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Quantifying choriocapillaris flow deficits using global and localized thresholding methods: a correlation study.

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Two choriocapillaris (CC) quantification methods, standard deviation (SD) and fuzzy C-means (FCM), show strong correlation and agreement in swept-source optical coherence tomography angiography (SS-OCTA) analysis. Both methods are suitable for clinical use, with SD requiring a normal database and FCM not.

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Area of Science:

  • Ophthalmology
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Choriocapillaris (CC) quantification is crucial for diagnosing and monitoring various ocular diseases.
  • Existing CC quantification methods using swept-source optical coherence tomography angiography (SS-OCTA) need comparative analysis for clinical utility.

Purpose of the Study:

  • To evaluate the correlation and agreement between two established choriocapillaris (CC) quantification methods.
  • To compare the performance of the standard deviation (SD) method and the fuzzy C-means (FCM) algorithm for analyzing flow deficits (FD) in CC using SS-OCTA data.

Main Methods:

  • Utilized SS-OCTA data from 164 normal adult subjects across various age groups.
  • Applied two methods, SD (global thresholding with a normal database) and FCM (local thresholding), to segment and quantify flow deficits (FD) including FD density (FDD) and mean FD size (MFDS).
  • Analyzed CC images from 3 mm × 3 mm and 6 mm × 6 mm scan patterns, quantifying multiple regions within each scan, and employed Spearman correlation and Bland-Altman analysis.

Main Results:

  • Strong correlations (r: 0.78-0.94) were found between the SD and FCM methods for all comparisons (P<0.0001).
  • Mean FD size (MFDS) generally showed higher correlation coefficients than FD density (FDD).
  • The 6 mm × 6 mm scan pattern demonstrated better agreement between the two methods compared to the 3 mm × 3 mm pattern, particularly in central macular regions.

Conclusions:

  • The SD and FCM methods exhibit strong correlations and satisfactory agreement for CC quantification.
  • The SD method necessitates a normal database, whereas the FCM method does not, offering flexibility in clinical application.
  • Both quantification methods are viable for analyzing CC flow deficits in clinical settings, contingent on study design and database availability.