ABSTRACT
Diabetic retinopathy (DR) poses a significant challenge in diabetes management, with its progression often asymptomatic until advanced stages. This underscores the urgent need for cost-effective and reliable screening methods. Consequently, the integration of artificial intelligence (AI) tools presents a promising avenue to address this need effectively. We provide an overview of the current state of the art results and techniques in DR screening using AI, while also identifying gaps in research for future exploration. By synthesizing existing database and pinpointing areas requiring further investigation, this paper seeks to guide the direction of future research in the field of automatic diabetic retinopathy screening. There has been a continuous rise in the number of articles detailing deep learning (DL) methods designed for the automatic screening of diabetic retinopathy especially by the year 2021. Researchers utilized various databases, with a primary focus on the IDRiD dataset. This dataset consists of color fundus images captured at an ophthalmological clinic situated in India. It comprises 516 images that depict various stages of DR and diabetic macular edema. Each of the chosen papers concentrates on various DR signs. Nevertheless, a significant portion primarily focused on detecting exudates, which remains insufficient to assess the overall presence of this disease. Various AI methods have been employed to identify DR signs. Among the chosen papers, 4.7 % utilized detection methods, 46.5 % employed classification techniques, 41.9 % relied on segmentation, and 7 % opted for a combination of classification and segmentation. Metrics calculated from 80 % of the articles employing preprocessing techniques demonstrated the significant benefits of this approach in enhancing results quality. In addition, multiple DL techniques, starting by classification, detection then segmentation. Researchers used mostly YOLO for detection, ViT for classification, and U-Net for segmentation. Another perspective on the evolving landscape of AI models for diabetic retinopathy screening lies in the increasing adoption of Convolutional Neural Networks for classification tasks and U-Net architectures for segmentation purposes; however, there is a growing realization within the research community that these techniques, while powerful individually, can be even more effective when integrated. This integration holds promise for not only diagnosing DR, but also accurately classifying its different stages, thereby enabling more tailored treatment strategies. Despite this potential, the development of AI models for DR screening is fraught with challenges. Chief among these is the difficulty in obtaining the high-quality, labeled data necessary for training models to perform effectively. This scarcity of data poses significant barriers to achieving robust performance and can hinder progress in developing accurate screening systems. Moreover, managing the complexity of these models, particularly deep neural networks, presents its own set of challenges. Additionally, interpreting the outputs of these models and ensuring their reliability in real-world clinical settings remain ongoing concerns. Furthermore, the iterative process of training and adapting these models to specific datasets can be time-consuming and resource-intensive. These challenges underscore the multifaceted nature of developing effective AI models for DR screening. Addressing these obstacles requires concerted efforts from researchers, clinicians, and technologists to develop new approaches and overcome existing limitations. By doing so, a full potential of AI may transform DR screening and improve patient outcomes.
ABSTRACT
Diabetic retinopathy (DR) remains one of the world's frequent eye illnesses, leading to vision loss among working-aged individuals. Hemorrhages and exudates are examples of signs of DR. However, artificial intelligence (AI), particularly deep learning (DL), is poised to impact nearly every aspect of human life and gradually transform medical practice. Insight into the condition of the retina is becoming more accessible thanks to major advancements in diagnostic technology. AI approaches can be used to assess lots of morphological datasets derived from digital images in a rapid and noninvasive manner. Computer-aided diagnosis tools for automatic detection of DR early-stage signs will ease the pressure on clinicians. In this work, we apply two methods to the color fundus images taken on-site at the Cheikh Zaïd Foundation's Ophthalmic Center in Rabat to detect both exudates and hemorrhages. First, we apply the U-Net method to segment exudates and hemorrhages into red and green colors, respectively. Second, the You Look Only Once Version 5 (YOLOv5) method identifies the presence of hemorrhages and exudates in an image and predicts a probability for each bounding box. The segmentation proposed method obtained a specificity of 85%, a sensitivity of 85%, and a Dice score of 85%. The detection software successfully detected 100% of diabetic retinopathy signs, the expert doctor detected 99% of DR signs, and the resident doctor detected 84%.
