Medical image classification based on artificial intelligence approaches: A practical study on normal and abnormal confocal corneal images

•A new intelligent system to tackle the main challenges of confocal corneal imaging is developed.•This system underpins the expertise of ophthalmologists.•It provides clinically useful factors, saves a useful amount of clinician time in the process.•It is able to model the stromal keratocyte cells for better evaluation and fast analysis.•Early approval by corneal clinicians.

Corneal images can be acquired using confocal microscopes which provide detailed views of the different layers inside a human cornea. Some corneal problems and diseases can occur in one or more of the main corneal layers: the epithelium, stroma and endothelium. Consequently, for automatically extracting clinical information associated with corneal diseases, identifying abnormality or evaluating the normal cornea, it is important to be able to automatically recognise these layers reliably. Artificial intelligence (AI) approaches can provide improved accuracy over the conventional processing techniques and save a useful amount of time over the manual analysis time required by clinical experts. Artificial neural networks (ANNs), adaptive neuro fuzzy inference systems (ANFIS) and a committee machine (CM) have been investigated and tested to improve the recognition accuracy of the main corneal layers and identify abnormality in these layers. The performance of the CM, formed from ANN and ANFIS, achieves an accuracy of 100% for some classes in the processed data sets. Three normal corneal data sets and seven abnormal corneal images associated with diseases in the main corneal layers have been investigated with the proposed system. Statistical analysis for these data sets is performed to track any change in the processed images. This system is able to pre-process (quality enhancement, noise removal), classify corneal images, identify abnormalities in the analysed data sets and visualise corneal stroma images as well as each individual keratocyte cell in a 3D volume for further clinical analysis.

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