TY - JOUR T1 - Image based analysis of meibomian gland dysfunction using conditional generative adversarial neural network JF - BMJ Open Ophthalmology JO - BMJ Open Ophth DO - 10.1136/bmjophth-2020-000436 VL - 6 IS - 1 SP - e000436 AU - Zakir Khan Khan AU - Arif Iqbal Umar AU - Syed Hamad Shirazi AU - Asad Rasheed AU - Abdul Qadir AU - Sarah Gul Y1 - 2021/02/01 UR - http://bmjophth.bmj.com/content/6/1/e000436.abstract N2 - Objective Meibomian gland dysfunction (MGD) is a primary cause of dry eye disease. Analysis of MGD, its severity, shapes and variation in the acini of the meibomian glands (MGs) is receiving much attention in ophthalmology clinics. Existing methods for diagnosing, detection and analysing meibomianitis are not capable to quantify the irregularities to IR (infrared) images of MG area such as light reflection, interglands and intraglands boundaries, the improper focus of the light and positioning, and eyelid eversion.Methods and analysis We proposed a model that is based on adversarial learning that is, conditional generative adversarial network that can overcome these blatant challenges. The generator of the model learns the mapping from the IR images of the MG to a confidence map specifying the probabilities of being a pixel of MG. The discriminative part of the model is responsible to penalise the mismatch between the IR images of the MG and confidence map. Furthermore, the adversarial learning assists the generator to produce a qualitative confidence map which is transformed into binary images with the help of fixed thresholding to fulfil the segmentation of MG. We identified MGs and interglands boundaries from IR images.Results This method is evaluated by meiboscoring, grading, Pearson correlation and Bland-Altman analysis. We also judged the quality of our method through average Pompeiu-Hausdorff distance, and Aggregated Jaccard Index.Conclusions This technique provides a significant improvement in the quantification of the irregularities to IR. This technique has outperformed the state-of-art results for the detection and analysis of the dropout area of MGD. ER -