Joint optic disk and cup segmentation for glaucoma screening using a region-based deep learning network

To develop and validate an end-to-end region-based deep convolutional neural network (R-DCNN) to jointly segment the optic disc (OD) and optic cup (OC) in retinal fundus images for precise cup-to-disc ratio (CDR) measurement and glaucoma screening.In total, 2440 retinal fundus images were retrospectively obtained from 2033 participants. An R-DCNN was presented for joint OD and OC segmentation, where the OD and OC segmentation problems were formulated into object detection problems. We compared R-DCNN's segmentation performance on our in-house dataset with that of four ophthalmologists while performing quantitative, qualitative and generalization analyses on the publicly available both DRISHIT-GS and RIM-ONE v3 datasets. The Dice similarity coefficient (DC), Jaccard coefficient (JC), overlapping error (E), sensitivity (SE), specificity (SP) and area under the curve (AUC) were measured.On our in-house dataset, the proposed model achieved a 98.51% DC and a 97.07% JC for OD segmentation, and a 97.63% DC and a 95.39% JC for OC segmentation, achieving a performance level comparable to that of the ophthalmologists. On the DRISHTI-GS dataset, our approach achieved 97.23% and 94.17% results in DC and JC results for OD segmentation, respectively, while it achieved a 94.56% DC and an 89.92% JC for OC segmentation. Additionally, on the RIM-ONE v3 dataset, our model generated DC and JC values of 96.89% and 91.32% on the OD segmentation task, respectively, whereas the DC and JC values acquired for OC segmentation were 88.94% and 78.21%, respectively.The proposed approach achieved very encouraging performance on the OD and OC segmentation tasks, as well as in glaucoma screening. It has the potential to serve as a useful tool for computer-assisted glaucoma screening.