Closing Editorial for Smart Healthcare: Technologies and Applications.

It is our honor to present this editorial to close the Special Issue "Smart Healthcare: Technologies and Applications", which we are coordinating [...

The use of kiosks to improve triage efficiency in the emergency department.

Triage is a system used to prioritise patients as they enter the emergency department (ED) based on their need for urgent care. In recent decades, EDs have becoming increasingly overcrowded, leading to longer pre-triage waiting times for patients. E-triage interventions like kiosks have been proposed as a solution to overcrowding.

Demonstration of Accuracy and Feasibility of Remotely Delivered Oximetry: A Blinded, Controlled, Real-World Study of Regional/Rural Children with Obstructive Sleep Apnoea.

Objectives: Evaluate diagnostic accuracy and feasibility of a mail-out home oximetry kit. Design: Patients were referred for both the tertiary/quaternary-centre hospital-delivered oximetry (HDO) and for the mail-out remotely-delivered oximetry (RDO). Quantitative and qualitative data were collected.

The Longitudinal Assessment of Vascular Parameters of the Retina and Their Correlations with Systemic Characteristics in Type 2 Diabetes-A Pilot Study.

The aim of the study was to assess various retinal vessel parameters of diabetes mellitus (DM) patients and their correlations with systemic factors in type 2 DM. A retrospective exploratory study in which 21 pairs of baseline and follow-up images of patients affected by DM were randomly chosen from the Sankara Nethralaya−Diabetic Retinopathy Study (SN DREAMS) I and II datasets. Patients’ fundus was photographed, and the diagnosis was made based on Klein classification.

Retinal capillary rarefaction is associated with arterial and kidney damage in hypertension.

Microvascular disease and rarefaction are key pathological hallmarks of hypertension. The retina uniquely allows direct, non-invasive investigation of the microvasculature. Recently developed optical coherence tomography angiography now allows investigation of the fine retinal capillaries, which may provide a superior marker of overall vascular damage.

Microvascular changes at different stages of chronic kidney disease.

Patients with progressing chronic kidney disease (CKD) are more likely to experience cardio- and cerebrovascular events than progressing to end-stage renal disease. The authors explored whether retinal microvascular calibers differed with the degree of renal impairment and between the standard and extended optic disk and may serve as a simple additional tool for risk stratification in this highly vulnerable patient cohort. The authors analyzed central retinal arteriolar and venular equivalent calibers (CRAE, CRVE) at different retinal zones (zone B&C) using digital retinal imaging in hypertensive patients with stage 2 (n = 66) or stage 3 CKD (n = 30).

Visualizing and understanding inherent features in SD-OCT for the progression of age-related macular degeneration using deconvolutional neural networks.

To develop a convolutional neural network visualization strategy so that optical coherence tomography (OCT) features contributing to the evolution of age-related macular degeneration (AMD) can be better determined. We have trained a U-Net model to utilize baseline OCT to predict the progression of geographic atrophy (GA), a late stage manifestation of AMD. We have augmented the U-Net architecture by attaching deconvolutional neural networks (deconvnets).

Teleophthalmology for the elderly population: A review of the literature.

Background: Ophthalmology is one of the most requested medical speciality services in the elderly population. Although numerous studies have shown the potentials of telemedicine for the provision of ophthalmology services, the extent of its usability in older adults and the aged population is not clear. The aim of this study was to investigate the characteristics and usability features of teleophthalmology for the elderly population.

Reliability of Graders and Comparison with an Automated Algorithm for Vertical Cup-Disc Ratio Grading in Fundus Photographs.

Introduction: We aimed to investigate the intergrader and intragrader reliability of human graders and an automated algorithm for vertical cup-disc ratio (CDR) grading in colour fundus photographs.

Materials And Methods: Two-hundred fundus photographs were selected from a database of 3000 photographs of patients screened at a tertiary ophthalmology referral centre. The graders included glaucoma specialists (n = 3), general ophthalmologists (n = 2), optometrists (n = 2), family physicians (n = 2) and a novel automated algorithm (AA).

Automated detection and classification of early AMD biomarkers using deep learning.

Age-related macular degeneration (AMD) affects millions of people and is a leading cause of blindness throughout the world. Ideally, affected individuals would be identified at an early stage before late sequelae such as outer retinal atrophy or exudative neovascular membranes develop, which could produce irreversible visual loss. Early identification could allow patients to be staged and appropriate monitoring intervals to be established.

Effect of Pupil Dilation with Tropicamide on Retinal Vascular Caliber.

: The retinal blood vessels reflect changes in the brain's micro-circulation and these changes have been shown to correlate with the incidence of diseases such as stroke, heart disease and Alzheimer's disease. Studies investigating the retinal vasculature routinely use pupil dilation with tropicamide to optimize image acquisition and quality. The aim of this study was to investigate the effects of tropicamide on retinal vascular parameters using retinal photography.

Robust optic disc and cup segmentation with deep learning for glaucoma detection.

Glaucoma is rated as the leading cause of irreversible vision loss worldwide. Early detection of glaucoma is important for providing timely treatment and minimizing the vision loss. In this paper, we developed a robust segmentation method for optic disc and cup segmentation using a modified U-Net architecture, which combines the widely adopted pre-trained ResNet-34 model as encoding layers with classical U-Net decoding layers.

Evaluation of Artificial Intelligence-Based Grading of Diabetic Retinopathy in Primary Care.

Importance: There has been wide interest in using artificial intelligence (AI)-based grading of retinal images to identify diabetic retinopathy, but such a system has never been deployed and evaluated in clinical practice.

Objective: To describe the performance of an AI system for diabetic retinopathy deployed in a primary care practice.

Design, Setting, And Participants: Diagnostic study of patients with diabetes seen at a primary care practice with 4 physicians in Western Australia between December 1, 2016, and May 31, 2017.

A Mobile Phone Informational Reminder to Improve Eye Care Adherence Among Diabetic Patients in Rural China: A Randomized Controlled Trial.

Purpose: To determine whether short message service (SMS) reminders improve adherence to scheduled ocular examinations among patients with diabetes in rural China.

Design: Randomized controlled trial.

Methods: This study enrolled consecutive patients with diabetes scheduled for eye examinations at 5 hospitals in low-income areas of Guangdong, China from March 1, 2015 to May 31, 2016.

Ocular Biomarkers of Alzheimer's Disease: The Role of Anterior Eye and Potential Future Directions.

Globally, Alzheimer's disease (AD) is a growing health and economic challenge that has no effective cure. Recent clinical trials indicate that preclinical treatment may be required but a routine screening tool for AD has been elusive. Hence, a simple, yet sensitive biomarker for preclinical AD, when the disease is most likely to be amenable to treatment, is lacking.

Machine Learning Based Automatic Neovascularization Detection on Optic Disc Region.

In this paper, the automatic detection of neovascularization in the optic disc region (NVD) for color fundus retinal image is presented. NV is the indicator for the onset of proliferative diabetic retinopathy and it is featured by the presence of new vessels in the retina. The new vessels are fragile and pose a high risk for sudden vision loss.

Automated Quality Assessment of Colour Fundus Images for Diabetic Retinopathy Screening in Telemedicine.

Fundus images obtained in a telemedicine program are acquired at different sites that are captured by people who have varying levels of experience. These result in a relatively high percentage of images which are later marked as unreadable by graders. Unreadable images require a recapture which is time and cost intensive.

Performance Evaluation of State-of-the-Art Local Feature Detectors and Descriptors in the Context of Longitudinal Registration of Retinal Images.

In this paper we systematically evaluate the performance of several state-of-the-art local feature detectors and descriptors in the context of longitudinal registration of retinal images. Longitudinal (temporal) registration facilitates to track the changes in the retina that has happened over time. A wide number of local feature detectors and descriptors exist and many of them have already applied for retinal image registration, however, no comparative evaluation has been made so far to analyse their respective performance.

A Novel Method for Correcting Non-uniform/Poor Illumination of Color Fundus Photographs.

Retinal fundus images are often corrupted by non-uniform and/or poor illumination that occur due to overall imperfections in the image acquisition process. This unwanted variation in brightness limits the pathological information that can be gained from the image. Studies have shown that poor illumination can impede human grading in about 10~15% of retinal images.