https://orcid.org/0000-0002-4822-6813
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Abstract
Purpose
To assess the efficacy of customized slab segmentation in eliminating projection artifacts in swept-source optical coherence tomography angiography (SS-OCTA) images of Best vitelliform macular dystrophy (BVMD).
Methods
Prospective case series including different stages of BVMD. We analyzed SS-OCTA images for flow signals in the outer retina and coregistered B-scan images for distortion of the segmentation slabs defining the outer retina. We applied a customized method for slab realignment whenever BVMD lesions produced distortion of the slabs. Afterward, we checked the images to determine whether the previously noted flow signal had persisted or disappeared, described as “true flow” or “pseudoflow”, respectively. Categorical variables were analyzed with X2 or Fisher’s exact tests, while quantitative variables were analyzed with independent t-test at p<0.05.
Results
The study included 39 eyes of 22 patients. We detected BVMD patterns I (dome-shaped hyperreflective lesion without neurosensory retinal detachment), II (knob-like hyperreflective lesion with localized neurosensory retinal detachment), and III (heterogeneous scattered hyperreflective material) in 49%, 23%, and 28% of eyes, respectively. Pseudoflow was evident mostly in eyes with pattern II lesions, presence of flow signal within BVMD lesions, and lesions whose height represented >80% of the retinal thickness (p<0.001).
Conclusion
Customized slab segmentation is effective in eliminating projection artifact in SS-OCTA images of BVMD.
Summary
Projection artifact is a significant confounding factor in emerging SS-OCTA technology through production of pseudoflow signals that can lead to misinterpretation of images of BVMD lesions. The present study proposes a customized method for correction of segmentation errors to eliminate projection artifacts in SS-OCTA images of BVMD patients.
Data Sharing Statement
The data collected from history-taking and clinical examinations of patients recruited in the current study are confidential. Access to these data is restricted by the MEDIC Eye Center, in accordance with our patient data–protection policy. Data are available for researchers who meet the criteria for access to confidential data through contacting the corresponding author.
Statement of Ethics
This study was approved by the institutional review board of MEDIC Eye Center, Tanta, Egypt.
It adhered strictly to the tenets of the Declaration of Helsinki of 1975 and the revision of 2013.
All participants received a thorough explanation of all imaging modalities entailed and expected complications whenever applicable. All patients/legal guardians signed informed consent prior to enrollment.
Disclosure
The authors report no conflicts of interest in this work.