Automated Bleb Appereance Grading Scale by

Using Stereo Images Database

Agwin Fahmi Fahanani1, Hasballah Zakaria2, Andika Prahasta3, Elsa Gustianty4, R. Maula Rifada5, Astrid Chairini6
1,2
Department of Biomedical Engineering, Institut Teknologi Bandung, Bandung, Indonesia
(E-mail: agwinfahmi@gmail.com1, hasballah@stei.itb.ac.id2)
3,4,5,6
Faculty of Medicine, Padjajaran University, Bandung, Indonesia
(E-mail: andikaprahasta@yahoo.com3, elsagustianty2017@gmail.com4, maularmd@gmail.com5, atid_gtct@yahoo.com6)
Abstract— According to World Health Organizaton (WHO), the second leading blindness caused in the world is glaucoma. Glaucoma
is caused by builded up of intraocular fluid due to the blocked drainage channel. In consequently, intraocular pressure is increasing, so
it presses the nerve cells. The most common treatment for glaucoma is trabeculectomy surgery, that provides a new drainage channel so
the intraocular fluid can flow properly and reabsorb. After the surgery, a slightly lifted tissue due to flowing fluid, called bleb, will
appear. The examination of bleb formation is necessary to calculate the succesful rate of the surgery. Indiana Bleb Appereance
Grading Scale (IBAGS) is the most common standard to asses the bleb formation. This standard provides four parameters to examine,
bleb height, bleb extent, bleb vascularity, and leakage. Ophthalomologist uses this standard to grade patients manually, so the result is
very subjective. This work proposed an image processing algorithm using stereo images database to produce better depth perception for
the assesment. The height bleb feature was extracted from disparity pixels, while feature from other parameters were calculated
afterwards. The K-NN algorithm used to classify the features from three parameters based on the IBAGS standard. The result showed
Cohen’s kappa coefficient rate from three parameters was increased from 0.21 to 0.36 indicating a better agreement between inter-
observers assesment.
Keywords—glaucoma, trabeculectomy, bleb, Indiana Bleb Appereance Grading Scale (key words)