Abstract

Worldwide, polypoidal choroidal vasculopathy (PCV) is a common vision-threatening exudative maculopathy, and pigment epithelium detachment (PED) is an important clinical characteristic. Thus, precise and efficient PED segmentation is necessary for PCV clinical diagnosis and treatment. We propose a dual-stage learning framework via deep neural networks (DNN) for automated PED segmentation in PCV patients to avoid issues associated with manual PED segmentation (subjectivity, manual segmentation errors, and high time consumption).The optical coherence tomography scans of fifty patients were quantitatively evaluated with different algorithms and clinicians. Dual-stage DNN outperformed existing PED segmentation methods for all segmentation accuracy parameters, including true positive volume fraction (85.74 ± 8.69%), dice similarity coefficient (85.69 ± 8.08%), positive predictive value (86.02 ± 8.99%) and false positive volume fraction (0.38 ± 0.18%). Dual-stage DNN achieves accurate PED quantitative information, works with multiple types of PEDs and agrees well with manual delineation, suggesting that it is a potential automated assistant for PCV management.

Highlights

  • Worldwide, polypoidal choroidal vasculopathy (PCV) is a common, vision-threatening exudative maculopathy

  • We propose a dual-stage learning framework via deep neural networks (DNN) for automated pigment epithelium detachment (PED) segmentation in PCV patients to avoid issues associated with manual PED segmentation.The optical coherence tomography scans of fifty patients were quantitatively evaluated with different algorithms and clinicians

  • Drusenoid PED seldom appears in PCV patients because it is caused by drusen, which is uncommon in PCV patients [9]

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Summary

Introduction

Polypoidal choroidal vasculopathy (PCV) is a common, vision-threatening exudative maculopathy. As PED volume can predict the treatment outcome of PCV disease [1,2,3,4], precise and reliable PED segmentation is required for quantification in clinical practice. PEDs can be divided into the three following types: serous, vascularized and drusenoid PEDs [3]. This work focuses on PEDs among PCV patients, i.e., serous and vascularized PEDs. Serous PED is caused by a collection of fluid in the sub-RPE space [5, 6]. Vascularized PED, which is the result of angiogenesis and sub-RPE neovascularization, is more sight threatening than other types of PED but is more responsive to treatment [7, 8]. Drusenoid PED seldom appears in PCV patients because it is caused by drusen, which is uncommon in PCV patients [9]

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