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Brief Report
March 2017

Evaluation of Segmentation of the Superficial and Deep Vascular Layers of the Retina by Optical Coherence Tomography Angiography Instruments in Normal Eyes

Author Affiliations
  • 1Vitreous Retina Macula Consultants of New York, New York
  • 2LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, New York
  • 3EyeSight Foundation of Alabama Vision Research Laboratories, Department of Ophthalmology, University of Alabama School of Medicine, Birmingham
JAMA Ophthalmol. 2017;135(3):259-262. doi:10.1001/jamaophthalmol.2016.5327
Key Points

Question  What is the difference in segmentation of the foveal vascular anatomy by 3 optical coherence tomographic angiography instruments compared with human anatomy as demonstrated in an autopsy specimen?

Findings  All 3 instruments segmented the vascular anatomy of the fovea incorrectly. In the central fovea, various amounts of the deep vascular plexus were considered to be part of the superficial plexus.

Meaning  Vascular involvement in macular disease cannot be correctly determined if the underlying segmentation is not correct.

Abstract

Importance  Correct attribution of vascular features in optical coherence tomography (OCT) angiography depends on accurate segmentation of retinal layers.

Objective  To evaluate the segmentation of retinal layers among 3 OCT angiography instruments in the central macula, an area where the superficial and deep vascular plexuses terminate.

Design, Setting, and Participants  A retrospective review of a representative OCT angiogram from 1 patient and an evaluation of the vascular pattern in an autopsied eye were conducted at a community retina practice at a university laboratory. A set of 3 × 3-mm scans centered on the fovea using the Cirrus 5000, RTVue XR Avanti, and Triton DRI OCT platforms with default layer segmentations were used to evaluate segmentation accuracy of a normal macula of a white man in his 60s as an emblematic example. A representative histologic section from the central macula of a normal eye was used as an exemplar.

Main Outcomes and Measures  Retinal layer segmentation and resultant vascular image compared with vessels as seen in histologic section.

Results  The segmentation slab designed to isolate the superficial vascular plexus included the deep vascular plexus in the central macula for all 3 instruments. None of the instruments produced segmented regions that followed the relevant anatomic layers correctly.

Conclusions and Relevance  Because of inherent errors in segmentation, studies of the superficial and deep vascular plexuses using manufacturer-recommended default settings are likely to be biased. A proposal for an improved segmentation strategy is presented.

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