Objective analysis of toric intraocular lens rotation and centration

PURPOSE: To assess the repeatability of an objective image analysis technique to determine intraocular lens (IOL) rotation and centration. SETTING: Six ophthalmology clinics across Europe. METHODS: One-hundred seven patients implanted with Akreos AO aspheric IOLs with orientation marks were imaged. Image quality was rated by a masked observer. The axis of rotation was determined from a line bisecting the IOL orientation marks. This was normalized for rotation of the eye between visits using the axis bisecting 2 consistent conjunctival vessels or iris features. The center of ovals overlaid to circumscribe the IOL optic edge and the pupil or limbus were compared to determine IOL centration. Intrasession repeatability was assessed in 40 eyes and the variability of repeated analysis examined. RESULTS: Intrasession rotational stability of the IOL was ±0.79 degrees (SD) and centration was ±0.10 mm horizontally and ±0.10 mm vertically. Repeated analysis variability of the same image was ±0.70 degrees for rotation and ±0.20 mm horizontally and ±0.31 mm vertically for centration. Eye rotation (absolute) between visits was 2.23 ± 1.84 degrees (10%>5 degrees rotation) using one set of consistent conjunctival vessels or iris features and 2.03 ± 1.66 degrees (7%>5 degrees rotation) using the average of 2 sets (P =.13). Poorer image quality resulted in larger apparent absolute IOL rotation (r =-0.45,P<.001). CONCLUSIONS: Objective analysis of digital retroillumination images allows sensitive assessment of IOL rotation and centration stability. Eye rotation between images can lead to significant errors if not taken into account. Image quality is important to analysis accuracy.

Rotational and centration stability of an aspheric intraocular lens with a simulated toric design

Purpose: To assess the stability of the Akreos AO intraocular lens (IOL) platform with a simulated toric design using objective image analysis. Setting: Six hospital eye clinics across Europe. Methods: After implantation in 1 eye of patients, IOLs with orientation marks were imaged at 1 to 2 days, 7 to 14 days, 30 to 60 days, and 120 to 180 days. The axis of rotation and IOL centration were objectively assessed using validated image analysis. Results: The study enrolled 107 patients with a mean age of 69.9 years ± 7.7 (SD). The image quality was sufficient for IOL rotation analysis in 91% of eyes. The mean rotation between the first day postoperatively and 120 to 180 days was 1.93 ± 2.33 degrees, with 96% of IOLs rotating fewer than 5 degrees and 99% rotating fewer than 10 degrees. There was no significant rotation between visits and no clear bias in the direction of rotation. In 71% of eyes, the dilation and image quality was sufficient for image analysis of centration. The mean change in centration between 1 day and 120 to 180 days was 0.21 ± 0.11 mm, with all IOLs decentering less than 0.5 mm. There was no significant decentration between visits and no clear bias in the direction of the decentration. Conclusion: Objective analysis of digital retroillumination images taken at different postoperative periods shows the aspheric IOL platform was stable in the eye and is therefore suitable for the application of a toric surface to correct corneal astigmatism.

ICA for watermarking digital images

A domain independent ICA-based approach to watermarking is presented. This approach can be used on images, music or video to embed either a robust or fragile watermark. In the case of robust watermarking, the method shows high information rate and robustness against malicious and non-malicious attacks, while keeping a low induced distortion. The fragile watermarking scheme, on the other hand, shows high sensitivity to tampering attempts while keeping the requirement for high information rate and low distortion. The improved performance is achieved by employing a set of statistically independent sources (the independent components) as the feature space and principled statistical decoding methods. The performance of the suggested method is compared to other state of the art approaches. The paper focuses on applying the method to digitized images although the same approach can be used for other media, such as music or video.

Transmission of image data over digital networks involving mobile terminals

There is a growing demand for data transmission over digital networks involving mobile terminals. An important class of data required for transmission over mobile terminals is image information such as street maps, floor plans and identikit images. This sort of transmission is of particular interest to the service industries such as the Police force, Fire brigade, medical services and other services. These services cannot be applied directly to mobile terminals because of the limited capacity of the mobile channels and the transmission errors caused by the multipath (Rayleigh) fading. In this research, transmission of line diagram images such as floor plans and street maps, over digital networks involving mobile terminals at transmission rates of 2400 bits/s and 4800 bits/s have been studied. A low bit-rate source encoding technique using geometric codes is found to be suitable to represent line diagram images. In geometric encoding, the amount of data required to represent or store the line diagram images is proportional to the image detail. Thus a simple line diagram image would require a small amount of data. To study the effect of transmission errors due to mobile channels on the transmitted images, error sources (error files), which represent mobile channels under different conditions, have been produced using channel modelling techniques. Satisfactory models of the mobile channel have been obtained when compared to the field test measurements. Subjective performance tests have been carried out to evaluate the quality and usefulness of the received line diagram images under various mobile channel conditions. The effect of mobile transmission errors on the quality of the received images has been determined. To improve the quality of the received images under various mobile channel conditions, forward error correcting codes (FEC) with interleaving and automatic repeat request (ARQ) schemes have been proposed. The performance of the error control codes have been evaluated under various mobile channel conditions. It has been shown that a FEC code with interleaving can be used effectively to improve the quality of the received images under normal and severe mobile channel conditions. Under normal channel conditions, similar results have been obtained when using ARQ schemes. However, under severe mobile channel conditions, the FEC code with interleaving shows better performance.

Novel hardwired distributive tactile sensing system for medical applications

This thesis described the research carried out on the development of a novel hardwired tactile sensing system tailored for the application of a next generation of surgical robotic and clinical devices, namely a steerable endoscope with tactile feedback, and a surface plate for patient posture and balance. Two case studies are examined. The first is a one-dimensional sensor for the steerable endoscope retrieving shape and ‘touch’ information. The second is a two-dimensional surface which interprets the three-dimensional motion of a contacting moving load. This research can be used to retrieve information from a distributive tactile sensing surface of a different configuration, and can interpret dynamic and static disturbances. This novel approach to sensing has the potential to discriminate contact and palpation in minimal invasive surgery (MIS) tools, and posture and balance in patients. The hardwired technology uses an embedded system based on Field Programmable Gate Arrays (FPGA) as the platform to perform the sensory signal processing part in real time. High speed robust operation is an advantage from this system leading to versatile application involving dynamic real time interpretation as described in this research. In this research the sensory signal processing uses neural networks to derive information from input pattern from the contacting surface. Three neural network architectures namely single, multiple and cascaded were introduced in an attempt to find the optimum solution for discrimination of the contacting outputs. These architectures were modelled and implemented into the FPGA. With the recent introduction of modern digital design flows and synthesis tools that essentially take a high-level sensory processing behaviour specification for a design, fast prototyping of the neural network function can be achieved easily. This thesis outlines the challenge of the implementations and verifications of the performances.

Digital image watermarking

In recent years, interest in digital watermarking has grown significantly. Indeed, the use of digital watermarking techniques is seen as a promising mean to protect intellectual property rights of digital data and to ensure the authentication of digital data. Thus, a significant research effort has been devoted to the study of practical watermarking systems, in particular for digital images. In this thesis, a practical and principled approach to the problem is adopted. Several aspects of practical watermarking schemes are investigated. First, a power constaint formulation of the problem is presented. Then, a new analysis of quantisation effects on the information rate of digital watermarking scheme is proposed and compared to other approaches suggested in the literature. Subsequently, a new information embedding technique, based on quantisation, is put forward and its performance evaluated. Finally, the influence of image data representation on the performance of practical scheme is studied along with a new representation based on independent component analysis.

Watermarking biomedical time series data

This thesis addresses the problem of information hiding in low dimensional digital data focussing on issues of privacy and security in Electronic Patient Health Records (EPHRs). The thesis proposes a new security protocol based on data hiding techniques for EPHRs. This thesis contends that embedding of sensitive patient information inside the EPHR is the most appropriate solution currently available to resolve the issues of security in EPHRs. Watermarking techniques are applied to one-dimensional time series data such as the electroencephalogram (EEG) to show that they add a level of confidence (in terms of privacy and security) in an individual’s diverse bio-profile (the digital fingerprint of an individual’s medical history), ensure belief that the data being analysed does indeed belong to the correct person, and also that it is not being accessed by unauthorised personnel. Embedding information inside single channel biomedical time series data is more difficult than the standard application for images due to the reduced redundancy. A data hiding approach which has an in built capability to protect against illegal data snooping is developed. The capability of this secure method is enhanced by embedding not just a single message but multiple messages into an example one-dimensional EEG signal. Embedding multiple messages of similar characteristics, for example identities of clinicians accessing the medical record helps in creating a log of access while embedding multiple messages of dissimilar characteristics into an EPHR enhances confidence in the use of the EPHR. The novel method of embedding multiple messages of both similar and dissimilar characteristics into a single channel EEG demonstrated in this thesis shows how this embedding of data boosts the implementation and use of the EPHR securely.

What is the prevalence of diabetic macular oedema involving the centre of the macula in patients undergoing digital diabetic retinopathy screening

Free Paper Sessions Design. Retrospective analysis. Purpose. To assess the prevalence of center-involving diabetic macular oedema (CIDMO) and risk factors. Methods. Retrospective review of patients who were screen positive for maculopathy (M1) during 2010 in East and North Birmingham. The CIDMO was diagnosed by qualitative identification of definite foveal oedema on optical coherence tomography (OCT). Results. Out of a total of 15,234 patients screened, 1194 (7.8%) were screen positive for M1 (64% bilateral). A total of 137 (11.5% of M1s) were diagnosed with macular oedema after clinical assessment. The OCT results were available for 123/137; 69 (56.1%) of these had CI-DMO (30 bilateral) which is 0.5% of total screens and 5.8% of those screen positive for M1. In those with CIDMO 60.9% were male and 63.8% Caucasian; 90% had type 2 diabetes and mean diabetes duration was 20 years (SD 9.7, range 2-48). Mean HbA1c was 8.34%±1.69, with 25% having an HbA1c =9%. Furthermore, 62% were on insulin, 67% were on antihypertensive therapy, and 64% were on a cholesterol-lowering drug. A total of 37.7% had an eGFR between 30% and 60% and 5.8% had eGFR <30. The only significant difference between the CIDMO and non-CIDMO group was mean age (67.83±12.26 vs 59.69±15.82; p=0.002). A total of 65.2% of those with CIDMO also had proliferative or preproliferative retinopathy in the worst eye and 68.1% had subsequently been treated with macular laser at the time of data review. Conclusions. The results show that the prevalence of CIDMO in our diabetic population was 0.5%. A significant proportion of macula oedema patients were found to have type 2 diabetes with long disease duration, suboptimal glycemic and hypertensive control, and low eGFR. The data support that medical and diabetic review of CIDMO patients is warranted particularly in the substantial number with poor glycemic control and if intravitreal therapies are indicated.

Task-based annotation and retrieval for image information management

Continuing advances in digital image capture and storage are resulting in a proliferation of imagery and associated problems of information overload in image domains. In this work we present a framework that supports image management using an interactive approach that captures and reuses task-based contextual information. Our framework models the relationship between images and domain tasks they support by monitoring the interactive manipulation and annotation of task-relevant imagery. During image analysis, interactions are captured and a task context is dynamically constructed so that human expertise, proficiency and knowledge can be leveraged to support other users in carrying out similar domain tasks using case-based reasoning techniques. In this article we present our framework for capturing task context and describe how we have implemented the framework as two image retrieval applications in the geo-spatial and medical domains. We present an evaluation that tests the efficiency of our algorithms for retrieving image context information and the effectiveness of the framework for carrying out goal-directed image tasks. © 2010 Springer Science+Business Media, LLC.

Quantitative analysis of multi-spectral fundus images

We have developed a new technique for extracting histological parameters from multi-spectral images of the ocular fundus. The new method uses a Monte Carlo simulation of the reflectance of the fundus to model how the spectral reflectance of the tissue varies with differing tissue histology. The model is parameterised by the concentrations of the five main absorbers found in the fundus: retinal haemoglobins, choroidal haemoglobins, choroidal melanin, RPE melanin and macular pigment. These parameters are shown to give rise to distinct variations in the tissue colouration. We use the results of the Monte Carlo simulations to construct an inverse model which maps tissue colouration onto the model parameters. This allows the concentration and distribution of the five main absorbers to be determined from suitable multi-spectral images. We propose the use of "image quotients" to allow this information to be extracted from uncalibrated image data. The filters used to acquire the images are selected to ensure a one-to-one mapping between model parameters and image quotients. To recover five model parameters uniquely, images must be acquired in six distinct spectral bands. Theoretical investigations suggest that retinal haemoglobins and macular pigment can be recovered with RMS errors of less than 10%. We present parametric maps showing the variation of these parameters across the posterior pole of the fundus. The results are in agreement with known tissue histology for normal healthy subjects. We also present an early result which suggests that, with further development, the technique could be used to successfully detect retinal haemorrhages.

The effect of digital image resolution and compression on anterior eye imaging

Aim: To determine the theoretical and clinical minimum image pixel resolution and maximum compression appropriate for anterior eye image storage. Methods: Clinical images of the bulbar conjunctiva, palpebral conjunctiva, and corneal staining were taken at the maximum resolution of Nikon:CoolPix990 (2048 × 1360 pixels), DVC:1312C (1280 × 811), and JAI:CV-S3200 (767 × 569) single chip cameras and the JVC:KYF58 (767 × 569) three chip camera. The images were stored in TIFF format and further copies created with reduced resolution or compressed. The images were then ranked for clarity on a 15 inch monitor (resolution 1280 × 1024) by 20 optometrists and analysed by objective image analysis grading. Theoretical calculation of the resolution necessary to detect the smallest objects of clinical interest was also conducted. Results: Theoretical calculation suggested that the minimum resolution should be ≥579 horizontal pixels at 25 × magnification. Image quality was perceived subjectively as being reduced when the pixel resolution was lower than 767 × 569 (p<0.005) or the image was compressed as a BMP or <50% quality JPEG (p<0.005). Objective image analysis techniques were less susceptible to changes in image quality, particularly when using colour extraction techniques. Conclusion: It is appropriate to store anterior eye images at between 1280 × 811 and 767 × 569 pixel resolution and at up to 1:70 JPEG compression.

Task-based image annotation and retrieval

In order to address problems of information overload in digital imagery task domains we have developed an interactive approach to the capture and reuse of image context information. Our framework models different aspects of the relationship between images and domain tasks they support by monitoring the interactive manipulation and annotation of task-relevant imagery. The approach allows us to gauge a measure of a user's intentions as they complete goal-directed image tasks. As users analyze retrieved imagery their interactions are captured and an expert task context is dynamically constructed. This human expertise, proficiency, and knowledge can then be leveraged to support other users in carrying out similar domain tasks. We have applied our techniques to two multimedia retrieval applications for two different image domains, namely the geo-spatial and medical imagery domains. © Springer-Verlag Berlin Heidelberg 2007.

Clinical monitoring of ocular physiology using digital image analysis

Aim: To examine the use of image analysis to quantify changes in ocular physiology. Method: A purpose designed computer program was written to objectively quantify bulbar hyperaemia, tarsal redness, corneal staining and tarsal staining. Thresholding, colour extraction and edge detection paradigms were investigated. The repeatability (stability) of each technique to changes in image luminance was assessed. A clinical pictorial grading scale was analysed to examine the repeatability and validity of the chosen image analysis technique. Results: Edge detection using a 3 × 3 kernel was found to be the most stable to changes in image luminance (2.6% over a +60 to -90% luminance range) and correlated well with the CCLRU scale images of bulbar hyperaemia (r = 0.96), corneal staining (r = 0.85) and the staining of palpebral roughness (r = 0.96). Extraction of the red colour plane demonstrated the best correlation-sensitivity combination for palpebral hyperaemia (r = 0.96). Repeatability variability was <0.5%. Conclusions: Digital imaging, in conjunction with computerised image analysis, allows objective, clinically valid and repeatable quantification of ocular features. It offers the possibility of improved diagnosis and monitoring of changes in ocular physiology in clinical practice. © 2003 British Contact Lens Association. Published by Elsevier Science Ltd. All rights reserved.

Validation of a multi-component digital dissolution model for irregular particles

A new mesoscale simulation model for solids dissolution based on an computationally efficient and versatile digital modelling approach (DigiDiss) is considered and validated against analytical solutions and published experimental data for simple geometries. As the digital model is specifically designed to handle irregular shapes and complex multi-component structures, use of the model is explored for single crystals (sugars) and clusters. Single crystals and the cluster were first scanned using X-ray microtomography to obtain a digital version of their structures. The digitised particles and clusters were used as a structural input to digital simulation. The same particles were then dissolved in water and the dissolution process was recorded by a video camera and analysed yielding: the overall dissolution times and images of particle size and shape during the dissolution. The results demonstrate the coherence of simulation method to reproduce experimental behaviour, based on known chemical and diffusion properties of constituent phase. The paper discusses how further sophistications to the modelling approach will need to include other important effects such as complex disintegration effects (particle ejection, uncertainties in chemical properties). The nature of the digital modelling approach is well suited to for future implementation with high speed computation using hybrid conventional (CPU) and graphical processor (GPU) systems.