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Quantifying segmentation sensitivity in OCTA: Device-specific profiles across three commercial platforms.

Michael Hafner1, Bettina von Livonius1, Daniel Deschler1

  • 1Department of Ophthalmology, LMU University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany.

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Summary
This summary is machine-generated.

Optical coherence tomography angiography (OCTA) measurements are sensitive to segmentation shifts. Device-specific OCTA metric variations highlight the need for standardized definitions and quality control in research.

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Area of Science:

  • Ophthalmology and Biomedical Imaging
  • Retinal Microvasculature Analysis
  • Quantitative OCT Angiography

Background:

  • Optical coherence tomography angiography (OCTA) provides quantitative insights into retinal microvasculature.
  • Accurate segmentation of superficial and deep capillary plexus slabs is crucial for reliable OCTA metrics.
  • Existing OCTA metrics may be susceptible to variations in layer segmentation boundaries.

Purpose of the Study:

  • To quantify the sensitivity of common OCTA metrics to systematic shifts in the boundary between superficial and deep capillary plexus slabs.
  • To assess the clinical meaningfulness of OCTA metric changes resulting from segmentation offsets.
  • To compare the segmentation offset sensitivity across three commercial OCTA devices.

Main Methods:

  • Prospective cross-sectional study involving 32 eyes from 16 healthy participants.
  • OCTA imaging performed on three devices: Intalight DREAM, Zeiss Cirrus, and Topcon Triton.
  • Systematic shifts (-10 to +10 μm) applied to the inner plexiform/inner nuclear layer boundary using native segmentation tools; OCTAVA pipeline analyzed en face images for vessel density, length, branching, and FAZ area.

Main Results:

  • Segmentation offset sensitivity was strongly device- and layer-dependent.
  • Intalight DREAM showed pronounced effects (e.g., superficial vessel area density +4.9%/10 μm, deep vessel area density -5.2%/10 μm, deep FAZ enlargement +15.5%/10 μm).
  • Zeiss Cirrus exhibited moderate deep-plexus sensitivity and high FAZ sensitivity (+16.1%/10 μm); Topcon Triton metrics were stable except for deep FAZ area (+9.8%/10 μm).
  • Micrometer-scale shifts produced changes comparable to early diabetic microvascular differences.

Conclusions:

  • Micrometer-scale slab definition changes can significantly bias OCTA-derived endpoints.
  • Device- and layer-specific sensitivities underscore the need for standardized slab definitions and quality control.
  • Transparent reporting of adjustments and establishing tolerance thresholds are essential for reliable interpretation in research and clinical practice.