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Updated: Apr 21, 2026
Doppler Optical Coherence Tomography of Retinal Circulation
Published on: September 18, 2012
Detection and Differentiation of Intraretinal Hemorrhage in Spectral Domain Optical Coherence Tomography
Marion R Munk1, Roman Dunavoelgyi1, Magdalena Baratsits1
1a Department of Ophthalmology , Medical University of Vienna , Vienna , Austria and.
Insights
Spectral domain optical coherence tomography (SD-OCT) can detect intraretinal hemorrhage (IRH). However, its severity grading shows weak agreement with color-fundus (CF) imaging, indicating potential for improved diagnostic criteria.
Area of Science:
- Ophthalmology
- Medical Imaging
- Retinal Diseases
Background:
- Intraretinal hemorrhage (IRH) is a significant indicator of various retinal conditions.
- Spectral domain optical coherence tomography (SD-OCT) offers high-resolution cross-sectional imaging of the retina.
- Color-fundus (CF) photography is a standard method for visualizing retinal abnormalities.
Purpose of the Study:
- To classify and detect intraretinal hemorrhage (IRH) using spectral domain optical coherence tomography (SD-OCT).
- To evaluate the agreement between SD-OCT and color-fundus (CF) imaging in assessing IRH presence and severity.
Main Methods:
- One reader initially described IRH presentation in SD-OCT for Branch Retinal Vein Occlusion (BRVO) patients, comparing with CF images.
- Two masked readers assessed IRH presence and severity using both SD-OCT and CF.
- Inter-device and inter-observer agreement were evaluated, and the area of IRH was compared between modalities.
Main Results:
- SD-OCT detected IRH in 61% of scans, while CF detected it in 46% (concordance: 73%).
- Inter-device agreement for IRH severity grading (dense, flame-like, dot-like) was weak (k values: 0.2-0.3).
- Inter-observer agreement was strong for both SD-OCT (k=0.9) and CF (k=0.8).
- The mean IRH area was significantly larger on SD-OCT (11.5 mm²) compared to CF (8.1 mm²).
Conclusions:
- Intraretinal hemorrhage (IRH) is detectable using spectral domain optical coherence tomography (SD-OCT).
- Established severity grading of IRH shows weak agreement between SD-OCT and color-fundus (CF) imaging.
- Further refinement of SD-OCT based IRH classification may be necessary for improved diagnostic accuracy.
Purpose:
The purpose of this study was to classify and detect intraretinal hemorrhage (IRH) in spectral domain optical coherence tomography (SD-OCT).
Methods:
Initially the presentation of IRH in BRVO-patients in SD-OCT was described by one reader comparing color-fundus (CF) and SD-OCT using dedicated software. Based on these established characteristics, the presence and the severity of IRH in SD-OCT and CF were assessed by two other masked readers and the inter-device and the inter-observer agreement were evaluated. Further the area of IRH was compared.
Results:
About 895 single B-scans of 24 eyes were analyzed. About 61% of SD-OCT scans and 46% of the CF-images were graded for the presence of IRH (concordance: 73%, inter-device agreement: k = 0.5). However, subdivided into previously established severity levels of dense (CF: 21.3% versus SD-OCT: 34.7%, k = 0.2), flame-like (CF: 15.5% versus SD-OCT: 45.5%, k = 0.3), and dot-like (CF: 32% versus SD-OCT: 24.4%, k = 0.2) IRH, the inter-device agreement was weak. The inter-observer agreement was strong with k = 0.9 for SD-OCT and k = 0.8 for CF. The mean area of IRH detected on SD-OCT was significantly greater than on CF (SD-OCT: 11.5 ± 4.3 mm(2) versus CF: 8.1 ± 5.5 mm(2), p = 0.008).
Conclusions:
IRH seems to be detectable on SD-OCT; however, the previously established severity grading agreed weakly with that assessed by CF.
