June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Posterior Pole Choroidal Vasculature (CV) Assessed By Automated Choroidal Vessel Segmentation In Standard Clinical Spectral-Domain Optical Coherence Tomography (SD-OCT) In Patients With Diabetic Macular Edema (DME)
Author Affiliations & Notes
  • Bianca Gerendas
    Ophthalmology & Optometry, Medical University of Vienna, Vienna, Austria
  • Sebastian Waldstein
    Ophthalmology & Optometry, Medical University of Vienna, Vienna, Austria
  • Bilal Haj Najeeb
    Ophthalmology & Optometry, Medical University of Vienna, Vienna, Austria
  • Li Zhang
    Electrical and Computer Engineering, University of Iowa, Iowa City, IA
  • Hrvoje Bogunovic
    Electrical and Computer Engineering, University of Iowa, Iowa City, IA
  • Michael Abramoff
    Ophthalmology & Visual Sciences, University of Iowa, Iowa City, IA
    Department of Veterans Affairs, Iowa City Veterans Administration Medical Center, Iowa City, IA
  • Christian Simader
    Ophthalmology & Optometry, Medical University of Vienna, Vienna, Austria
  • Milan Sonka
    Electrical and Computer Engineering, University of Iowa, Iowa City, IA
    Ophthalmology & Visual Sciences, University of Iowa, Iowa City, IA
  • Ursula Schmidt-Erfurth
    Ophthalmology & Optometry, Medical University of Vienna, Vienna, Austria
  • Footnotes
    Commercial Relationships Bianca Gerendas, None; Sebastian Waldstein, None; Bilal Haj Najeeb, None; Li Zhang, None; Hrvoje Bogunovic, None; Michael Abramoff, IDx LLC (E), IDx LLC (I), University of Iowa (P); Christian Simader, None; Milan Sonka, US 7,995,810 (P); Ursula Schmidt-Erfurth, Alcon (C), Bayer Healthcare (C), Novartis (C)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 3162. doi:
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      Bianca Gerendas, Sebastian Waldstein, Bilal Haj Najeeb, Li Zhang, Hrvoje Bogunovic, Michael Abramoff, Christian Simader, Milan Sonka, Ursula Schmidt-Erfurth, ; Posterior Pole Choroidal Vasculature (CV) Assessed By Automated Choroidal Vessel Segmentation In Standard Clinical Spectral-Domain Optical Coherence Tomography (SD-OCT) In Patients With Diabetic Macular Edema (DME). Invest. Ophthalmol. Vis. Sci. 2013;54(15):3162.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

The ability to image the choroid by OCT using enhanced depth imaging or long-wavelength light sources has triggered substantial scientific interest in the role of the CV in ocular pathology, especially in retinal vascular diseases such as DME. However, the need for specific scanning protocols or equipment, and the laborious and variable process of manual evaluation limit the clinical application of quantitative choroidal analysis. In this study, we investigated the CV using an automated validated segmentation in standard spectral-domain SD-OCT, and correlated the extent of CV pathology with retinal vascular damage.

 
Methods
 

284 standardized Cirrus SD-OCT 512x128 scans of 142 patients with treatment naïve DME in one eye were analyzed by certified graders of the Vienna Reading Center. After automated detection of the retinal layers, the entire CV was segmented using Hessian analysis-based object detection followed by classic region-growing segmentation to quantify choroidal thickness (CT) by fitting a thin-plate spline on both sides and determining local surface-to-surface distances. CT was calculated after early treatment diabetic retinopathy study grid centering at the fovea and at the peak of edema. Data were compared to fellow eyes without DME and to a healthy population. Furthermore, CT was compared to the maximum area of leakage (LA) measured on standard late-phase fluorescein angiography images.

 
Results
 

Mean CT was 175µm±23µm in DME patients (A), 190µm±23µm in healthy controls (B) and 177µm±20µm in non-DME fellow eyes (C) (ANOVA ABC: p=0.03, t-test AC: p=0.59). A trend for a correlation between retinal thickness (RT) and CT at the foveal central millimeter was observed (r2=0.104, p=0.14). No significant correlation between RT and CT at the center or at the peak of edema could be detected. In eyes with DME, the mean LA was 23mm2. A minimal negative correlation was found between LA and CT (r=-0.16, p=0.02).

 
Conclusions
 

CV segmentation and assessment of CT demonstrated consistent, significant thinning of the choroidal vascular compartment across the entire macula in patients with diabetes regardless of the presence of DME. Further comparison between the retinal and choroidal vascular disease state revealed no significant correlation of the individual degree of vasculopathy.

     
Keywords: 499 diabetic retinopathy • 452 choroid • 550 imaging/image analysis: clinical  
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