Assessment of a spectral domain OCT segmentation software in a retrospective cohort study of exudative AMD patients

To assess the ability of the Spectralis optical coherence tomography (OCT) segmentation software to identify the inner limiting membrane and Bruch's membrane in exudative age-related macular degeneration (AMD) patients.

Thirty-eight eyes of 38 naive exudative AMD patients were retrospectively included. They all had a complete ophthalmologic examination including Spectralis OCT at baseline, at month 1 and 2. Reliability of the segmentation software was assessed by 2 ophthalmologists. Reliability of the segmentation software was defined as good if both inner limiting membrane and Bruch's membrane were correctly drawn.

A total of 38 patients charts were reviewed (114 scans). The inner limiting membrane was correctly drawn by the segmentation software in 114/114 spectral domain OCT scans (100%). Conversely, Bruch's membrane was correctly drawn in 59/114 scans (51.8%). The software was less reliable in locating Bruch's membrane in case of pigment epithelium detachment (PED) than without PED (42.5 vs. 73.5%, respectively; p = 0.049), but its reliability was not associated with SRF or CME (p = 0.55 and p = 0.10, respectively).

Segmentation of the inner limiting membrane was constantly trustworthy but Bruch's membrane segmentation was poorly reliable using the automatic Spectralis segmentation software. Based on this software, evaluation of retinal thickness may be incorrect, particularly in case of PED. PED is effectively an important parameter which is not included when measuring retinal thickness.