Investigative Ophthalmology & Visual Science Cover Image for Volume 65, Issue 7
June 2024
Volume 65, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2024
Can AI provide more consistent fluid measurements in nAMD across OCT devices than humans?
Author Affiliations & Notes
  • Christian Unterrainer
    RetInsight GmbH, Vienna, Austria
  • Ariadne Whitby
    RetInsight GmbH, Vienna, Austria
  • Jacob Pichelmann
    RetInsight GmbH, Vienna, Austria
  • Klaudia Kostolna
    Medizinische Universitat Wien Universitatsklinik fur Augenheilkunde und Optometrie, Wien, Wien, Austria
  • Gregor Sebastian Reiter
    Medizinische Universitat Wien Universitatsklinik fur Augenheilkunde und Optometrie, Wien, Wien, Austria
  • Ursula Schmidt-Erfurth
    Medizinische Universitat Wien Universitatsklinik fur Augenheilkunde und Optometrie, Wien, Wien, Austria
  • Footnotes
    Commercial Relationships   Christian Unterrainer RetInSight GmbH, Code E (Employment); Ariadne Whitby RetInSight GmbH, Code E (Employment); Jacob Pichelmann RetInSight GmbH, Code E (Employment); Klaudia Kostolna None; Gregor Reiter Bayer, Code C (Consultant/Contractor), RetInSight, Code F (Financial Support); Ursula Schmidt-Erfurth Genentech, Kodiak, Novartis, Apellis, RetInSight, Code C (Consultant/Contractor), RetInSight, Code F (Financial Support)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2024, Vol.65, 5636. doi:
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      Christian Unterrainer, Ariadne Whitby, Jacob Pichelmann, Klaudia Kostolna, Gregor Sebastian Reiter, Ursula Schmidt-Erfurth; Can AI provide more consistent fluid measurements in nAMD across OCT devices than humans?. Invest. Ophthalmol. Vis. Sci. 2024;65(7):5636.

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

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Abstract

Purpose : Various OCT devices are implemented in multicenter clinical trials and retina clinics. However, their differences still pose a challenge in unifying the performance of fluid volume quantification. This study aimed to evaluate the accuracy and reliability of device-specific deep learning models for automated measuring fluid volume in patients with neovascular age-related macular degeneration (nAMD) using two different devices (Spectralis and Triton) and to compare the results with human measurements.

Methods : Intraretinal fluid (IRF) and subretinal fluid (SRF) volume measurements from 29 patients with nAMD were obtained on device-paired data (Spectralis and Triton) from expert readers via manual annotation and segmentation using MDR-certified device-specific deep learning models: RetInSight TCFM and HEFM. The models had been trained on unpaired manual annotations using different architectures (ensemble of encoder–decoder semantic segmentation networks); however, the validation performance was similar. Bland-Altman analysis was used to investigate the agreement of automated measurements between devices and manual measurements between devices. The limit of agreement was determined via bootstrapping since the data was not normally distributed. Outliers were identified and investigated based on the differences between devices in human measurements but were not excluded.

Results : The mean bias for AI-based measurement of IRF volume between devices was -8.08 nl (95% CI: -17.72 to -0.56) Human measurement between devices exhibited a mean bias of -17.1 nl (95% CI: -38.48 to -2.66). AI-based agreement on SRF volume showed a mean bias of -7.8 nl (95% CI: -16.31 to -1.88) and the human measurement a mean bias of -9.28 nl (95% CI: -17.78 to -2.65) (Figs. 1 and 2).

Conclusions : We observed less mean bias and a higher degree of agreement between AI-based fluid volume measurements for Spectralis and Triton than for human measurements. We observed a consistent bias for higher fluid measurements with the Spectralis device (human and AI), indicating that the visible fluid in the Triton device underestimated the actual fluid volume.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.

 

Fig. 1 | Bland-Altman plots for automated and human measurements.
The mean bias for automated IRF volume measurement (a) was significantly lower compared to human measurement (b) and lower for automated SRF volume measurement (c) compared to human measurement (d).

Fig. 1 | Bland-Altman plots for automated and human measurements.
The mean bias for automated IRF volume measurement (a) was significantly lower compared to human measurement (b) and lower for automated SRF volume measurement (c) compared to human measurement (d).

 

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