Automated segmentation of choroidal layers from 3-dimensional macular optical coherence tomography scans

Background: Changes in choroidal thickness are associated with various ocular diseases, and the choroid can be imaged using spectral-domain optical coherence tomography (SD-OCT) and enhanced depth imaging OCT (EDI-OCT). New method: Eighty macular SD-OCT volumes from 80 patients were obtained using the Zeiss Cirrus machine. Eleven additional control subjects had two Cirrus scans done in one visit along with enhanced depth imaging (EDI-OCT) using the Heidelberg Spectralis machine. To automatically segment choroidal layers from the OCT volumes, our graph-theoretic approach was utilized. The segmentation results were compared with reference standards from two independent graders, and the accuracy of automated segmentation was calculated using unsigned/signed border positioning/thickness errors and Dice similarity coefficient (DSC). The repeatability and reproducibility of our choroidal thicknesses were determined by intraclass correlation coefficient (ICC), coefficient of variation (CV), and repeatability coefficient (RC). Results: The mean unsigned/signed border positioning errors for the choroidal inner and outer surfaces are 3.39 +/- 1.26 mu m (mean +/- standard deviation)/1.52 +/- 1.63 mu m and 16.09 +/- 6.21 mu m/4.73 +/- 9.53 mu m, respectively. The mean unsigned/signed choroidal thickness errors are 16.54 +/- 6.47 mu m/6.25 +/- 9.91 mu m, and the mean DSC is 0.949 +/- 0.025. The ICC (95% confidence interval), CV, RC values are 0.991 (0.977-0.997), 2.48%, 14.25 mu m for the repeatability and 0.991 (0.977-0.997), 2.49%, 14.30 mu m for the reproducibility studies, respectively. Comparison with existing method(s): The proposed method outperformed our previous method using choroidal vessel segmentation and inter-grader variability. Conclusions: This automated segmentation method can reliably measure choroidal thickness using different OCT platforms.