Automated foveal location detection on spectral-domain optical coherence tomography in geographic atrophy patients

Graefes Arch Clin Exp Ophthalmol. 2022 Jul;260(7):2261-2270. doi: 10.1007/s00417-021-05520-6. Epub 2022 Jan 19.


Purpose: To develop a fully automated algorithm for accurate detection of fovea location in atrophic age-related macular degeneration (AMD), based on spectral-domain optical coherence tomography (SD-OCT) scans.

Methods: Image processing was conducted on a cohort of patients affected by geographic atrophy (GA). SD-OCT images (cube volume) from 55 eyes (51 patients) were extracted and processed with a layer segmentation algorithm to segment Ganglion Cell Layer (GCL) and Inner Plexiform Layer (IPL). Their en face thickness projection was convolved with a 2D Gaussian filter to find the global maximum, which corresponded to the detected fovea. The detection accuracy was evaluated by computing the distance between manual annotation and predicted location.

Results: The mean total location error was 0.101±0.145mm; the mean error in horizontal and vertical en face axes was 0.064±0.140mm and 0.063±0.060mm, respectively. The mean error for foveal and extrafoveal retinal pigment epithelium and outer retinal atrophy (RORA) was 0.096±0.070mm and 0.107±0.212mm, respectively. Our method obtained a significantly smaller error than the fovea localization algorithm inbuilt in the OCT device (0.313±0.283mm, p <.001) or a method based on the thinnest central retinal thickness (0.843±1.221, p <.001). Significant outliers are depicted with the reliability score of the method.

Conclusion: Despite retinal anatomical alterations related to GA, the presented algorithm was able to detect the foveal location on SD-OCT cubes with high reliability. Such an algorithm could be useful for studying structural-functional correlations in atrophic AMD and could have further applications in different retinal pathologies.

Keywords: Age-related macular degeneration; Algorithm; Foveal location; Geographic atrophy; Optical coherence tomography.

MeSH terms

  • Fovea Centralis / pathology
  • Geographic Atrophy* / diagnosis
  • Humans
  • Reproducibility of Results
  • Retinal Pigment Epithelium / pathology
  • Tomography, Optical Coherence / methods