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Choroidalyzer: An open-source, end-to-end pipeline for choroidal analysis in optical coherence tomography

2023/12/05 by Justin Engelmann, Jamie Burke, Engelmann, Justin +29
Engineering · Medicine · #Computer Vision and Pattern Recognition (cs.CV) #FOS: Biological sciences #FOS: Computer and information sciences #FOS: Electrical engineering #Image and Video Processing (eess.IV) #Machine Learning (cs.LG) #Optical Coherence Tomography Applications #Quantitative Methods (q-bio.QM) #Retinal Diseases and Treatments #Retinal Imaging and Analysis #electronic engineering #information engineering

paper · pdf · doi:10.48550/arxiv.2312.02956

openalex publication_date 2023/12/05 · openalex created_date 2023/12/07 · openalex updated_date 2026/07/28

Abstract

Purpose: To develop Choroidalyzer, an open-source, end-to-end pipeline for segmenting the choroid region, vessels, and fovea, and deriving choroidal thickness, area, and vascular index. Methods: We used 5,600 OCT B-scans (233 subjects, 6 systemic disease cohorts, 3 device types, 2 manufacturers). To generate region and vessel ground-truths, we used state-of-the-art automatic methods following manual correction of inaccurate segmentations, with foveal positions manually annotated. We trained a U-Net deep-learning model to detect the region, vessels, and fovea to calculate choroid thickness, area, and vascular index in a fovea-centred region of interest. We analysed segmentation agreement (AUC, Dice) and choroid metrics agreement (Pearson, Spearman, mean absolute error (MAE)) in internal and external test sets. We compared Choroidalyzer to two manual graders on a small subset of external test images and examined cases of high error. Results: Choroidalyzer took 0.299 seconds per image on a standard laptop and achieved excellent region (Dice: internal 0.9789, external 0.9749), very good vessel segmentation performance (Dice: internal 0.8817, external 0.8703) and excellent fovea location prediction (MAE: internal 3.9 pixels, external 3.4 pixels). For thickness, area, and vascular index, Pearson correlations were 0.9754, 0.9815, and 0.8285 (internal) / 0.9831, 0.9779, 0.7948 (external), respectively (all p<0.0001). Choroidalyzer's agreement with graders was comparable to the inter-grader agreement across all metrics. Conclusions: Choroidalyzer is an open-source, end-to-end pipeline that accurately segments the choroid and reliably extracts thickness, area, and vascular index. Especially choroidal vessel segmentation is a difficult and subjective task, and fully-automatic methods like Choroidalyzer could provide objectivity and standardisation.

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