An established method for glaucoma diagnosis is the morphological
analysis of the optic nerve head (ONH) by the scanning-laser-tomography (SLT). This analysis depends on prior manual outlining of the ONH. The first automated segmentation method that we developed is limited in its reliability by noise, non-uniform illumination and presence of blood vessels. Inspired by recent medical research we developed a new algorithm improving our previous method by segmenting in registered multimodal retinal images. The multimodal approach combines SLT-images with color fundus photographs (CFP). The first step of the algorithm, the registration, is based on gradient-image mutual information maximization using controlled random search as the optimization procedure. The kernel of the segmentation module consists in the anchored active contours. The initial contour is obtained from the CFP. The points the initial curve should be attracted to, the anchors, are constrained by the Hough transform applied to a morphologically processed SLT-image. The false anchors are eliminated by masking out blood vessels that are extracted in the CFP. The method was tested on 174 multimodal image pairs. The overall performance of the system yielded 89% correctly segmented ONH, qualitatively evaluated comparing the automated contours with manual ones drawn by an experienced ophthalmologist. This represents an appreciable improvement in reliability (from 74% to 89%) compared to monomodal approach. The developed method is the basis for a promising tool for glaucoma screening.
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