Computerized enhancement of retinal nerve fiber layer.

We investigated a number of image processing techniques for enhancing the retinal nerve fiber layer (NFL) in fundus photographs taken with red-free light. Wedge-type defects within the NFL were enhanced best by contrast enhancement algorithms such as histogram modification and extremum sharpening. Narrow, slitlike NFL defects can be enhanced by directional enhancement techniques. Normal NFL features were enhanced best by high-pass filtering techniques such as homomorphic filtering and adaptive enhancement. The enhanced normal NFL may be useful in the analysis of diffuse NFL loss. All of these successful enhancements of normal and defective features indicate that enhancing fundus photographs with digital image processing techniques should facilitate early detection of optic nerve damage from glaucoma and other diseases.