Qualitative and quantitative comparison of two semi-manual retinal vascular density analyzing methods on optical coherence tomography angiography images of healthy individuals

Scientific Reports · 11 authors, 10 centres

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Thirty-eight healthy eyes from 38 volunteers were imaged using a Zeiss Cirrus HD-OCT 5000 AngioPlex device.

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Thirty-eight healthy eyes from 38 volunteers were imaged using a Zeiss Cirrus HD-OCT 5000 AngioPlex device. Both methods reduced noise to a similar extent (65.8% vs 65.24%). MHF produced significantly higher skeleton density and vessel density values than ST in most ETDRS sectors, while ST produced considerably higher vessel diameter index values. Bland–Altman analysis showed systematic differences between methods across all sectors, with mean differences significantly different from zero in nearly all comparisons. Standard deviations were generally larger with ST. Limitations include the use of healthy volunteers only, a single OCTA device, and manual FAZ removal in the MHF method introducing evaluator-dependent error.

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other

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ophthalmology

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ORIGINAL PAPER

PMC10562399

Qualitative and quantitative comparison of two semi-manual retinal vascular density analyzing methods on optical coherence tomography angiography images of healthy individuals

Scientific Reports

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ABSTRACT

Abstract The aim of this study was to evaluate qualitative and quantitative differences in vascular density analysis of an established and a novel alternative for post-processing on optical coherence tomography angiography (OCTA) images in healthy individuals. OCTA examinations of 38 subjects were performed. After extracting the images, two semi-manual post-processing techniques, the already established Mexican hat filtering (MHF) and an alternative, the Shanbhag thresholding (ST) were applied. We assessed Vessel Density (VD), Skeleton Density (SkD) and Vessel Diameter Index (VDI). We analyzed the results in order to establish similarities or potentially relevant differences. Regarding SkD and VD, MHF generally gave higher values than ST. Simultaneously, mean values were also predominantly higher by MHF; however, standard deviations (SD) were higher by ST (range [mean ± SD]: 0.054 ± 0.038 to 0.134 ± 0.01 and 0.134 ± 0.095 to 0.362 ± 0.028 vs 0.012 ± 0.014 to 0.087 ± 0.03 and 0.039 ± 0.047 to 0.4 ± 0.095 for SkD and VD with MHF vs SkD and VD with ST, respectively). Values of VDI were considerably higher with ST than with MHF, while standard deviation was still significantly higher with ST (range [mean ± SD]: 2.459 ± 0.144 to 2.71 ± 0.084 and 2.983 ± 0.929 to 5.19 ± 1.064 for VDI with MHF and ST, respectively). The noise level reduction of the two methods were almost identical (noise levels: 65.8% with MHT and 65.24% with ST). Using MHF, the vascular network gets more fragmented by an average of 40% compared to ST. Both methods allow the segmentation of the vascular network and the examination of vascular density parameters, but they produce largely inconsistent results. To determine if these inconsistent results are clinically meaningful, and which method is more suitable for clinical use, our results provide further evidence that detailed understanding of the image analysis method is essential for reliable decision making for patients with retinal pathology. For longitudinal monitoring, use of the same image processing method is recommended. Subject terms: Image processing, Medical research, Retina, Medical imaging

CITATION EXPORT

Orsolya Angeli, Dorottya Hajdu, Aniko Jeney et al.. Qualitative and quantitative comparison of two semi-manual retinal vascular density analyzing methods on optical coherence tomography angiography images of healthy individuals. Scientific Reports. (2023). https://doi.org/10.1038/s41598-023-44234-z

AUTHORS

11 · 10 CENTRES

Orsolya Angeli, Dorottya Hajdu, Aniko Jeney, Balint Czifra, Balazs Vince Nagy, Tamas Balazs, Dora Jakaboczkine Nemoda, Gabor Mark Somfai, Zoltan Z Nagy, Tunde Peto, Miklos Schneider

1Department of Ophthalmology, Semmelweis University, Budapest, Hungary
2Department of Ophthalmology and Optometry, Vienna Clinical Trial Center (VTC), Medical University of Vienna, Vienna, Austria
3Department of Ophthalmology, Flor Ferenc Hospital, Kistarcsa, Hungary
4Department of Mechatronics, Optics and Mechanical Engineering, Budapest University of Technology and Economics, Budapest, Hungary
5Healthware Ltd, Budapest, Hungary
6Department of Ophthalmology, Stadtspital Zurich, Zurich, Switzerland
7Spross Research Institute, Zurich, Switzerland
8Centre for Public Health, Queen’s University Belfast, Belfast, UK
9Research Unit of Ophthalmology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
10Department of Ophthalmology, Rigshospitalet Glostrup, Valdemar Hansens Vej 1-23, 2600 Glostrup, Denmark