TY - JOUR
T1 - Automated quantification of nonperfusion in three retinal plexuses using projection-resolved optical coherence tomography angiography in diabetic retinopathy
AU - Zhang, Miao
AU - Hwang, Thomas S.
AU - Dongye, Changlei
AU - Wilson, David J.
AU - Huang, David
AU - Jia, Yali
N1 - Funding Information:
Supported by Grants DP3 DK104397, R01 EY024544, R01 EY023285, and P30 EY010572 from the National Institutes of Health and unrestricted departmental funding from Research to Prevent Blindness. Oregon Health & Science University (OHSU), David Huang, and Yali Jia have a significant financial interest in Optovue, Inc., a company that may have a commercial interest in the Results of this research and technology. These potential conflicts of interest have been reviewed and managed by OHSU. David Huang receives royalties on an optical coherence tomography patent licensed by the Massachusetts Institute of Technology (MIT) to Carl Zeiss Meditec, Inc. Other authors do not have financial interest in the subject of this article.
Publisher Copyright:
© 2016, Association for Research in Vision and Ophthalmology Inc. All rights reserved.
PY - 2016/10
Y1 - 2016/10
N2 - Purpose. The Purpose of this study was to evaluate an automated algorithm for detecting avascular area (AA) in optical coherence tomography angiograms (OCTAs) separated into three individual plexuses using a projection-resolved technique. Methods. A3☓ 3 mm macular OCTA was obtained in 13 healthy and 13 mild nonproliferative diabetic retinopathy (NPDR) participants. A projection-resolved algorithm segmented OCTA into three vascular plexuses: superficial, intermediate, and deep. An automated algorithm detected AA in each of the three plexuses that were segmented and in the combined inner-retinal angiograms. We assessed the diagnostic accuracy of extrafoveal and total AA using segmented and combined angiograms, the agreement between automated and manual detection of AA, and the within-visit repeatability. Results. The sum of extrafoveal AA from the segmented angiograms was larger in the NPDR group by 0.17 mm2 (P < 0.001) and detected NPDR with 94.6% sensitivity (area under the receiver operating characteristic curve [AROC] = 0.99). In the combined inner-retinal angiograms, the extrafoveal AA was larger in the NPDR group by 0.01 mm2 (P = 0.168) and detected NPDR with 26.9% sensitivity (AROC = 0.62). The total AA, inclusive of the foveal avascular zone, in the segmented and combined angiograms, detected NPDR with 23.1% and 7.7% sensitivity, respectively. The agreement between the manual and automated detection of AA had a Jaccard index of >0.8. The pooled SDs of AA were small compared with the difference in mean for control and NPDR groups. Conclusions. An algorithm to detect AA in OCTA separated into three individual plexuses using a projection-resolved algorithm accurately distinguishes mild NPDR from control eyes. Automatically detected AA agrees with manual delineation and is highly repeatable.
AB - Purpose. The Purpose of this study was to evaluate an automated algorithm for detecting avascular area (AA) in optical coherence tomography angiograms (OCTAs) separated into three individual plexuses using a projection-resolved technique. Methods. A3☓ 3 mm macular OCTA was obtained in 13 healthy and 13 mild nonproliferative diabetic retinopathy (NPDR) participants. A projection-resolved algorithm segmented OCTA into three vascular plexuses: superficial, intermediate, and deep. An automated algorithm detected AA in each of the three plexuses that were segmented and in the combined inner-retinal angiograms. We assessed the diagnostic accuracy of extrafoveal and total AA using segmented and combined angiograms, the agreement between automated and manual detection of AA, and the within-visit repeatability. Results. The sum of extrafoveal AA from the segmented angiograms was larger in the NPDR group by 0.17 mm2 (P < 0.001) and detected NPDR with 94.6% sensitivity (area under the receiver operating characteristic curve [AROC] = 0.99). In the combined inner-retinal angiograms, the extrafoveal AA was larger in the NPDR group by 0.01 mm2 (P = 0.168) and detected NPDR with 26.9% sensitivity (AROC = 0.62). The total AA, inclusive of the foveal avascular zone, in the segmented and combined angiograms, detected NPDR with 23.1% and 7.7% sensitivity, respectively. The agreement between the manual and automated detection of AA had a Jaccard index of >0.8. The pooled SDs of AA were small compared with the difference in mean for control and NPDR groups. Conclusions. An algorithm to detect AA in OCTA separated into three individual plexuses using a projection-resolved algorithm accurately distinguishes mild NPDR from control eyes. Automatically detected AA agrees with manual delineation and is highly repeatable.
KW - Avascular area
KW - Diabetic retinopathy
KW - Optical coherence tomography angiography
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U2 - 10.1167/iovs.16-19776
DO - 10.1167/iovs.16-19776
M3 - Article
C2 - 27699408
AN - SCOPUS:85016067708
SN - 0146-0404
VL - 57
SP - 5101
EP - 5106
JO - Investigative Ophthalmology and Visual Science
JF - Investigative Ophthalmology and Visual Science
IS - 13
ER -