A Deep-Learning Approach for Automated OCT En-Face Retinal Vessel Segmentation in Cases of Optic Disc Swelling Using Multiple En-Face Images as Input

PURPOSE: In cases of optic disc swelling, segmentation of projected retinal blood vessels from optical coherence tomography (OCT) volumes is challenging due to swelling-based shadowing artifacts. Based on our hypothesis that simultaneously considering vessel information from multiple projected retinal layers can substantially increase vessel visibility, in this work, we propose a deep-learning-based approach to segment vessels involving the simultaneous use of three OCT en-face images as input. METHODS: A human expert vessel tracing combining information from OCT en-face images of the retinal pigment epithelium (RPE), inner retina, and total retina as well as a registered fundus image served as the reference standard. The deep neural network was trained from the imaging data from 18 patients with optic disc swelling to output a vessel probability map from three OCT en-face input images. The vessels from the OCT en-face images were also manually traced in three separate stages to compare with the performance of the proposed approach. RESULTS: On an independent volume-matched test set of 18 patients, the proposed deep-learning-based approach outperformed the three OCT-based manual tracing stages. The manual tracing based on three OCT en-face images also outperformed the manual tracing using only the traditional RPE en-face image. CONCLUSIONS: In cases of optic disc swelling, use of multiple en-face images enables better vessel segmentation when compared with the traditional use of a single en-face image. TRANSLATIONAL RELEVANCE: Improved vessel segmentation approaches in cases of optic disc swelling can be used as features for an improved assessment of the severity and cause of the swelling.