Use of fundus imaging in quantification of age-related macular change

Hannah E. Bartlett*, Frank Eperjesi

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


This review will discuss the use of manual grading scales, digital photography, and automated image analysis in the quantification of fundus changes caused by age-related macular disease. Digital imaging permits processing of images for enhancement, comparison, and feature quantification, and these techniques have been investigated for automated drusen analysis. The accuracy of automated analysis systems has been enhanced by the incorporation of interactive elements, such that the user is able to adjust the sensitivity of the system, or manually add and remove pixels. These methods capitalize on both computer and human image feature recognition and the advantage of computer-based methodologies for quantification. The histogram-based adaptive local thresholding system is able to extract useful information from the image without being affected by the presence of other structures. More recent developments involve compensation for fundus background reflectance, which has most recently been combined with the Otsu method of global thresholding. This method is reported to provide results comparable with manual stereo viewing. Developments in this area are likely to encourage wider use of automated techniques. This will make the grading of photographs easier and cheaper for clinicians and researchers. © 2007 Elsevier Inc. All rights reserved.

Original languageEnglish
Pages (from-to)655-671
Number of pages17
JournalSurvey of ophthalmology
Issue number6
Publication statusPublished - Nov 2007

Bibliographical note

NOTICE: this is the author’s version of a work that was accepted for publication in Survey of Opthalmology. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Bartlett, Hannah E. and Eperjesi, Frank (2007). Use of fundus imaging in quantification of age-related macular change. Survey of Opthalmology, 52 (6), pp. 655-671. DOI 10.1016/j.survophthal.2007.08.022


  • age-related macular disease
  • drusen
  • grading
  • imaging
  • quantification


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