An automated CAD system for accurate grading of uveitis using optical coherence tomography images

Uveitis is one of the leading causes of severe vision loss that can lead to blindness world-wide. Clinical records show that early and accurate detection of vitreous inflammation can potentially reduce the blindness rate. In this paper, a novel framework is proposed for automatic quantification of the vitreous on optical coherence tomography (OCT) with particular application for use in the grading of vitreous inflammation. The proposed pipeline consists of two stages, vitreous region segmentation followed by a neural network classifier. In the first stage, the vitreous region is automatically segmented using a U-net convolutional neural network (U-CNN). For the input of U-CNN, we utilized three novel image descriptors to account for the visual appearance similarity of the vitreous region and other tissues. Namely, we developed an adaptive appearance-based approach that utilizes a prior shape information, which consisted of a labeled dataset of the manually segmented images. This image descriptor is adaptively updated during segmentation and is integrated with the original greyscale image and a distance map image descriptor to construct an input fused image for the U-net segmentation stage. In the second stage, a fully connected neural network (FCNN) is proposed as a classifier to assess the vitreous inflammation severity. To achieve this task, a novel discriminatory feature of the segmented vitreous region is extracted. Namely, the signal intensities of the vitreous are represented by a cumulative distribution function (CDF). The constructed CDFs are then used to train and test the FCNN classifier for grading (grade from 0 to 3). The performance of the proposed pipeline is evaluated on a dataset of 200 OCT images. Our segmentation approach documented a higher performance than related methods, as evidenced by the Dice coefficient of 0.988 ± 0.01 and Hausdorff distance of 0.0003 mm ± 0.001 mm. On the other hand, the FCNN classification is evidenced by its average accuracy of 86%, which supports the benefits of the proposed pipeline as an aid for early and objective diagnosis of uvea inflammation.