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Updated: Dec 8, 2025

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Repeatability of binarization thresholding methods for optical coherence tomography angiography image quantification.

Nihaal Mehta1,2, Phillip X Braun1,3, Isaac Gendelman1,4

  • 1Department of Ophthalmology, New England Eye Center, Tufts Medical Center, 800 Washington Street, Box 450, Boston, MA, 02111, USA.

Scientific Reports
|September 22, 2020
PubMed
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This summary is machine-generated.

Binarization methods for optical coherence tomography angiography (OCTA) images show inconsistent repeatability. Metrics varied significantly across devices and retinal layers, impacting reliable OCTA analysis.

Area of Science:

  • Ophthalmology
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Binarization is essential for analyzing retinal optical coherence tomography angiography (OCTA) images.
  • Previous studies have used various binarization methods, but their repeatability is not well-established.
  • Assessing repeatability across different devices and retinal plexuses is crucial for reliable OCTA quantification.

Purpose of the Study:

  • To evaluate the repeatability of OCTA quantification metrics using diverse binarization thresholding methods.
  • To compare the performance of different binarization techniques across multiple OCTA devices and retinal vascular plexuses.
  • To investigate the impact of image processing techniques and contrast adjustments on OCTA metric repeatability.

Main Methods:

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  • Acquisition of successive 3x3 mm foveal OCTA images from 13 healthy eyes using three different devices.
  • Independent application of contrast adjustments, three image processing techniques (linear registration, histogram normalization, contrast-limited adaptive histogram equalization), and 11 binarization thresholding methods.
  • Calculation of vessel area density (VAD) and vessel length for retinal vascular images, and VAD and flow deficit for choriocapillaris (CC) images.
  • Measurement of repeatability using the intra-class correlation coefficient (ICC).

    • Main Results:

    • Repeatability of OCTA metrics was generally low (ICC < 0.8) and inconsistent across binarization thresholds, devices, and plexuses.
    • Local binarization thresholds often misclassified the foveal avascular zone in retinal vascular images.
    • No single image processing technique consistently yielded highly repeatable metrics.
    • Retinal vascular images exhibited the lowest repeatability under contrast changes, while CC images showed the highest.

    Conclusions:

    • Current binarization methods for OCTA analysis lack consistent repeatability across devices and retinal layers.
    • The choice of binarization threshold significantly impacts the reliability of OCTA quantification metrics.
    • Further research is needed to develop robust and repeatable binarization strategies for accurate OCTA analysis.