Enhanced Detection of Reticular Pseudodrusen on Color Fundus Photos by Image Embossing

Abstract

Purpose

To evaluate whether processing a color fundus photo (CFP) using an image embossing technique can improve the detection of reticular pseudodrusen (RPD).

Methods

This post-hoc analysis included the eyes of subjects enrolled in the Amish Eye Study with early or intermediate age-related macular degeneration and evidence of RPD. All patients underwent CFP, near-infrared reflectance (NIR), and fundus autofluorescence (FAF) imaging. The ground-truth presence of RPD was established with a combination of NIR and FAF imaging. An embossing processed (EP) image was created by replacing each pixel of the CFP image with a highlight or a shadow representing light and dark boundaries in the original CFP image. The presence of RPD in CFP and EP images was assessed by two graders in a masked fashion and the sensitivity of CFP and EP for detection of RPD was evaluated. Cohen’s kappa (k) was used to test inter-grader agreement for CFP and EP.

Results

A total of 106 eyes from 62 patients with RPDs were analyzed. The sensitivity for detection of RPD on CFP and EP was 63.2% (95%CI: 52.0%–74.4%) and 91.5% (95%CI: 85.0%–98.0%), respectively. The inter-rater reliabilities of CFP and EP for RPD detection were 0.81 and 0.84, respectively.

Conclusions

Embossing of CFP can improve the sensitivity for detection of RPD. The embossing technique can be a useful tool for better assessment of the true frequency of RPD in datasets where only CFP images are available.

Keywords:

• Age-related macular degeneration
• reticular pseudodrusen
• image processing
• embossing

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Correction

Correction Statement

This article was originally published with errors, which have now been corrected in the online version. Please see Correction (http://dx.doi.org/10.1080/02713683.2023.2200072)

Disclosure statement

Shin Kadomoto: Consultant: Canon; Onisa Nanegrungsunk: none; Muneeswar Gupta Nittala: none; Ayesha Karamat: none; SriniVas R. Sadda: Consultant: Allergan/Abbvie, Alexion, Apellis, Iveric, Amgen, Regeneron, Novartis, Roche/Genentech, Oxurion, Nanoscope, Gyroscope, Pfizer, 4dMT, Jannsen, Heidelberg, Optos, Centervue; Research Instruments: Heidelberg, Optos, Centervue, Carl Zeiss Meditec, Nidek, Topcon.

Additional information

Funding

This study was supported by National Eye Institute of the National Institute of Health under Award Number R01EY023164 and R01EY030614. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of health. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.