Comparison of Reliability in Diabetic Macular Edema Estimates between Two Image Analysis Algorithms

PURPOSE: To evaluate segmentation reliability in diabetic macular edema (DME) estimates between a Cirrus™ HD-OCT image analysis algorithm and an Iowa reference algorithm, which are an automatic segmentation software. METHODS: Thirty eyes from 23 patients diagnosed with DME were included and underwent spectral-domain optical coherence scans (Cirrus™ HD-OCT). Central foveal thickness (CFT) and ganglion cell layer-inner plexiform layer segmentation data were compared with those produced by the Cirrus™ HD-OCT segmentation algorithm and Iowa reference algorithm. Measurement agreement was assessed using intraclass correlation (ICC) and segmentation errors were confirmed by 2 ophthalmologists. RESULTS: The mean CFT in the 1-mm central area determined by the manufacturer-supplied Cirrus software and Iowa reference algorithm was 512.07 ± 182.35 µm and 476.53 ± 32.36 µm, respectively (p < 0.05). The mean paired difference was 35.53 ± 92.46 µm (ICC, 0.929). Segmentation errors were demonstrated in eyes with a CFT less than 400 µm, specifically for 45% of scans obtained by the Cirrus algorithm and 9% from the Iowa algorithm; in eyes with a CFT equal to or higher than 400 µm, the error rates were 95% and 42%, respectively. CONCLUSIONS: CFT measurement in eyes with diabetic macular edema using the Cirrus algorithm and Iowa algorithm showed relatively high degrees of agreement and significant correlation. In eyes with a CFT equal to or higher than 400 µm, the Iowa algorithm showed higher reliability in retinal segmentation than the Cirrus algorithm.

New Modalities for the Diagnosis and Treatment of Diabetic Retinopathy / 대한내과학회지

Over the past decade, significant advances have been made in both the diagnosis and treatment of diabetic retinopathy. Ultrawide field fundus photography and spectral domain optical coherence tomography have allowed more accurate, convenient, and early diagnosis of diabetic retinopathy. Numerous randomized clinical trials have demonstrated the effectiveness of anti-vascular endothelial growth factor agents for the treatment of diabetic retinopathy, although more work is necessary in terms of long-term clinical outcomes and socioeconomic costs associated with these treatments.