Exudate detection in color retinal images for mass screening of diabetic retinopathy

Xiwei Zhang, Guillaume Thibault, Etienne Decencière, Beatriz Marcotegui, Bruno Laÿ, Ronan Danno, Guy Cazuguel, Gwénolé Quellec, Mathieu Lamard, Pascale Massin, Agnès Chabouis, Zeynep Victor, Ali Erginay

Research output: Contribution to journalArticlepeer-review

204 Scopus citations


The automatic detection of exudates in color eye fundus images is an important task in applications such as diabetic retinopathy screening. The presented work has been undertaken in the framework of the TeleOphta project, whose main objective is to automatically detect normal exams in a tele-ophthalmology network, thus reducing the burden on the readers. A new clinical database, e-ophtha EX, containing precisely manually contoured exudates, is introduced. As opposed to previously available databases, e-ophtha EX is very heterogeneous. It contains images gathered within the OPHDIAT telemedicine network for diabetic retinopathy screening. Image definition, quality, as well as patients condition or the retinograph used for the acquisition, for example, are subject to important changes between different examinations. The proposed exudate detection method has been designed for this complex situation. We propose new preprocessing methods, which perform not only normalization and denoising tasks, but also detect reflections and artifacts in the image. A new candidates segmentation method, based on mathematical morphology, is proposed. These candidates are characterized using classical features, but also novel contextual features. Finally, a random forest algorithm is used to detect the exudates among the candidates. The method has been validated on the e-ophtha EX database, obtaining an AUC of 0.95. It has been also validated on other databases, obtaining an AUC between 0.93 and 0.95, outperforming state-of-the-art methods.

Original languageEnglish (US)
Pages (from-to)1026-1043
Number of pages18
JournalMedical Image Analysis
Issue number7
StatePublished - Oct 2014
Externally publishedYes


  • Diabetic retinopathy screening
  • E-Ophtha EX database
  • Exudates segmentation
  • Mathematical morphology

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Computer Vision and Pattern Recognition
  • Health Informatics
  • Computer Graphics and Computer-Aided Design


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