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Abstract
Purpose
To determine the frequency and potential causes of segmentation errors in spectral domain optical coherence tomography (SD-OCT) imaging of retinal nerve fiber layer (RNFL) scans.
Methods
Segmentation errors for the RNFL thickness analysis were recorded during a retrospective chart review of 214 eye scans from 132 consecutive patients with glaucoma or glaucoma suspect who underwent a complete eye exam using Spectralis™ OCT scanning from August 2014 to November 2014. Segmentation errors were classified as inner, outer, inner and outer segmentation errors, and degraded images. The risk factors including age, sex, intraocular pressure, spherical equivalents, severity of glaucoma, and associated ocular disorders were evaluated using logistic regression analysis.
Results
A total of 71 eye scans included segmentation errors. Risk factors of inner segmentation error (8.9%) were age, epiretinal membrane, and degenerative myopia. Risk factors of outer segmentation error (29.9%) were age, peripapillary atrophy, posterior vitreous detachment, and severity of glaucoma. Risk factors of inner and outer segmentation errors (6.1%) were age and degenerative myopia. The single risk factor of degraded image (2.3%) was degenerative myopia.
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References
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 | Figure 1.Optical coherence tomography. (A) Normalperipapillary retinal nerve fiber layer thickness (RNFL) profile automatically segmented in Spectralis optical coherence tomography. Inner line indicated as internal limiting membrane are located between vitreous and RNFL. Outer line indicated as RNFL are located between RNFL and ganglion cell layer. (B) Unsegmentednormal peripapillary RNFL thickness profile. |
 | Figure 2.Examples of 4 segmentation error types in Spectralis™ imaging for retinal nerve fiber layer thickness. (A) Inner segmentation error associated with epiretinal membrane (arrow). (B) Outer segmentation error associated with large peripapillary atrophy (arrows). (C) Inner and outer segmentation error associated with epiretinal membrane and macular edema (arrows). (D) Degraded image (QS = 9) and outer segmentation error associated with degenerative myopia (arrow). |
Table 1.
Baseline demographics and descriptive data
| Parameters | Values |
|---|---|
| Age (years) | |
| Mean ± SD | 59.6 ± 15.2 |
| Range | 18–96 |
| Sex (n, %) | |
| Male | 55 (41.7) |
| Female | 77 (58.3) |
| BCVA (log MAR) | 0.11 ± 0.37 |
| IOP (mm Hg) | 12.6 ± 3.2 |
| SE (diopters) | −1.04 ± 2.98 |
Table 2.
Prevalence of the 4 types of segmentation errors
| Numbers of scans (n) | Percentage of scans (%) | |
|---|---|---|
| Inner segmentation error | 19 | 8.9 |
| Outer segmentation error | 64 | 29.9 |
| Inner and outer segmentation error | 13 | 6.1 |
| Degraded image | 5 | 2.3 |
Table 3.
Univariate and multivariate analysis for risk factors for inner segmentation errors
Table 4.
Univariate and multivariate analysis for risk factors for outer segmentation errors
Table 5.
Univariate and multivariate analysis for risk factors for inner and outer segmentation errors
Table 6.
Univariate and multivariate analysis for risk factors for degraded images
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