GANGLION CELL LAYER THICKNESS AND VISUAL IMPROVEMENT AFTER EPIRETINAL MEMBRANE SURGERY

With the introduction of spectral-domain optical coherence tomography (OCT), much larger image datasets are routinely acquired compared to what was possible using the previous generation of time-domain OCT. Thus, the need for 3-D segmentation methods for processing such data is becoming increasingly important. We report a graph-theoretic segmentation method for the simultaneous segmentation of multiple 3-D surfaces that is guaranteed to be optimal with respect to the cost function and that is directly applicable to the segmentation of 3-D spectral OCT image data. We present two extensions to the general layered graph segmentation method: the ability to incorporate varying feasibility constraints and the ability to incorporate true regional information. Appropriate feasibility constraints and cost functions were learned from a training set of 13 spectral-domain OCT images from 13 subjects. After training, our approach was tested on a test set of 28 images from 14 subjects. An overall mean unsigned border positioning error of 5.69+/-2.41 microm was achieved when segmenting seven surfaces (six layers) and using the average of the manual tracings of two ophthalmologists as the reference standard. This result is very comparable to the measured interobserver variability of 5.71+/-1.98 microm.

Current techniques for segmenting macular optical coherence tomography (OCT) images have been 2-D in nature. Furthermore, commercially available OCT systems have only focused on segmenting a single layer of the retina, even though each intraretinal layer may be affected differently by disease. We report an automated approach for segmenting (anisotropic) 3-D macular OCT scans into five layers. Each macular OCT dataset consisted of six linear radial scans centered at the fovea. The six surfaces defining the five layers were identified on each 3-D composite image by transforming the segmentation task into that of finding a minimum-cost closed set in a geometric graph constructed from edge/regional information and a priori determined surface smoothness and interaction constraints. The method was applied to the macular OCT scans of 12 patients (24 3-D composite image datasets) with unilateral anterior ischemic optic neuropathy (AION). Using the average of three experts' tracings as a reference standard resulted in an overall mean unsigned border positioning error of 6.1 +/- 2.9 microm, a result comparable to the interobserver variability (6.9 +/- 3.3 microm). Our quantitative analysis of the automated segmentation results from AION subject data revealed that the inner retinal layer thickness for the affected eye was 24.1 microm (21%) smaller on average than for the unaffected eye (p < 0.001), supporting the need for segmenting the layers separately.