enabling tailored care. Additionally, AI-driven systems help track the development of diseases, resulting in therapies that are more successful [2].
Different Machine Learning (ML) and Convolutional Neural Networks (CNNs) are efficient at analyzing images and are particularly incredible at recognizing complex patterns in medical images [3]. Their ability to diagnose complicated retinal diseases is efficient without a doubt, but in medical practice, using CNNs depends not only on how well they can diagnose the issues but also on how useful they are in places with limited computational resources. Not only CNN, but different variants of CNN like ResNet [4], VGG [5] and more have produced good accuracies statistically. These CNNs and their variants have a very high number of training parameters, and many layers which make it time-consuming in real-time predictions [6] and integration with the Internet-of-Medical-Things (IoMT) [7].
As AI technology advances, it has become essential to not only achieve better diagnostic abilities but also to understand how these AI systems make predictions and decisions [8][9][10]. As these models can be hard to understand because of their statistical nature making them black boxes [11], the addition of Explainable Artificial Intelligence (XAI) into these models can solve the problem. The combination of small and efficient CNN models in IoMT devices with XAI, as a bio-marker, helps retinal disease diagnosis to be more accurate and more accessible for medical experts, practitioners, and even ordinary people.

2. Deep Learning Methods for Retinal Disease Diagnosis

Researchers in health informatics are leveraging the predictive power of Deep Learning (DL) to address the automated diagnosis of various diseases such as COVID-19 [12], monkeypox [13], kidney stone [14] and so on. This section summarises the recent DL methods that have been employed for retinal disease diagnosis using various image modalities. These methods can be categorized into two broad classes: pre-trained DL models (that leverage the transfer learning strategies) and custom-designed CNN (which needs training from scratch).
Subramanian et al. [15] utilised four CNN models such as VGG16, DenseNet-201, Inception-V3, and Xception, to classify seven different retinal diseases. Moreover, Bayesian optimization was employed to fine-tune the hyperparameters of these CNN models, coupled with image augmentation techniques to enhance their ability to generalize. The use of DenseNet-201 in classifying retinal diseases on the Retinal OCT Image dataset resulted in an accuracy exceeding 99%, demonstrating superior performance compared to alternative methods. Puneet et al. [16] implemented the combination of Attention and Transfer Learning approaches into a DCNN for categorizing retinal diseases such as CNV, DME, and Drusen using OCT images. Their proposal achieved notable results, attaining accuracies of 97.79% during training and 95.6% during testing. Kayadibi et al. [17] implemented a hybrid fine-tuned CNN for retinal disease classification from OCT images. They utilized PCA to reduce the feature size and enhance the performance. The benchmarking outcomes for two OCT datasets demonstrated a high level of promise in terms of accuracy. Specifically, the UCSD dataset yielded an impressive accuracy of 99.70% according to Kermany et al.’s study [18], while the Duke dataset achieved a perfect 100% accuracy as reported by Srinivasan et al. [19]. In their research, Kim and colleagues [20] harnessed a variety of Convolutional Neural Networks (CNNs) like VGG16, ResNet50, DenseNet121, and Inception-v3 as feature extractors. Subsequently, they employed these features to develop binary OCT image classification models. A binary classifier model is developed for each category (CNV, DME, Drusen and Normal) and the VGG-16-based model for CNV vs. other classes achieved 98.6% accuracy. They achieve high accuracy using the pre-trained DL models. However, their proposal needs the training of individual models for each class which incurs high computational complexity. A pre-trained VGG-16 network was implemented by Li et al. [21] for retinal image classification on OCT images. They validated the model’s performance on 1000 independent OCT images. Their work revealed that the transfer learning with the VGG-16 model has a promising accuracy of 98.6%, sensitivity of 97.8%, and specificity of 00.4%. With such commendable performance of the model, deep learning can automate the diagnosis of retinal disease. Li et al. [22] adopted the ensemble models for retinal disease classification using OCT images. They trained four DL- models based on improved ResNet50 to build the ensemble and achieved the highest accuracy of 96.3%, sensitivity of 96.6%, and specificity of 98.7%. However, the ResNet50 model is itself the heavyweight model.
In addition to employing pre-trained deep learning models, only a limited number of researchers have created custom CNNs for the classification of retinal images. For example, a deep CNN with six convolution blocks (including the Relu, batch normalization, and pooling operation) was implemented by Sujina et al. [23]. Their proposal achieved a promising accuracy of 99.69% with a low misclassification rate. However, the generalisability of the CNN on additional datasets is not reported. Altan et al. [24] implemented a deep learning architecture to detect the macular edema on OCT images and reported an accuracy of 99.20%.
Hybrid deep learning models for retinal image classification have also been proposed recently. For instance, a hybrid deep learning model for OCT image classification was implemented by Khan et al. [25]. They extracted retinal features from OCT images using three pre-trained deep learning models (DenseNet121, InceptionV3, and ResNet50), and ant colony optimization was used for best feature selection. Finally, the SVM and KNN were employed for classification. Their proposal achieved high performance on OCT image classification. However, the approach is not applicable to end-to-end training of the model.

This entry is adapted from the peer-reviewed paper 10.3390/jimaging9100219

References

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