Diabetic Retinopathy (DR) is the leading cause of blindness in working-age adults globally. Primary screening of DR is essential, and it is recommended that diabetes patients undergo this procedure at least once per year to prevent vision loss. However, in addition to the insufficient number of ophthalmologists available, the eye examination itself is labor-intensive and time-consuming. Thus, an automated DR screening method using retinal images is proposed in this paper to reduce the workload of ophthalmologists in the primary screening process and so that ophthalmologists may make effective treatment plans promptly to help prevent patient blindness. First, all possible candidate lesions of DR were segmented from the whole retinal image using a combination of morphological-top-hat and Kirsch edge-detection methods supplemented by pre- and post-processing steps. Then, eight feature extractors were utilized to extract a total of 208 features based on the pixel density of the binary image as well as texture, color, and intensity information for the detected regions. Finally, hybrid simulated annealing was applied to select the optimal feature set to be used as the input to the ensemble bagging classifier. The evaluation results of this proposed method, on a dataset containing 1200 retinal images, indicate that it performs better than previous methods, with an accuracy of 97.08%, a sensitivity of 90.90%, a specificity of 98.92%, a precision of 96.15%, an F-measure of 93.45% and the area under receiver operating characteristic curve at 98.34%.
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