title: SPECTRAL DOMAIN-OPTICAL COHERENCE TOMOGRAPHY IMAGE CONTRAST AND BACKGROUND COLOR SETTINGS INFLUENCE IDENTIFICATION OF RETINAL STRUCTURES.
abstract: OBJECTIVE
  To evaluate image contrast and color setting on assessment of retinal structures and morphology in spectral-domain optical coherence tomography.
  
  
  METHODS
  Two hundred and forty-eight Spectralis spectral-domain optical coherence tomography B-scans of 62 patients were analyzed by 4 readers. B-scans were extracted in 4 settings: W + N = white background with black image at normal contrast 9; W + H = white background with black image at maximum contrast 16; B + N = black background with white image at normal contrast 12; B + H = black background with white image at maximum contrast 16. Readers analyzed the images to identify morphologic features. Interreader correlation was calculated. Differences between Fleiss-kappa correlation coefficients were examined using bootstrap method. Any setting with significantly higher correlation coefficient was deemed superior for evaluating specific features.
  
  
  RESULTS
  Correlation coefficients differed among settings. No single setting was superior for all respective spectral-domain optical coherence tomography parameters (P = 0.3773). Some variables showed no differences among settings. Hard exudates and subretinal fluid were best seen with B + H (κ = 0.46, P = 0.0237 and κ = 0.78, P = 0.002). Microaneurysms were best seen with W + N (κ = 0.56, P = 0.025). Vitreomacular interface, enhanced transmission signal, and epiretinal membrane were best identified using all color/contrast settings together (κ = 0.44, P = 0.042, κ = 0.57, P = 0.01, and κ = 0.62, P ≤ 0.0001).
  
  
  CONCLUSIONS
  Contrast and background affect the evaluation of retinal structures on spectral-domain optical coherence tomography images. No single setting was superior for all features, though certain changes were best seen with specific settings.
authors.affiliation: *Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; †Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria; ‡Department of Ophthalmology, Medical University of Vienna, Vienna, Austria; and §Department of Ophthalmology, Inselspital, Bern University Hospital, Bern, Switzerland.
authors.forename: Camille V
authors.initials: CV
authors.lastname: Palma
authors.forename: Ruchita
authors.initials: R
authors.lastname: Amin
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Huf
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Schlanitz
authors.forename: Katharina
authors.initials: K
authors.lastname: Eibenberger
authors.forename: Lee M
authors.initials: LM
authors.lastname: Jampol
authors.forename: Marion R
authors.initials: MR
authors.lastname: Munk
mesh_terms: D003116:Color; D006801:Humans; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D012160:Retina / Q000473:pathology*; D012164:Retinal Diseases / Q000175:diagnosis*; D041623:Tomography, Optical Coherence / Q000295:instrumentation*