title: A new quality assessment parameter for optical coherence tomography.
abstract: OBJECTIVE
  To create a new, automated method of evaluating the quality of optical coherence tomography (OCT) images and to compare its image quality discriminating ability with the quality assessment parameters signal to noise ratio (SNR) and signal strength (SS).
  
  
  METHODS
  A new OCT image quality assessment parameter, quality index (QI), was created. OCT images (linear macular scan, peripapillary circular scan, and optic nerve head scan) were analysed using the latest StratusOCT system. SNR and SS were collected for each image. QI was calculated based on image histogram information using a software program of our own design. To evaluate the performance of these parameters, the results were compared with subjective three level grading (excellent, acceptable, and poor) performed by three OCT experts.
  
  
  RESULTS
  63 images of 21 subjects (seven each for normal, early/moderate, and advanced glaucoma) were enrolled in this study. Subjects were selected in a consecutive and retrospective fashion from our OCT imaging database. There were significant differences in SNR, SS, and QI between excellent and poor images (p = 0.04, p = 0.002, and p<0.001, respectively, Wilcoxon test) and between acceptable and poor images (p = 0.02, p<0.001, and p<0.001, respectively). Only QI showed significant difference between excellent and acceptable images (p = 0.001). Areas under the receiver operating characteristics (ROC) curve for discrimination of poor from excellent/acceptable images were 0.68 (SNR), 0.89 (IQP), and 0.99 (QI).
  
  
  CONCLUSIONS
  A quality index such as QI may permit automated objective and quantitative assessment of OCT image quality that performs similarly to an expert human observer.
authors.affiliation: UPMC Eye Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, 203 Lothrop Street, Eye and Ear Institute Suite 816, Pittsburgh, PA 15213, USA.
authors.forename: D M
authors.initials: DM
authors.lastname: Stein
authors.forename: H
authors.initials: H
authors.lastname: Ishikawa
authors.forename: R
authors.initials: R
authors.lastname: Hariprasad
authors.forename: G
authors.initials: G
authors.lastname: Wollstein
authors.forename: R J
authors.initials: RJ
authors.lastname: Noecker
authors.forename: J G
authors.initials: JG
authors.lastname: Fujimoto
authors.forename: J S
authors.initials: JS
authors.lastname: Schuman
mesh_terms: D000368:Aged; D005901:Glaucoma / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods / Q000592:standards; D008266:Macula Lutea / Q000473:pathology; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology; D009898:Optic Disk / Q000473:pathology; D012372:ROC Curve; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000592:standards*