Assessing Changes in Diabetic Retinopathy Caused by Diabetes Mellitus and Glaucoma Using Support Vector Machines in Combination with Differential Evolution Algorithm

The aim of this study is to evaluate the changes related to diabetic retinopathy (DR) (no changes, small or moderate changes) in patients with glaucoma and diabetes using artificial intelligence instruments: Support Vector Machines (SVM) in combination with a powerful optimization algorithm-Differential Evolution (DE). In order to classify the DR changes and to make predictions in various situations, an approach including SVM optimized with DE was applied. The role of the optimizer was to automatically determine the SVM parameters that lead to the lowest classification error. The study was conducted on a sample of 52 patients: particularly, 101 eyes with glaucoma and diabetes mellitus, in the Ophthalmology Clinic I of the "St. Spiridon" Clinical Hospital of Iasi. The criteria considered in the modelling action were normal or hypertensive open-angle glaucoma, intraocular hypertension and associated diabetes. The patients with other types of glaucoma pseudoexfoliation, pigment, cortisone, neovascular and primitive angle-closure, and those without associated diabetes, were excluded. The assessment of diabetic retinopathy changes were carried out with Volk lens and Fundus Camera Zeiss retinal photography on the dilated pupil, inspecting all quadrants. The criteria for classifying the DR (early treatment diabetic retinopathy study-ETDRS) changes were: without changes (absence of DR), mild forma nonproliferative diabetic retinopathy (the presence of a single micro aneurysm), moderate form (micro aneurysms, hemorrhages in 2-3 quadrants, venous dilatations and soft exudates in a quadrant), severe form (micro aneurysms, hemorrhages in all quadrants, venous dilatation in 2-3 quadrants) and proliferative diabetic retinopathy (disk and retinal neovascularization in different quadrants). Any new clinical element that occurred in subsequent checks, which led to their inclusion in severe nonproliferative or proliferative forms of diabetic retinopathy, was considered to be the result of the progression of diabetic retinopathy. The results obtained were very good; in the testing phase, a 95.23% accuracy has been obtained, only one sample being wrongly classified. The effectiveness of the classification algorithm (SVM), developed in optimal form with DE, and used in predictions of retinal changes related to diabetes, was demonstrated.