IDENTIFICATION AND

CLASSIFICATION OF
GLAUCOMA USING
DEEP LEARNING
BASED AI MODEL

Presented by:-

Ananya Singh
Aayush Srivastava
Amit Rawat
Nayanpath Jhunjhunwalla
INTRODUCTION
• Glaucoma is a leading cause of irreversible blindness. This presentation explores the use
of deep learning AI models for its identification and classification.
• Glaucoma is the second most common cause of blindness in the United States and the
single most important cause of blindness among African-Americans. Although
approximately 3 million Americans have glaucoma, only 1 million are aware that they
have the disease. About 80,000 Americans are blind from glaucoma.
• Glaucoma is a group of eye conditions that damage the optic nerve.
It can lead to vision loss if not detected and treated early.

• Glaucoma may be defined as an optic neuropathy with

characteristic optic nerve head and nerve fiber layer changes. With
disease progression, characteristic visual field defects develop.

• The characteristic optic nerve head changes include increased size

of the central cup, thinning of the disc rim, progressive loss of
neural rim tissue, disc hemorrhages, and loss of nerve fibers.

• The changes in the visual field may manifest as visual loss either in
the nasal field, near the central field, or in the midperipheral field.
• Although elevated intraocular pressure (IOP) is a risk factor for glaucoma,
the sensitivity, specificity, and positive predictive value of IOP screening
for glaucoma is poor. Up to 50% of all patients with glaucoma may have
pressures below 22 mm Hg at any given screening; therefore, glaucoma
may remain undetected if these patients are screened on the basis of
intraocular pressure alone.

• Because one-sixth of individuals with glaucoma may have intraocular

pressures consistently below 22 mm Hg, an IOP of 22 mm Hg or higher is
no longer part of the definition of glaucoma. In the past, a measurement of
21 mm Hg was considered the cutoff point for glaucoma because it is two
standard deviations away from the mean IOP for the population in the
United States, 16 mm Hg (assuming a normal, ie, Gaussian, distribution).

• Deep learning AI models have shown great promise in various healthcare

applications, including glaucoma diagnosis.
 TYPES OF GLAUCOMA
• There are several types of glaucoma: primary open-angle
glaucoma (POAG), angle-closure glaucoma, congenital
glaucoma, childhood glaucoma, and secondary glaucoma.
This program principally discusses primary open-angle
glaucoma and angle-closure glaucoma.

• The normal eye, aqueous humor is made by the ciliary body

and flows through the pupil into the anterior chamber, where
it is drained primarily through the trabecular meshwork to a
canal leading to the venous system
• Congenital glaucoma presents in an infant as tearing,
photophobia, an enlarged eye, and a hazy cornea. Infants may
show signs of congenital glaucoma within days of birth, although
some cases manifest later in the first year of life. It is more
common in male infants and may be unilateral or bilateral.

• Angle-closure glaucoma is the second most common type of

glaucoma in the United States, accounting for approximately 10%
of all glaucoma cases. It is characterized by appositional or
synechia closure of the drainage angle of the eye. Because the
angle closure prevents the aqueous from leaving the eye, the
intraocular pressure may rise rapidly to high levels and damage
the optic nerve.
OPTIC DISC EVALUATION

• Retinal nerve fibers, or axons, originate in the ganglion cells of

the retina. These nerve fibers radiate in a linear or curvilinear
pattern toward the optic nerve, with the majority of the fibers
entering the optic nerve via the superior and inferior poles.
• A healthy optic nerve has approximately 1.2 million nerve
fibers. These nerve fibers pass through a sieve-like portion of the
posterior sclera, called the lamina cribrosa, before exiting the
eye. It is here that glaucomatous damage is thought to occur.
• The tissue between the border of the cup and the disc is the
neuroretina rim. This tissue consists mainly of nerve fibers with
some glial cells and is usually pink. It tends to be symmetric at
the superior and inferior margins of each disc.
• The vast majority of optic nerves have a recognizable central
depression or cup. An estimate of the ratio of cup diameter to disc
diameter is best made vertically along an imaginary line drawn
from the 12-o’clock to the 6-o’clock position through the center of
the disc.
• The tissue between the border of the cup and the disc is the
neuroretinal rim. This tissue consists mainly of nerve fibers with
some glial cells and is usually pink. It tends to be symmetric at the
superior and inferior margins of each disc.
• Glaucomatous optic nerve damage involves the loss of axons. This
nerve fiber loss is irreversible, and thus the blindness caused by
glaucoma is irreversible. The nerve fibers most susceptible in
glaucoma are those entering the optic nerve in the superior and
inferior poles.
AUTOMATIC GLAUCOMA DETECTION USING
DEEP LEARNING
• Convolutional neural networks (CNNs) have surfaced as a potent architecture in deep learning for
scrutinizing medical images, notably in the context of diagnosing glaucoma based on retinal
imagery. CNNs possess a specific design to automatically learn and derive essential features from
images, rendering them well-suited for tasks demanding visual pattern recognition.
• The success of CNNs in medical imaging analysis can be attributed to their proficiency in capturing
spatial relationships within images. Unlike conventional machine learning algorithms reliant on
manually crafted features.
• In the context of glaucoma diagnosis, CNNs can scrutinize retinal images and pinpoint precise
patterns and irregularities linked to the disease. Through training on extensive datasets of labeled
retinal images.
• Convolutional, pooling, and fully linked layers are just a few of the many layers found in a typical
CNN design. On the input image, convolutional layers apply learnable filters to extract localized
characteristics and gather spatial data.
• The diagnostic efficacy of CNNs in glaucoma diagnosis has been extensively
evaluated using various performance metrics. Accuracy, which measures the
overall correctness of the model's predictions, is a commonly used metric.
• Specificity, on the other hand, measures the true negative rate, indicating the
model's ability to correctly identify non-glaucomatous eyes. Out of all real
negative cases, it shows the percentage of true negative predictions (properly
identified non-glaucomatous eyes) (nonglaucoma Tous eyes in the dataset).
• In addition to these metrics, other evaluation techniques such as cross-
validation and confusion matrices are often employed to assess the robustness
and generalizability of the CNN model. In cross-validation, the dataset is
divided into several subgroups.
• Confusion matrices provide a detailed breakdown of the model's predictions,
showing the number of true positives, true negatives, false positives, and false
negatives. These matrices offer insights into the model's strengths and
weaknesses, allowing for further refinement and optimization.
GLAUCOMA DETECTION USING IMAGE
PROCESSING AND SUPERVISED LEARNING FOR
CLASSIFICATION
• The Ophthalmology Grand Challenge (OGC) dataset is a widely recognized dataset extensively utilized in
glaucoma research. It comprises retinal images from both glaucoma and non-glaucoma patients, acquired
through diverse imaging modalities like fundus photography and optical coherence tomography (OCT).
• The Singapore Eye Research Institute (SERI) dataset stands as another valuable resource in glaucoma
research. It encompasses an extensive collection of retinal images from a diverse population, encompassing
both glaucoma and non-glaucoma cases.
• The Drishti-GS dataset is specifically tailored for glaucoma screening and diagnosis. It includes retinal
images from glaucoma suspects and healthy individuals, captured using fundus photography. The dataset is
annotated for optic disc and cup segmentation, crucial features for glaucoma diagnosis
• Leveraging these openly accessible datasets provides researchers
access to a broad spectrum of retinal images, patient demographics,
and clinical data. This enables training and evaluation of deep
learning models on a standardized and representative dataset,
enhancing the development of robust and accurate models for
glaucoma identification and classification.
• Glaucoma, a leading cause of irreversible blindness worldwide,
poses a significant challenge for early detection and accurate
diagnosis. Particularly in glaucoma identification and classification.
Among these architectures, Convolutional Neural Networks (CNNs)
such as Alex Net.
• These networks consist of multiple layers of interconnected neurons,
each responsible for detecting specific patterns or features in the
input images. By stacking these layers, CNNs can capture
increasingly complex features, enabling them to distinguish between
healthy and glaucomatous retinal images.
METHODOLOGY
DATA COLLECTION

• Various openly available datasets, such as the Ophthalmology Grand Challenge (OGC)
dataset and the Singapore Eye Research Institute (SERI) dataset, can be employed for this
purpose. These datasets have been extensively utilized in glaucoma research, providing a
diverse array of retinal images and associated clinical information.\
• The Ophthalmology Grand Challenge (OGC) dataset is a well-established collection of
retinal images from both glaucoma and non-glaucoma patients. It encompasses images
captured through various imaging modalities like fundus photography and optical
coherence tomography (OCT).
DATA PREPROCESSING
• The preprocessing of the collected data is vital to enhance its quality and eliminate any
noise or artifacts. This process might involve tasks like image resizing, normalization, and
augmentation techniques to bolster the robustness and generalization of the AI model.
• One commonly used preprocessing technique is image resizing, which ensures uniformity
by standardizing the dimensions and resolution of retinal images. This aids in achieving
consistency and streamlines the training process. Additionally, it helps in reducing
computational complexity and memory requirements during model training.
• Normalization is another pivotal preprocessing step, encompassing the scaling of pixel
values of retinal images to a standardized range, typically between 0 and 1. This step
eradicates variations in brightness or contrast across different images, making them more
comparable and suitable for training the AI model.
• Augmentation techniques are employed to enhance the robustness and generalization of
the AI model by applying various transformations to the retinal images, such as rotation,
translation, scaling, and flipping. By augmenting the dataset with these transformed
images, the model becomes more resilient to variations in image orientation, position, and
size.
RESULTS AND DISCUSSION

• In this section, we present the results obtained from our deep learning-based AI model for
glaucoma identification and classification. We report key performance metrics, including
accuracy, sensitivity, specificity, and AUC-ROC.
• Additionally, the AUC-ROC metric summarizes the overall performance of the model
across all possible classification thresholds. A higher AUC-ROC value indicates superior
discrimination between glaucoma and non-glaucoma cases.
• These metrics offer a comprehensive understanding of the model's performance, covering
aspects like avoiding false positives, detecting all positive cases, and striking a balance
between precision and recall. We also compute the Receiver Operating Characteristic
(ROC).
• Moving on to cross-validation, we employ the k-fold cross-validation technique to ensure
the model's generalization performance and mitigate overfitting risks. By dividing the
dataset into k subsets, training the model on k-1 folds, and evaluating on the remaining fold.
CONCLUSION AND FUTURE SCOPE

• While the results show promise, the identification and classification of glaucoma using deep learning-
based AI models face several challenges. These encompass the necessity for extensive and varied
datasets, the model's decision interpretability, and its applicability in real-world clinical setups .
• A primary hurdle is the limited availability of comprehensive and varied datasets. Deep learning models
demand a significant volume of accurately labelled data for effective learning and generalization.
• Another obstacle lies in understanding the rationale behind the model's decisions. Deep learning models
often operate as enigmatic entities, making it challenging to comprehend the logic guiding their
predictions
• Generalizing the model's performance to real-world clinical scenarios is yet another challenge. Deep
learning models trained on specific datasets might not exhibit the same level of performance when
applied to different populations or imaging devices