title: Automatic assessment of time-resolved OCT images for selective retina therapy.
abstract: OBJECTIVE
  In recent years, selective retina laser treatment (SRT), a sub-threshold therapy method, avoids widespread damage to all retinal layers by targeting only a few. While these methods facilitate faster healing, their lack of visual feedback during treatment represents a considerable shortcoming as induced lesions remain invisible with conventional imaging and make clinical use challenging. To overcome this, we present a new strategy to provide location-specific and contact-free automatic feedback of SRT laser applications.
  
  
  METHODS
  We leverage time-resolved optical coherence tomography (OCT) to provide informative feedback to clinicians on outcomes of location-specific treatment. By coupling an OCT system to SRT treatment laser, we visualize structural changes in the retinal layers as they occur via time-resolved depth images. We then propose a novel strategy for automatic assessment of such time-resolved OCT images. To achieve this, we introduce novel image features for this task that when combined with standard machine learning classifiers yield excellent treatment outcome classification capabilities.
  
  
  RESULTS
  Our approach was evaluated on both ex vivo porcine eyes and human patients in a clinical setting, yielding performances above 95 % accuracy for predicting patient treatment outcomes. In addition, we show that accurate outcomes for human patients can be estimated even when our method is trained using only ex vivo porcine data.
  
  
  CONCLUSIONS
  The proposed technique presents a much needed strategy toward noninvasive, safe, reliable, and repeatable SRT applications. These results are encouraging for the broader use of new treatment options for neovascularization-based retinal pathologies.
authors.affiliation: ARTORG Research Center Biomedical Engineering Research, University of Bern, Murtenstrasse 50, 3008, Bern, Switzerland.
authors.forename: Sarah
authors.initials: S
authors.lastname: Zbinden
authors.affiliation: ARTORG Research Center Biomedical Engineering Research, University of Bern, Murtenstrasse 50, 3008, Bern, Switzerland. serife.kucur@artorg.unibe.ch.
authors.forename: Şerife Seda
authors.identifier: http://orcid.org/0000-0001-7995-2458
authors.initials: ŞS
authors.lastname: Kucur
authors.affiliation: ARTORG Research Center Biomedical Engineering Research, University of Bern, Murtenstrasse 50, 3008, Bern, Switzerland.
authors.forename: Patrick
authors.initials: P
authors.lastname: Steiner
authors.affiliation: Department of Ophthalmology, Inselspital Bern, Freiburgstrasse 12, 3010, Bern, Switzerland.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Wolf
authors.affiliation: ARTORG Research Center Biomedical Engineering Research, University of Bern, Murtenstrasse 50, 3008, Bern, Switzerland.
authors.forename: Raphael
authors.initials: R
authors.lastname: Sznitman
mesh_terms: D000818:Animals; D019540:Area Under Curve; D004195:Disease Models, Animal; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D012164:Retinal Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D055213:Retinal Pigment Epithelium / Q000473:pathology; D012680:Sensitivity and Specificity; D013552:Swine; D041623:Tomography, Optical Coherence / Q000379:methods*
keywords: Computer-assisted intervention; Feature design; Retinal laser therapy; Time-resolved OCT; Treatment outcome estimation