Automated Assessment of Drusen Using Three-Dimensional Spectral-Domain Optical Coherence Tomography

PURPOSE. To compare automated assessment of macular drusen delineated by the authors' originally developed algorithm on three-dimensional (3D) spectral-domain optical coherence tomography (SD-OCT) with the assessment by certified graders on color fundus photographs in nonneovascular age-related macular degeneration (AMD). METHODS. Automated assessment of macular drusen was performed using raster scan by 3D OCT scans in 18 eyes with nonneovascular AMD with at least one large druse (>= 125 mu m) and predominantly soft indistinct drusen. Drusen was defined as the regions that have the distance between the retinal pigment epithelium and calculated Bruch's membrane lines > predefined threshold distances. The agreement was assessed on maximum drusen size and drusen area within grid between 3D SD-OCT and color fundus photographs, and false-negative and false-positive drusen at each threshold distance. RESULTS. There was agreement or agreement within one step in all eyes in maximum drusen size, and 15 (83.3%) of the eyes in the drusen area, except 6 pixels, regardless of threshold distances. However, the number of eyes with exact agreement in the drusen area increased when the threshold distances were smaller than 4 pixels. In the three cases with disagreement in the drusen area, false-negative drusen on 3D SD-OCT were characterized by being small in area and height. CONCLUSIONS. Automated assessment of drusen parameters based on the authors' algorithm on 3D SD-OCT, which was limited by the poor detection ability of small drusen, showed good agreement with the assessment by certified graders on color fundus photography in these subjects. (Invest Ophthalmol Vis Sci. 2012;53:1576-1583) DOI:10.1167/iovs.11-8103