Development and validation of a novel automated method for quantification of choroidal thickness in age-related macular degeneration

Abstract

Age-related Macular Degeneration (AMD) is a progressive, irreversible retinal disorder, and one of the leading causes of severe visual impairment or even blindness in the elderly population. The choroid plays a vital role in the pathophysiology of AMD. It is known that abnormal choroidal blood flow leads to retinal photoreceptor dysfunction and eventual death. We propose a new automated algorithm that can be used to quantify choroidal thickness (CT) from Optical Coherence Tomography (OCT) images of the retina. This thickness evaluation procedure includes image contrast enhancement, localization around the fovea centralis, segmentation of Retinal Pigment Epithelium (RPE) and choroidal layer, followed by CT measurement at multiple locations in the sub-foveal region at intervals of 0.5 mm on both nasal and temporal sides up to a distance of 1 mm from the center of the foveal pit. The horizontal radial scan OCT images (Cirrus 5000, Carl Zeiss Meditec Inc., Dublin, CA) of both healthy and AMD patients were used to measure the CT using the new algorithm. The statistical tests convey that the CT of AMD patients is relatively smaller than the normal condition. Furthermore, t-Test conducted between the proposed approach and clinical approach of extracting CT measurements confirm that the proposed method is in good agreement with the clinical measurements. On an average, the thickness of the choroid is found to be 0.32 ± 0.10 mm for the normal category and 0.21 ± 0.06 mm for the AMD category, in the central sub-foveal region, as obtained from the proposed automatic CT measurement method. The clinical significance and the results of automated choroid extraction are discussed in this paper. © COPYRIGHT SPIE. Downloading of the abstract is permitted for personal use only.