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Automatic segmentation in three-dimensional analysis of fibrovascular pigmentepithelial detachment using high-definition optical coherence tomography
  1. C Ahlers1,
  2. C Simader1,
  3. W Geitzenauer1,
  4. G Stock1,
  5. P Stetson2,
  6. S Dastmalchi2,
  7. U Schmidt-Erfurth1
  1. 1
    Medical University of Vienna, Department of Ophthalmology, Vienna, Austria
  2. 2
    Carl Zeiss Meditec, Dublin, CA, USA
  1. C Ahlers, Klinik für Optometrie und Augenheilkunde, der medizinschen Universität Wien, Waehringer Guertel 18–20, 1090 Vienna, Austria; christian.ahlers{at}


Background/aims: A limited number of scans compromise conventional optical coherence tomography (OCT) to track chorioretinal disease in its full extension. Failures in edge-detection algorithms falsify the results of retinal mapping even further. High-definition-OCT (HD-OCT) is based on raster scanning and was used to visualise the localisation and volume of intra- and sub-pigment-epithelial (RPE) changes in fibrovascular pigment epithelial detachments (fPED). Two different scanning patterns were evaluated.

Methods: 22 eyes with fPED were imaged using a frequency-domain, high-speed prototype of the Cirrus™ HD-OCT. The axial resolution was 6 μm, and the scanning speed was 25 kA scans/s. Two different scanning patterns covering an area of 6×6 mm in the macular retina were compared. Three-dimensional topographic reconstructions and volume calculations were performed using MATLAB™-based automatic segmentation software.

Results: Detailed information about layer-specific distribution of fluid accumulation and volumetric measurements can be obtained for retinal- and sub-RPE volumes. Both raster scans show a high correlation (p<0.01; R2>0.89) of measured values, that is PED volume/area, retinal volume and mean retinal thickness. Quality control of the automatic segmentation revealed reasonable results in over 90% of the examinations.

Conclusion: Automatic segmentation allows for detailed quantitative and topographic analysis of the RPE and the overlying retina. In fPED, the 128×512 scanning-pattern shows mild advantages when compared with the 256×256 scan. Together with the ability for automatic segmentation, HD-OCT clearly improves the clinical monitoring of chorioretinal disease by adding relevant new parameters. HD-OCT is likely capable of enhancing the understanding of pathophysiology and benefits of treatment for current anti-CNV strategies in future.

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  • Competing interests: Carl Zeiss Meditec provided an HD-OCT-System to support the scientific collaboration. Further commercial relations: None.

  • Ethics approval: The study complied with the declaration of Helsinki and was approved by the local ethics committee.