2008 Congress on Image and Signal Processing
Neural Network Based Retinal Image Analysis
J.David
College of Engineering Trivandrum,Kerala,India
daviddavisdale@yahoo.com
Abstract
Diabetic-retinopathy contributes to serious health
problem in many parts of the world. With the
motivation of the needs of the medical community
system for early screening of diabetics and other
diseases a computer aided diagnosis system is
proposed. This work is aimed to develop an automated
system to analyze the retinal images for important
features of diabetic retinopathy using image
processing techniques and an image classifier based
on artificial neural network which classify the images
according to the disease conditions. The consistent
identifying and quantifying of changes in blood vessels
and different findings such as exudates in the retina
over time can be used for the early detection of
diabetic retinopathy. The algorithm has been tested on
an image data base and the results are presented.
Vascular network, optic disc and lesions like exudates
are identified. A neural network classifier is developed
and a comparative study on the performance is also
presented.
1. Introduction
Diabetic retinopathy is a micro vascular
complication that may occur in patients with diabetes.
The occurrence of diabetic retinopathy will result in
the disturbance of visual capability and can eventually
leads to blindness. The longer a person has untreated
diabetes, the higher his chance of developing diabetic
retinopathy. Along with diabetes, high blood sugar
levels in long periods can affect small vessels in the
retina. Diabetic retinopathy becomes symptomatic in
its later stage. In the first stage, diabetic patients may
not be aware of having infected by the disease [1].
Early detection of diabetic retinopathy plays a major
role in the success of such disease treatment, so that the
worse case can be anticipated.
978-0-7695-3119-9/08 $25.00 © 2008 IEEE
DOI 10.1109/CISP.2008.666
Authorized licensed use limited to: Jawaharlal Nehru Technological University. Downloaded on July 17, 2009 at 00:59 from IEEE Xplore. Restrictions apply.
Rekha Krishnan Sukesh Kumar. A
Diagnosis of diabetic retinopathy is usually
conducted by the Ophthalmologist by employing
retinal images of patients. By using a fundus camera,
an ophthalmologist can obtain retinal images from
patients to be diagnosed. From the image symptoms
will be identified manually by an ophthalmologist,
therefore the more patients to be diagnosed; the more
time will be needed. A computerized screening system
can be used for fully automated mass screening [2].
Such systems screen a large number of retinal images
and identify abnormal images, which are then further
examined by an ophthalmologist. This would save a
significant amount of workload and time for
ophthalmologists, allowing them to concentrate their
resources on surgery and treatment.
Normal structures of retina are the optic disk,
macula, and blood vessels. The characteristic features
of diabetic retinopathy are microaneurysms,
hemorrhages and exudates. This work describes image
analysis methods for the automatic recognition of
retinal components and pathologies like exudates [3].
From the set of parameters like vessel ratio, ratio of
exudates area to the total area of the images are
distributed into different groups like normal, severe,
mild, abnormal etc. Neural network can be used
effectively in data classification [4].
2. Proposed System
The fundus photographs were taken with a fundus
camera during mass screening. These photographs
were then scanned by a flat-bed scanner and saved as
image files. The image files were then analyzed using
the algorithms described in the following section: The
block diagram of the proposed system is shown in
figure (1).
49
 RETINAL PRE-
FUNDUS PROCESSING
IMAGES
COMPARISON
WITH PARAMETER
NORMAL AQUISITION
VALUES
NEURAL RESULTS
NETWORK
CLASSIFIER
Figure 1. Block diagram of proposed system
RGB color system is converted to HIS. Optic disc
was well discernable in hue and intensity channel. So
intensity channel was selected for further analysis.
Intensity channel was converted to grayscale image
and histogram equalization was applied. To reduce the
speckle noise in the image, median filter was applied.
Figure 2. shows the original and preprocessed image.
Figure 2. a. Original fundus image
b. Preprocessed image
Optic disc is the reference for the other features in the
retinal fundus image. It delivers a calibration of the
measurements that are done, and it determines
approximately the localization of the macula, the
center of vision, which is of great importance as
lesions in the macular region affects vision immediate
[5].
The detection of optic disc is based on the fact
that it is one of the brightest image regions, although
not the brightest. First apply a 5×5 median filter to
attenuate image noise. Then apply morphological
closing followed by opening to suppress most of the
information of blood vessel. The structuring element
is a disc larger than largest vessel cross-section
.Finally we will get a bright area as plausible optic disc
candidate. Figure 3. shows the detected optic disc.
Authorized licensed use limited to: Jawaharlal Nehru Technological University. Downloaded on July 17, 2009 at 00:59 from IEEE Xplore. Restrictions apply.
FEATURE
EXTRACTION
Figure 3. Detected Optic Disc
Blood vessels appear as networks of either deep or
orange-red filaments that originate within the optic-
disc and are of progressively diminishing width.
Information about blood vessels in retinal images can
be used in grading disease severity. This helps the
ophthalmologists to analyze the case of diabetic
retinopathy with progression of time [6]. Blood
vessels are extracted by the segmentation with wavelet
transform. The Haar wavelet was used to transform
target images with minimal loss and in conjunction
with a thresholding technique. Figure 4 shows the
Extracted blood vessels.
Exudates are one of the most common occurring
lesions in diabetic retinopathy. They are often
distributed in a circular pattern peripheral to areas of
chronic focal leakage. The shape, brightness and
location of exudates vary among different patients [7].
Exudates are detected using thresholding approach.
Since the lesion appear as bright regions in a fundus
image, thresholding the image with a high gray value
will result in a binary image containing only optic disc
and exudates regions. We use connected component
method to distinguish exudates regions from the optic
disc.Fig.5 shows the detected exudates from a retinal
image.
The parameters used for the classification of images
are ratio of main blood vessels and area of exudates.
Due to blockages in the vessels and change in the
blood sugar levels caused by diabetes, there will be a
change in the diameters of the blood vessels. This
change is inverse in the arteries and the veins. The
diameter of arteries will decrease and that of veins
increases. The normal ratio of the diameter of the main
venule to the main arteriole in the retinal vascular
system is less then 1.5. For diabetic patients this ratio
increases above 1.5 [8].
50
 Table 1: Parameters used for classification

Ratio of exudates
Ratio of blood
area with total area Diabetic stages
vessels
0.0167
3..9000 Severe
0.0166
1.7189 Severe

1.7176 0.0096 Severe

1.7500 0.0008 Severe

1.7000 0.0029 Severe

Figure 4. Extracted blood vessels 0.1044

4.0025 Severe

1.8779 0.0500 Severe

0.0471
1.8277 Severe

1.7625 0.0494 Severe

1.7405 0.0105 Severe

1.6631 0 Moderate

1.6858 0.0002 Moderate

1.6139 0.0129 Moderate

1.6900 0 Moderate

1.6130 0 Moderate

Figure 5. Detected exudates 1.6410 0.0032 Moderate

0.0048
1.6320 Moderate
As the disease progresses, exudates may appear in the 1.5827 0.0239 Mild
retina and the presence of exudates indicates the extent
of the disease. Estimation of exudates can reveal the 1.5904 0.0062 Mild
severity of diabetic retinopathy. 1.5340 0.0049 Mild
0.0049
1.5375 Mild
3. Neural Network Classifier
In this work we investigated two types of classifiers 1.5078
0.0088
Mild
called Learning Vector Quantization (LVQ) network
and back propagation network. 1.5425 0 Mild
LVQ is a type of neural network which makes the 1.5229 0.0004 Normal
classification by creating a number of free parameter
0.0001
vectors in the feature space, corresponding to different 1.5089 Normal
classes. Each class may have a number of such vectors.
1.5006 0 Normal
Each candidate object is classified depending on which
codebook vector is closest, and the training set is used 1.4820 0 Normal
to set the codebook vectors to the correct classes. This 1.5047 0 Normal
has the advantage of adding nonlinearity to the
1.4980 0 Normal
classification, where the amount of nonlinearity is
proportional to the number of codebook vectors [9].
LVQ networks classify input vectors into target classes
by using a competitive layer to find subclasses of input
vectors, and then combining them into the target
classes. Figure 6 shows the architecture of the
implemented LVQ network.

51

Authorized licensed use limited to: Jawaharlal Nehru Technological University. Downloaded on July 17, 2009 at 00:59 from IEEE Xplore. Restrictions apply.
 random fluctuations in the weight space, which in turn
may lead to an unstable situation in the sense that the
network weights may not converge[11].

Both learning vector quantization algorithm and back

Figure 6.Architecture of implemented
network
Back-propagation was created by generalizing the
Widrow-Hoff learning rule to multiple-layer networks
and nonlinear differentiable transfer functions. The
network is trained by supervised learning method. The
network weights are moved along the negative of the
gradient of the performance function. Input vectors and
the corresponding target vectors are used to train a
network until it can approximate a function, associate
input vectors with specific output vectors, or classify
input vectors in an appropriate way as defined by the
user. Networks with biases, a sigmoid layer, and a
linear output layer are capable of approximating any
function with a finite number of discontinuities [10].
Figure 7 shows the architecture of implemented back
propagation network.
propagation algorithm is simulated in Matlab. Images
LVQ are classified in to four classes where class1 for images
having severe risk of diabetic retinopathy, class2
belongs to moderate diabetic stage, class 3 for images
having mild diabetic condition and class 4 represents
normal stage. A training set of 30 values and testing set
of 20 values are used. Accuracy of classification of
training data for back propagation net is 96.67% and
for LVQ is 93.3%.Accuracy of classification of testing
data for back propagation net is 95% and for LVQ is
90.3%.Performance of both classifiers is observed.
From the performance of the nets for the same training
and testing set, we infer that with back-propagation net
is best suited for the classification of this particular set
of data.

Figure 7. Architecture of implemented back

propagation network

Figure 8. Performance of LVQ network

The back propagation learning involves propagation

of the error backwards from the output layer to the
hidden layers in order to determine the update for the
weights leading to the units in a hidden layer. The
weight adjustment is proportional to the negative
gradient of the error with respect to the weight which
is done by presenting the given set of training patterns
several times. Randomizing the presentation of these
patterns tends to make the search in the weight space
stochastic, and thus reduces the possibility of limit
cycles in the trajectory in the weight space during
learning. Learning rate parameter plays a crucial role in
the back-propagation learning. The order of the values
for learning rate parameter depends on the variance of
Figure 9. Performance of back propagation
the input data. If the this parameter is too large the
network
learning speed may increase, but will result in a large

52

Authorized licensed use limited to: Jawaharlal Nehru Technological University. Downloaded on July 17, 2009 at 00:59 from IEEE Xplore. Restrictions apply.
 9. Conclusion
In this paper we described image processing
techniques, which can play a major role in the
diagnosis of diabetic retinopathy. A comparative study
of the performance of neural network classifiers for the
set of data shows that back-propagation network give
good performance. This study can be extended for the
analysis of other diseases like hypertension, stroke,
migraine, hearing loss etc. Methods are currently being
investigated for improving performance.
[7] A. Osareh, M. Mirmehdi, B. Thomas, and R. Markham,
“Automatic recognition of exudative maculopathy
using fuzzy c-means clustering and neural networks,” in
Proc. Medical Image Understanding Analysis Conf.,
July 2001, pp. 49–55.
[8] L Gang, 0 Chutatape, and S M Krishnan, "Detection and
measurement of retinal vessels in fundus images using
amplitude modified second-order gaussian filter," IEEE
Trans. Biomedical Engineering, vol. 49, pp 168-
172, 2002.
[9] B. Yegnanarayana, Artificial neural networks, Prentice-
Hall of India private limilted,1999.

10. Acknowledgment [10] Simon Haykin., Neural networks a comprehensive

foundation, Pearson Education Asia, 2001.
Authors would like to thank Dr. K. Mahadevan,
[11] C.M. Bishop, Neural Networks for Pattern Recognition.
Department of ophthalmology, Regional Institute of 1995, New York: Oxford University Press.
ophthalmology, Thiruvananthapuram for providing
database of retina images and Clinical details.

11. References
[1] D. Klein, B. E Klein, S. E Moss et al “The Wisconsin
epidemiologic study of diabetic retinopathy VII.
Diabetic nonproliferative retinal lesions,” Br. J
Ophthalmol,vol 94,1986

[2] Michael Goldbaum, Saied Moezzi, Adam Taylor,

Shankar Chatterjee, Jeff Boyd, Edward Hunter, and
Ramesh Jain, “Automated diagonosis and image
understanding with object extraction, object
classification, and inferencing in retinal images”. Br. J
Ophthalmol, vol 83,august 1999

[3] C.Sinthanayothin, J. Boyce, H. Cook, and T.

Williamson, “Automated localisation of optic disc,
fovea, and retinal blood vessels from digital color
fundus images”, Br. J Ophthalmol, vol 83,august 1999

[4] Anil K. Jain Michigan State University, Jianchang

Mao IBM Almaden Research Center.,” Artificial
neural networks: A tutorial”.,1996

[5] A.Osareh, M. Mirmehdi, B. Thomas and R. Markham,

"Colour Morphologic and Fast and Robust Optic Disc
Detection and Snakes for optic disc Localisation", In the
Proceedings of 7th European method. Conference on
Computer Vision, Springer LNCS 2353, 2002, pp. 502-
516.

[6] Huiqi Li and Opas Chutatape,”Automated feature

extraction in color retinal images by a model based
approach”, IEEE Trans. on Biomedical Engineering,
vol 51,No 2,February 2004

53

Authorized licensed use limited to: Jawaharlal Nehru Technological University. Downloaded on July 17, 2009 at 00:59 from IEEE Xplore. Restrictions apply.