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88     CHAPTER 5  Automatic landmark detection in fundus photography




                         vertical dark bar and different width X patterns running through the middle of the
                         circle. While the dark bar and X patterns make sense in trying to represent the darker
                         vasculature, the bright circle on black background provided the best results through
                         empirical means. This method also adapts the template to the pixel size of the OD
                         based on the field of view (FOV) of the image, pixel footprint and known average
                         values for retinal area and OD size in millimeters. The formulas to calculate the OD
                         size in pixels then become:
                                                           A
                                                      f img  =  FOV                       (6)
                                                           N FOV
                         where the image foot print, f img , is equal to A FOV , a known area that a certain FOV
                         covers, over N FOV , the pixel footprint of the image. For instance, a 45° FOV has an
                                              2
                         average area of 124.8 mm . The radius of the OD in pixels, r OD_img , then becomes:
                                                           D (  / ) 2  2
                                                   r    =    OD                           (7)
                                                     _
                                                   OD img
                                                             f img
                            Where D OD  is a known average value for the disc diameter, in this case 1.85 mm.
                         Using these formulas, the template can be adjusted based on the pixel footprint and
                         FOV to help ensure accurate template matching.
                            The actual template matching is performed on an illumination corrected version
                         of the image. To speed up the matching, the template is correlated (using the Pearson
                         correlation coefficient, c ij ) to the image on a grid, as opposed to each pixel in the
                         image.
                                                    ( (
                                               ∑   fx y) − ) ( ( tx iy −  j) − )
                                                                −
                                                      ,
                                                                  ,
                                                                        t
                                                          f
                                      c =        xy ,     m             m                 (8)
                                       ij
                                                                 ( (
                                                  ( (
                                                                             2
                                                         2
                                           (∑  xy ,  fx y) − ) ) ∑ , (  xy  tx − iy,  − ) − ) )
                                                                   −
                                                                           t
                                                                        j
                                                       f
                                                   ,
                                                        m
                                                                           m
                         where t m  and f m  are the mean intensities of the template and the sub-image overlap-
                         ping the template. This speeds up the processing, recognizing that this is the first of
                         a two-step process that will be refined. To avoid being stuck in a local maximum that
                         may or may not be the OD (due to bright lesions or camera artifacts), a small percent-
                         age of candidates are chosen for the second step of processing.
                            Once the candidates have been found, the final OD is localized through vertical
                         matched filtering. The main vessel arcades leave the OD vertically before curving to
                         a parabolic shape around the retina. A Gaussian kernel is used to match the intensity
                         profile across the vessels in the green channel image through convolution.
                                                          − x  2   L
                                                    , (
                                                Gx y) =− ae 2σ 2  ,  for y ≤              (9)
                                                                   2
                            The length, L, is the length for which the vessel has fixed orientation. The size of the
                         Gaussian kernel should be fixed to the width of the main retinal vessels. The candidate
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