title: Quantitative comparison of macular segmentation performance using identical retinal regions across multiple spectral-domain optical coherence tomography instruments.
abstract: OBJECTIVE
  Comparison of optical coherence tomography (OCT) segmentation performance regarding technical accuracy and clinical relevance.
  
  
  METHODS
  29 eyes were imaged prospectively with Spectralis (Sp), Cirrus (Ci), 3D-OCT 2000 (3D) and RS-3000 (RS) OCTs. Raw data were evaluated in validated custom software. A 1 mm diameter subfield, centred on the fovea, was investigated to compare identical regions for each case. Segmentation errors were corrected on each B-scan enclosed in this subfield. Proportions of wrongly segmented A-scans were noted for inner and outer retinal boundaries. Centre point thickness (CPT) and central macular thickness (CMT) were compared before and after correction.
  
  
  RESULTS
  Segmentation errors occurred in 77% and affected on average 29% of A-scans, resulting in mean differences of 24/13 µm (CPT/CMT). The incidence of segmentation errors was 48% (Sp), 79% (Ci), 86% (3D) and 93% (RS), p<0.001. Mean proportions of A-scans with wrong outer retinal boundary were 30% (Sp), 9% (Ci), 23% (3D) and 10% (RS), p=0.006; proportions for the inner retinal boundary were 11% (Sp), 12% (Ci), 6% (3D) and 21% (RS), p=0.034. Mean deviations in CPT/CMT were 41/28 µm (Sp), 17/11 µm (Ci), 30/13 µm (3D) and 18/8 µm (RS), p=0.409/0.477.
  
  
  CONCLUSIONS
  By comparison of identical regions, substantial differences were detected between the tested OCT devices regarding technical accuracy and clinical impact. Spectralis showed lowest error incidence but highest error impact.
authors.affiliation: Department of Ophthalmology, Christian-Doppler-Laboratory for Ophthalmic Image Analysis, Vienna Reading Center, Medical University of Vienna, Vienna, Austria.
authors.forename: Sebastian M
authors.initials: SM
authors.lastname: Waldstein
authors.affiliation: Department of Ophthalmology, Christian-Doppler-Laboratory for Ophthalmic Image Analysis, Vienna Reading Center, Medical University of Vienna, Vienna, Austria.
authors.forename: Bianca S
authors.initials: BS
authors.lastname: Gerendas
authors.affiliation: Department of Ophthalmology, Christian-Doppler-Laboratory for Ophthalmic Image Analysis, Vienna Reading Center, Medical University of Vienna, Vienna, Austria.
authors.forename: Alessio
authors.initials: A
authors.lastname: Montuoro
authors.affiliation: Department of Ophthalmology, Christian-Doppler-Laboratory for Ophthalmic Image Analysis, Vienna Reading Center, Medical University of Vienna, Vienna, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Simader
authors.affiliation: Department of Ophthalmology, Christian-Doppler-Laboratory for Ophthalmic Image Analysis, Vienna Reading Center, Medical University of Vienna, Vienna, Austria.
authors.forename: Ursula
authors.initials: U
authors.lastname: Schmidt-Erfurth
mesh_terms: D000465:Algorithms; D016477:Artifacts; D003930:Diabetic Retinopathy / Q000175:diagnosis; D003951:Diagnostic Errors; D019773:Epiretinal Membrane / Q000175:diagnosis; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008268:Macular Degeneration / Q000175:diagnosis; D008269:Macular Edema / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012160:Retina / Q000473:pathology*; D012164:Retinal Diseases / Q000175:diagnosis*; D012170:Retinal Vein Occlusion / Q000175:diagnosis; D000080362:Stargardt Disease; D041623:Tomography, Optical Coherence / Q000295:instrumentation*; D057135:Wet Macular Degeneration / Q000175:diagnosis
keywords: Diagnostic tests/Investigation; Imaging; Macula; Retina