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F. G. Schlanitz, B. Baumann, C. Ahlers, T. Spalek, S. M. Schriefl, I. Golbaz, M. Pircher, E. Gotzinger, C. K. Hitzenberger, U. Schmidt-Erfurth; Automatic Delineation of Drusen With Polarization-Sensitive Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1783.
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Aim of this study was to evaluate the performance of Polarization-sensitive Optical Coherence Tomography (PS-OCT) to identify drusen in patients with non-atrophic and non-neovascular age-related macular degeneration (AMD). For this purpose we used a custom made segmentation algorithm which is able to delineate the exact localization of the retinal pigment epithelium (RPE), an additional information given by the PS-OCT.
15 eyes of 15 patients with drusen of AREDS II/III classification were examined with the PS-OCT engineered by the Center for Biomedical Engineering and Physics Vienna. The study adhered to the tenets of the Declaration of Helsinki. After performing the automatic segmentation procedures, every druse in an individual B-scan was identified and compared to the automatic segmentation result. Errors in the segmentation were classified as negligible, medium and severe. Relations between the size of the druse and its appearance in the segmentation algorithm were evaluated.
Polarization-sensitive Optical Coherence Tomography was able to detect 98.5% of the identified drusen with negligible error. The mean extent of a successfully detected druse was 229 µm (SD 204, median 152). However, the segmentation line which should delineate Bruch's membrane made errors in 7.2 % of all slices.Counting the plotted drusen identified by PS-OCT resulted in a significantly higher amount of drusen than seen on the standard fundus photography (p<0.05).
As expected, the ability of the PS-OCT to detect the exact localization of the RPE is a great advantage not only for several retinal diseases like neovascular AMD, but also for the delineation of drusen. The drusen size and total area, two factors that have been shown to be relevant for prognosis for AMD in the AREDS Study, can be measured accurately in a fast and objective manner.The significantly higher amount of drusen detected by PS-OCT compared to fundus photography is an interesting finding which should be investigated in further studies.
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