Proceedings of the Second International Conference on Smart Electronics and Communication (ICOSEC).

IEEE Xplore Part Number: CFP21V90-ART; ISBN: 978-1-6654-3368-6

Diabetic Retinopathy Diagnosis in OCT images

using Convolutional Neural Network
1. P.Leela Jancy 2. Dr.Iwin Thanakumar Joseph.S
2021 2nd International Conference on Smart Electronics and Communication (ICOSEC) | 978-1-6654-3368-6/21/$31.00 ©2021 IEEE | DOI: 10.1109/ICOSEC51865.2021.9591885

Department of CSE,
Department of Information Technology
Karunya Institute of Technology and Sciences
Sri SaiRam Institute of Technology,
Coimbatore.
Chennai, Tamil Nadu ,India. iwinjoseph@karunya.edu
leela.it@sairamit.edu.in

3. Dr.J.Shiny Duela 4.Dr.D.Muruga Radha Devi

Department of Computer Science and Engineering, Department of Information Technology
SRM Institute of Science and Technology, Sri SaiRam Institute of Technology,
Ramapuram Campus,Chennai, Chennai, Tamil Nadu ,India.
Tamil Nadu,India. murugaradha.it@sairamit.edu.in

5. C. Prasanna Lakshmi
Department of Information Technology
Sri SaiRam Institute of Technology,
Chennai, Tamil Nadu ,India.

Diabetic Ret inopathy is class ified into 4 types namely

Abstract— Diabetes M ellitus or Diabetes occurs when the glucose Non-Pro liferative Diabetic Retinopathy (NPDR)-mild
content in blood is high. Diabetes M ellitus affects the eye. Diabetes moderate, severe and Proliferative Diabetic Retinopathy.
M ellitus leads to the damage of blood vessels of retina termed as During Early stage of DR, M icroaneurysm develop and they
Diabetic Retinopathy. Diabetic Retinopathy in its initial stage has no are the first symptom. Hence it is mo re important to look for
/mild symptoms. But the progression rate of Diabetic Retinopathy is
the appearance of microaneurysm to detect the early stage.
very high. Eventually, Diabetic Retinopathy causes unexpected
visualization failure left untreated. Computer Aided Diagnosis (CAD) Microaneurysm appears as small / moderate shadow in the
systems assist doctors during diagnosis. This paper proposes an OCT retinal images.
automatic diagnosis system to accurately classify the stages of
Diabetic Retinopathy in Optical Coherence Tomography retinal S.No Acronym Description
images using Convolutional Neural Networks.
1 CAD Computer Aided Diagnosis
Keywords— Computer Aided Diagnosis (CAD), Diabetic 2 DR Diabetic Retinopathy
Retinopathy (DR), Optical Coherence Tomography (OCT), 3 SD - OCT Spectral Do main Optical Coherence
Convolutional Neural Network (CNN). Tomography
4 CNN Convolutional Neural Network
INT RODUCT ION 5 DM Diabetes M ellitus
Diabetes is due to elevated level of sugar substance in 6 NPDR Non-Proliferative Diabetic
blood. Diabetes patients can develop Diabetic Retinopathy. Retinopathy
Diabetic Retinopathy is an eye sickness which is created due 7 PDR Proliferative Diabetic Retinopathy
to the presence of high content of sugar in blood. Patients with Table 1: Acronyms and Descriptions
diabetics type II are at the risk of having this eye disease.
Routine eye check-Up is needed for diabetic patients. Diabetic SD-OCT (Spectral Do main Optical Coherence
Retinopathy leads to sudden vision loss. DR causes the blood Tomography) ,ophthalmic imag ing which is a non-invasive
vessels that are present in the retina to swell and leak. In some method with h igh resolution. OCT modality imaging takes the
case, it leads to the growth of nu mber of abnormal blood cross-sectional view of your eyes and can display the retina in
vessels in macula. Since DR is irreversib le, earlier stage 3D v iew. Optical Coherence Tomography imaging method
detection of Diabetic Retinopathy is needed. uses optical rays to capture the internal layers of retina as in
figure 1.

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 Proceedings of the Second International Conference on Smart Electronics and Communication (ICOSEC).
IEEE Xplore Part Number: CFP21V90-ART; ISBN: 978-1-6654-3368-6
Fig.1: OCT re tinal Image
Due to its high resolution, OCT images are utilized to
identify much retinal sickness like Diabetic Retinopathy,
Macular degeneration, damages due to high pressure.
Ophthalmo logists can identify d ifferent ret inal diseases using
OCT images of retina. Manual interpretation consumes more
time. OCT images helps to identify minute variation in the
thickness, intensity and reflectivity of the retinal layers. More
studies were performed using fundus retinal images for the
decades. Fundus Retinal images takes more time during
capturing and it is an invasive imaging modality. Automatic
Co mputer Aided diagnosis (CA D) needs a modality that needs
to capture the anatomy of the ret ina which clearly exp lores the
layers to predict the retinal d iseases. SD-OCT helps by
provides all the features that supports the automatic CAD
systems for the recognition of Diabetic Retinopathy.
Convolutional Neural Net work is among the deep
learning algorith ms mainly considered during the analysis of
health related images. It outperforms classification,
segmentation and object identifications in medical images.
Convolutional Neural Network co mprises layers like
convolution, pooling, flattening and fully connected layers.
Convolution layer employs filters for getting the features fro m
input image. The filters of first stage of convolution layer
extracts the basic information while the filters at the final
layers extract the more detailed information. Pooling layers
down sample the images. Both feature extract ion and
classification are performed by the CNN. The main principle
of the work is building an automatic d iagnosis structure to
accurately classify stages of Diabetic Retinopathy in Optical
Coherence To mography retinal images with Convolutional
Neural Network.
RELATED WORKS
Sohini Roy chowdhury , Dara D. Koozekanani , Keshab K.
Parhi [1] proposed a computer aided system that uses machine
learning algorith ms to classify the retinal fundus images into
Diabetic Retinopathy grades. They used classifiers to
distinguish between lesions and they have used reduced
features for classification. Yitian Zhao, Yalin Zheng, Yonghuai
Liu, Jian Yang, Yifan Zhao, Duanduan Chen, Yongtian
Wang[2] proposed a method that uses the prominent features to
identify the leakage in fluorescein angiography. Ramon Pires,
Sandra Avila, Herbert F. Jelinek, Jacques Wainer , Eduardo
Valle, Anderson Rocha [3] directly trains the classifiers using
midlevel features to detect the DR. Xianglong Zeng, Haiquan
Chen,Yuan Luo,Wenbin Ye [4] proposed a binocular model to
classify 5 grades of DR.Xiaomeng Li,Xiaowei Hu, Lequan Yu,
Lei Zhu, Chi-Wing Fu, Pheng-Ann Heng [5] proposed a model
that captures the features of two retinal diseases namely
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diabetic Retinopathy and Diabetic Macular Edema and
relationship among two retinal diseases to classify the grades of
both the retinal diseases. Lifeng Qiao, Ying Zhu, Hui Zhou [6]
proposed a method to detect the presence of microaneurysm in
the fundus images to detect the earlier stages of Diabetic
Retinopathy. Teresa Araújo, Guilherme Aresta ,Luís
Mendonça, Susana Penas, Caro lina Maia, Angela Carneiro
,Ana Maria Mendonça , Aurélio Campilho [7] proposed the
method by introducing the NVs into the retinal images so as to
improve the performance of the model. Sehrish Qummar, Fiaz
Gu l Khan, Sajid Shah, Ah mad Khan ,Shahaboddin
Shamshirband, Zia Ur Reh man, Iftikhar Ah med Khan, Waqas
Jadoon [8] proposed the model that uses an ensemble model
with convolutional Neural Networks to improve the
classification model for d ifferent stages of Diabetic
Retinopathy. Laxmi Gella, Rajiv Raman, Padmaja Ku mari
Rani, and Tarun Sharma[9] reported the appearance of
Dia/betic Retinopathy lesions in retinal layers using SD-OCT
images. Mohammed Ghazal, Samr Samir Ali, Ali H.
Mahmoud, Ahmed M. Shalaby, Ayman El-Baz [10] proposed a
CAD system to identify the beginning stages of Diabetic
Retinopathy by extracting nasal patches and temporal patches
fro m the OCT images with CNN model.References [11] - [15]
discussed the retinal layer segmentation regarding OCT
images. They used different methods to slice the OCT retinal
layers into layers. The segmentation of retinal layer is very
much important during DR grade diagnosis. References [16]-
[19] d iscussed the usage of image processing techniques and
artificial intelligence for the analysis of image.
MATERIALS AND METHOD
The proposed make use of non-invasive modality imaging
technique to predict the grades of Diabetic Retinopathy. This
proposed model consists of four sections. The first section
describes about Architectural Diagram, the second section
describes about the OCT Data set, the third section describes
about the pre-processing stage and the fourth section describes
about the feature extraction and dual classification model.
Architectural diagram
Since the OCT ret inal images are captured using light
waves, the multip le interference o f light waves towards and
outwards the retina causes speckle noise. Hence the speckle
noise should be removed using med ian filters. Enhancement
technique is applied to OCT images so as to get more detailed
informat ion by increasing the brightness of the image. The
images are then normalized.The architectural d iagram o f the
DR classification model is exposed in figure 2.
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 Proceedings of the Second International Conference on Smart Electronics and Communication (ICOSEC).
IEEE Xplore Part Number: CFP21V90-ART; ISBN: 978-1-6654-3368-6

grades of Diabetic Ret inopathy are determined by counting the

number of microaneurysm, hard exudates, soft exudates,
abnormal blood vessels .

Fig.2: Architecture of the automatic DR stages classification Model Fig.4: Preprocessing of the OCT Retinal Image
OCT Dataset
The OCT ret inal Data set is splitted into Test set Feature Extraction and Classification using CNN Model
(20%) and remain ing 80% of OCT retinal images are further The convolutional Neural network is imp lemented using
divided into validation set (20%) and Training set (80%). The keras API. Sequential model is used for this classification.
set comprising training data and validation data are used for This model uses six alternate layers of convolution layers and
training the CNN Model and the test set is used for calculat ing Pooling layers are used. Initial Convolution layer co mprises
the performance of the CNN model. The Splitting of the filters to mine basic attributes of the images. The remain ing
Dataset set is shown in figure 3. layers extract co mplex features that are needed for the
classification of DR. Pooling layers perform down sampling
which retains the information while reducing the special
OCT resolution. In our model, Max-pooling is used. The activation
Retinal function (ReLu ) is used in our model. To avoid overfitting,
Data set drop out layer is added. Flattening layers are added to convert
2D into 1D vectors. This model uses 3 fully connected layers
80% Training (dense). The first two dense layer uses ReLu activation
Set 20% Test Set function and the last dense layer includes soft-max act ivation
function. Two stages namely classificat ion stage-1 and
classification stage-2 are used in our model. Classification
80% Training 20% Validation stage-1 classifies whether the ret inal image is either with DR
Set Set or not. The classification stage-2 classifies the DR image into
four grades namely NPDR-mild, moderate, severe and PDR.
Fig.3. Splitting of OCT Retinal Data Set Model summary of classification stage-1 is shown in Figure 5.

Preprocessing
Input OCT images are segmented into 12 layers using
Markov Gibbs Random Fields (M GRF) method. The Fovea is
located in the center of the image. All the 12 layers are not of
same thickness. Nearly 5 layers are merged in the fovea
region. Fovea region is also very much needed for the
detection of DR. Three patches namely (temporal patches,
Nasal patches and foveal patches) are ext racted as in figure 4.
Three patches contain information related to reflectivity,
thickness and curvature. The thickness of each retinal layers
detects the type of retinal diseases. Reflectivity of damaged
retinal varies fro m normal ret ina. These features are included
for identify ing the occurrence of microaneurysm, hard
exudates, hemorrhage in OCT images. The performance of
CNN model improves when the training data s et increases.
Data augmentation is used to increase the training images.
Operations like flipping, shifting and rotation are used for data
augmentation. These operations are included on the fly during
processing hence it does not occupy more space. In OCT ,the

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PT defines the numeral of OCT retinal similes properly

classified as similes with DR.NT defines the numeral of OCT
retinal images properly classified as images with no DR.PF
defines as the numeral OCT retinal images improperly
classified as images with DR.NF defines the numeral of OCT
retinal images improperly classified as images with no DR.
Sensitivity determine the fraction of properly classified images
with DR. Specificity determine the fraction of properly
classified images with no DR.

RESULT S AND DISCUSSION

The train ing patches (temporal, nasal and foveal) are fed
into two classification models. The train ing accuracy of the
model is 98.97%. The classificat ion stage-1 classifies the
images with an accuracy of 96.32%. The classificat ion stage-2
classifies the stages of DR with an accuracy of 95%. The
accuracy of the classificat ion of DR grades is 95%.The
method combines the three patches namely nasal, foveal and
temporal as features in support of classification regarding DR
stages in OCT images, accuracy of the classification model
improves.The newness of the model lies in the categorizat ion
of DR in OCT retinal images using three patches which was
missing in earlier studies.

Fig.5: CNN model summary for classification Stage-1 CONCLUSION AND FUT URE SCOPE
Manual interpretation of OCT retinal images is t ime
The classification stage-2 consists of 4 alternative
consuming. More -over the interpretation of OCT retinal
convolution layers with ReLu activation function and pooling
images differ accord ing to the Ophthalmologist experience
layers (Max). Dropout layer is also included in the d irection of
and review. Th is computer aided diagnosis system that
avoiding the overfitting problem. Rectified Linear Unit
automatically classifies the OCT retinal images will help the
(ReLu ) provides the input for positive input value and zero for
patients to get the opinion. Due to the high resolution of OCT
negative input value. To stop linearity, ReLu is used. It works
imaging modality, the earlier stages of Diabetic Retinopathy
so that it will not activate the neuron equally thereby
can be accurately detected. Diabetic Retinopathy using OCT
providing a Non-Linear output at each level. Three fu lly
imaging modality need further exploration in the area of
connected layers are used for classificat ion. Activation
research so as to classify the earlier stages of DR in precise.
function Sig moid is used in the final dense layer which
performs mult iclass classification. OCT ret inal images are
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