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Optical coherence tomography (OCT) is used to produce high resolution depth images of the retina and is now the standard of care for in-vivo ophthalmological assessment. In particular, OCT is used to study the changes in layer thickness across various pathologies. The automated image analysis of these OCT images has primarily been performed with graph based methods. Despite the preeminence of graph based methods, deep learning based approaches have begun to appear within the literature. Unfortunately, they cannot currently guarantee the strict biological tissue order found in human retinas. We propose a cascaded fully convolutional network (FCN) framework to segment eight retina layers and preserve the topological relationships between the layers. The first FCN serves as a segmentation network which takes retina images as input and outputs the segmentation probability maps of the layers. We next perform a topology check on the segmentation and those patches that do not satisfy the topology criterion are passed to a second FCN for topology correction. The FCNs have been trained on Heidelberg Spectralis images and validated on both Heidelberg Spectralis and Zeiss Cirrus images.

A major goal of analyzing retinal optical coherence tomography (OCT) images is retinal layer segmentation. Accurate automated algorithms for segmenting smooth continuous layer surfaces, with correct hierarchy (topology) are desired for monitoring disease progression. State-of-the-art methods use a trained classifier to label each pixel into background, layer, or surface pixels. The final step of extracting the desired smooth surfaces with correct topology are mostly performed by graph methods (e.g. shortest path, graph cut). However, manually building a graph with varying constraints by retinal region and pathology and solving the minimization with specialized algorithms will degrade the flexibility and time efficiency of the whole framework. In this paper, we directly model the distribution of surface positions using a deep network with a fully differentiable soft argmax to obtain smooth, continuous surfaces in a single feed forward operation. A special topology module is used in the deep network both in the training and testing stages to guarantee the surface topology. An extra deep network output branch is also used for predicting lesion and layers in a pixel-wise labeling scheme. The proposed method was evaluated on two publicly available data sets of healthy controls, subjects with multiple sclerosis, and diabetic macular edema; it achieves state-of-the art sub-pixel results.