June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
A heuristic method for automatically controlling image brightness in widefield fundus angiography sequences
Author Affiliations & Notes
  • Katharina Foote
    Carl Zeiss Meditec, Inc., Dublin, California, United States
  • Grace Tsai
    Carl Zeiss Meditec, Inc., Dublin, California, United States
  • Conor Leahy
    Carl Zeiss Meditec, Inc., Dublin, California, United States
  • Footnotes
    Commercial Relationships   Katharina Foote Carl Zeiss Meditec, Inc., Code E (Employment); Grace Tsai Carl Zeiss Meditec, Inc., Code E (Employment); Conor Leahy Carl Zeiss Meditec, Inc., Code E (Employment)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 2078. doi:
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      Katharina Foote, Grace Tsai, Conor Leahy; A heuristic method for automatically controlling image brightness in widefield fundus angiography sequences. Invest. Ophthalmol. Vis. Sci. 2023;64(8):2078.

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

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Abstract

Purpose : Traditional fundus cameras require the operator to manually adjust flash brightness throughout an angiogram. In this work, we describe a widefield fundus imaging system that provides a very high dynamic range such that an operator does not need to adjust image brightness while capturing an ICGA image sequence. The brightness of each raw image is then adjusted for viewing, using a scheme that balances contrast enhancement with maintaining image-to-image brightness consistent with variations in the original captured fluorescent signal.

Methods : Sequences which are each comprised of ICGA images from 14 eyes acquired using CLARUS™ 700 prototype SW (ZEISS, Dublin, CA) were post-processed using three different schemes: i) no enhancement, ii) balanced contrast enhancement, iii) maximum contrast enhancement. The sequences were then randomized by brightness and graded as whole image sequences, which were comprised of early, mid, and late phases. Grading was performed by an expert grader using a 5-point image quality grading criteria from 5 (excellent image quality) to 1 (very poor image quality). Grading was performed focusing on the importance of both image contrast and consistency with dye transit over time of the entire sequence.

Results : Image sequences over the three schemes from a sample patient are depicted (Figure 1). Average image quality scores for sequences (Figure 2) from 14 eyes were statistically significantly different (Wilcoxon signed rank test) between all scheme combinations (p < 0.001). The majority of sequences from scheme i were 3 (fair) and 2 (poor), and from scheme ii, majority 4 (good). All sequences of scheme iii proved to be of image quality 5 (excellent) or 4 (good).

Conclusions : Using a high dynamic range fundus camera with automatic post-acquisition contrast adjustment, angiography sequences may be captured at a fixed flash level without risk of image under- or over-exposure. Eliminating the need for manual flash adjustment in this manner may simplify angiography workflow for the operator.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

Figure 1. Sample ICGA image sequences from 1 eye over 3 brightness schemes; i) no enhancement, ii) balanced contrast enhancement, iii) maximum contrast enhancement.

Figure 1. Sample ICGA image sequences from 1 eye over 3 brightness schemes; i) no enhancement, ii) balanced contrast enhancement, iii) maximum contrast enhancement.

 

Figure 2. Average image quality scores for images sequences from 14 eyes; error bars indicate standard deviations, asterisks indicate significance.

Figure 2. Average image quality scores for images sequences from 14 eyes; error bars indicate standard deviations, asterisks indicate significance.

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