Diabetic retinopathy is the major issue of diabetes-induced blindness worldwide but is curable if detected in time. Cotton wool spots (CWSs) are the critical lesions of diabetic retinopathy, which indicate not only advanced nonproliferative but also preproliferative diabetic retinopathy. It is crucial to detect CWSs for grading the severity of diabetic retinopathy. By grading the severity of diabetic retinopathy accurately, the eye specialist can make an effective treatment plan to protect the patient's vision against blindness. CWSs detection remains challenging because of their uneven appearance, in which some CWSs are not clearly visible and some resemble hard exudates. This paper proposed an automatic CWS detection method based on adaptive thresholding and ant colony optimization (ACO) coupled with support vector machine (SVM). One-hundred and sixtytwo features from five feature sets, namely morphologies, first-order statistics, gray-level co-occurrence matrix, gray-level run length matrix, and lacunarity, are extracted, and then four feature selection methods,namely genetic algorithm, particle swarm optimization, stepwise method, and ACO, are coupled with SVM classifiers. The evaluation results of the proposed methods on local, standard diabetic retinopathy database calibration level 1, and high-resolution fundus image database datasets containing 319 images indicate that ACO coupling cubic SVM performs better than the other pairs with sensitivity 90.16%, specificity 97.92%, accuracy 96.96%, and area under receiver operating characteristic curve 97.19%. , since 2009. He is currently a Dean of the School of Information and Telecommunication Engineering, Tokai University. His current research interests include information design. Especially, he is interested in medical information, human interface design, and virtual reality. He has about 60 papers published in Transactions and Journals and about 85 papers presented at international conferences. Prof. Hamamoto is a member of the IEEE and many national societies in Japan. He also takes active part in national societies as a committee member.
RonakornPanjaphongse (Non-member) received the M.D. degree from the Faculty of Medicine Siriraj Hospital, Bangkok, Thailand, in 2001. He is currently the Head of the Retinal Unit, Ophthalmology Department, Bhumibol Adulyadej Hospital, Royal Thai Air Force, Bangkok, Thailand. His interests include studies related to retinal diseases, especially in diabetic retinopathy, including applying artificial intelligence for medical imaging.