Automated Segmentation of the Choroid from Clinical SD-OCT

Zhang, Li; Lee, Kyungmoo; Niemeijer, Meindert; Mullins, Robert F.; Sonka, Milan; Abràmoff, Michael D.

doi:10.1167/iovs.12-10311

Cited by 127 publications

(124 citation statements)

References 28 publications

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“…6 Our study suggests that other SD-OCT parameters like choroidal thickness may also be useful outcome parameters in dry AMD trials. However, the moderate interrater agreement that we observed in the measurement of choroid thickness suggests that other methods for measuring choroid thickness, such as automated algorithms, 38 may be more reproducible than manual measurements. Furthermore, diurnal fluctuations in choroidal thickness 39,40 would need to be accounted for in the clinical use of these measurements.…”

Section: Discussionmentioning

confidence: 65%

Optical Coherence Tomography–based Correlation Between Choroidal Thickness and Drusen Load in Dry Age-Related Macular Degeneration

Cao

Pakzad-Vaezi

et al. 2013

Retina

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Purpose-Spectral domain optical coherence tomography can be used to measure both choroidal thickness and drusen load. The authors conducted an exploratory study using spectral domain optical coherence tomography to determine if a correlation between choroidal thickness and drusen load exists in patients with dry age-related macular degeneration.Methods-Forty-four patients with dry age-related macular degeneration were recruited. The drusen area and volume were determined using the automated software algorithm of the spectral domain optical coherence tomography device, and choroidal thickness was measured using enhanced depth imaging. Correlations were determined using multivariable and univariable analyses.Results-The authors found an inverse correlation between choroidal thickness and drusen load (r = −0.35, P = 0.04). Drusen load was also correlated with visual acuity (r = 0.32, P = 0.04). A correlation between choroidal thickness and visual acuity was suggested (r = −0.22, P = 0.21).Conclusion-Spectral domain optical coherence tomography can be used to assess the correlation between drusen load and choroidal thickness, both of which show a relationship with visual acuity. The measurement of these outcomes may serve as important outcome parameters in routine clinical care and in clinical trials for patients with dry age-related macular degeneration. Age-related macular degeneration (AMD) is one of the leading causes of vision loss in people over the age of 50 in the developed world. The role of the choroid in the pathogenesis and progression of dry AMD through the formation and accumulation of drusen deserves further investigation. The choroid provides the only circulation for the retinal pigment epithelium (RPE) and outer retina. Therefore, it is the primary means of metabolic support for these tissues. 1 It has been shown that the choriocapillaris has unique features including high flow rate and low oxygen extraction that are mandatory to sustain normal photoreceptor metabolism. 3 Hence, the choroid's critical role of metabolic support for the retina and RPE suggests that this vascular layer may have a role in drusen development. In other words, RPE with poor metabolic support secondary to deficient choroidal supply may be more prone to developing drusen as they are unable to completely metabolize photoreceptor byproducts. 4,5 Spectral domain optical coherence tomography (SD-OCT) is a relatively new technology that allows detailed imaging within the retina, including the photoreceptor layer and RPE, as well as the choroid. 6 High-definition SD-OCT has previously been used to measure choroidal thickness in AMD. 7 It has been demonstrated that enhanced depth imaging (EDI) SD-OCT, which produces an inverted image from 100 scans to improve signal-to-noise ratio, can be used to visualize the choroid even better. [8][9][10][11] The new technology has lead to better understanding of the role of choroid in various macular diseases, including central serious chorioretinopathy, 9-11 high myopia, 12,13 Vogt-Koy...

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Section: Discussionmentioning

confidence: 65%

Optical Coherence Tomography–based Correlation Between Choroidal Thickness and Drusen Load in Dry Age-Related Macular Degeneration

Cao

Pakzad-Vaezi

et al. 2013

Retina

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“…Those modalities might be expected to improve the repeatability of CT measurements; however, the current study suggests that further evaluations are needed to verify the repeatability of novel methods, particularly in the thick choroid. 6,9,22,24,25 In conclusion, CT measurement in eyes with a very thick choroid may be inaccurate. Increased CT leads to a lower interobserver compared with intraobserver repeatability, and this tendency was consistent despite the thorough peer-review process.…”

Section: Eyementioning

confidence: 92%

“…A few recent studies have reported on the automated segmentation of choroid, whereby experienced observers with a good knowledge of the anatomical structure of the choroid as yet measured CT manually. 5,6 Consequently, the reliability of manual measurements has been demonstrated several times, and CT measurements made by experts show high repeatability. 7,8 As indistinct choroidal junctions decrease the reliability of the measurement of CT, studies have been conducted to determine the factors affecting manual CT measurement.…”

Section: Introductionmentioning

confidence: 99%

Influence of choroidal thickness on subfoveal choroidal thickness measurement repeatability using enhanced depth imaging optical coherence tomography

Cho

Choi

Kim

2014

Eye

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“…We and others have previously developed fully automated 3D algorithms for segmenting choroid on standard clinically available SD-OCT scans. [9][10][11][12][13][14] In our approach, choroidal thickness was estimated by defining the Euclidian distance between the enveloping surfaces of a choroidal vasculature segmentation (see Fig. 3).…”

mentioning

confidence: 99%

Validity of Automated Choroidal Segmentation in SS-OCT and SD-OCT

Zhang

Buitendijk

Lee

et al. 2015

Invest. Ophthalmol. Vis. Sci.

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PURPOSE.To evaluate the validity of a novel fully automated three-dimensional (3D) method capable of segmenting the choroid from two different optical coherence tomography scanners: swept-source OCT (SS-OCT) and spectral-domain OCT (SD-OCT). METHODS.One hundred eight subjects were imaged using SS-OCT and SD-OCT. A 3D method was used to segment the choroid and quantify the choroidal thickness along each A-scan. The segmented choroidal posterior boundary was evaluated by comparing to manual segmentation. Differences were assessed to test the agreement between segmentation results of the same subject. Choroidal thickness was defined as the Euclidian distance between Bruch's membrane and the choroidal posterior boundary, and reproducibility was analyzed using automatically and manually determined choroidal thicknesses.RESULTS. For SS-OCT, the average choroidal thickness of the entire 6-by 6-mm 2 macular region was 219.5 lm (95% confidence interval [CI], 204.9-234.2 lm), and for SD-OCT it was 209.5 lm (95% CI, 197.9-221.0 lm). The agreement between automated and manual segmentations was high: Average relative difference was less than 5 lm, and average absolute difference was less than 15 lm. Reproducibility of choroidal thickness between repeated SS-OCT scans was high (coefficient of variation [CV] of 3.3%, intraclass correlation coefficient [ICC] of 0.98), and differences between SS-OCT and SD-OCT results were small (CV of 11.0%, ICC of 0.73). CONCLUSIONS.We have developed a fully automated 3D method for segmenting the choroid and quantifying choroidal thickness along each A-scan. The method yielded high validity. Our method can be used reliably to study local choroidal changes and may improve the diagnosis and management of patients with ocular diseases in which the choroid is affected.

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Automated Segmentation of the Choroid from Clinical SD-OCT

Cited by 127 publications

References 28 publications

Optical Coherence Tomography–based Correlation Between Choroidal Thickness and Drusen Load in Dry Age-Related Macular Degeneration

Optical Coherence Tomography–based Correlation Between Choroidal Thickness and Drusen Load in Dry Age-Related Macular Degeneration

Influence of choroidal thickness on subfoveal choroidal thickness measurement repeatability using enhanced depth imaging optical coherence tomography

Validity of Automated Choroidal Segmentation in SS-OCT and SD-OCT

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