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Automated computer-based enumeration of acellular capillaries for assessment of diabetic retinopathy

Diabetic retinopathy (DR) is the most common complications of diabetes; if untreated the DR can lead to a vision loss. The treatment options for DR are limited and the development of newer therapies are of considerable interest. Drug screening for the retinopathy treatment is undertaken using animal models in which the quantification of acellular capillaries (capillary without any cells) is used as a marker to assess the severity of retinopathy and the treatment response. The traditional approach to quantitate acellular capillaries is through manual counting. The purpose of this investigation was to develop an automated technique for the quantitation of acellular capillaries using computer-based image processing algorithms. We developed a custom procedure using the Python, the medial axis transform (MAT) and the connected component algorithm. The program was tested on the retinas of wild-type and diabetic mice and the results were compared to single blind manual counts by two independent investigators. The program successfully identified and enumerated acellular capillaries. The acellular capillary counts were comparable to the traditional manual counting. In conclusion, we developed an automated computer-based program, which can be effectively used for future pharmacological development of treatments for DR. This algorithm will enhance consistency in retinopathy assessment and reduce the time for analysis, thus, contributing substantially towards the development of future pharmacological agents for the treatment of DR.