Algorithms for the Automated Analysis of Age-Related Macular Degeneration Biomarkers on Optical Coherence Tomography: A Systematic Review

Maximilian Wintergerst, Thomas Schultz, Johannes Birtel, Alexander Schuster, Norbert Pfeiffer, Steffen Schmitz-Valckenberg, Frank Holz und Robert Finger
In: Translational Vision Science & Technology (2017), 6:10
 

Abstract

Purpose: To assess the quality of optical coherence tomography (OCT) grading algorithms for retinal biomarkers of age-related macular degeneration (AMD).

Methods: Following a systematic review of the literature data on detection and quantification of AMD retinal biomarkers by available algorithms were extracted and descriptively synthesized. Algorithm quality was assessed using a modified version of the Quality Assessment of Diagnostic Accuracy Studies 2 checklist with a focus on accuracy against established reference standards and risk of bias.

Results: Thirty five studies reporting computer-aided diagnosis (CAD) tools for qualitative analysis or algorithms for quantitative analysis were identified. Compared with manual assessment in reference standards correlation coefficients ranged from 0.54 to 0.97 for drusen, 0.80 to 0.98 for geographic atrophy (GA), and 0.30 to 0.98 for intra- or subretinal fluid and pigment epithelial detachment (PED) detection by automated algorithms. CAD tools achieved area under the curve (AUC) values of 0.94 to 0.99, sensitivity of 0.90 to 1.00, and specificity of 0.89 to 0.92.

Conclusions: Automated analysis of AMD biomarkers on OCT is promising. However, most of the algorithm validation was performed in preselected patients, exhibiting the targeted biomarker only. In addition, type and quality of reported algorithm validation varied substantially.

Translational Relevance: The development of algorithms for combined, simultaneous analysis of multiple AMD biomarkers including AMD staging and the agreement on standardized validation procedures would be of considerable translational value for the clinician and the clinical researcher.

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Bibtex

@ARTICLE{Wintergerst:TVST17,
    author = {Wintergerst, Maximilian and Schultz, Thomas and Birtel, Johannes and Schuster, Alexander and
              Pfeiffer, Norbert and Schmitz-Valckenberg, Steffen and Holz, Frank and Finger, Robert},
     title = {Algorithms for the Automated Analysis of Age-Related Macular Degeneration Biomarkers on Optical
              Coherence Tomography: A Systematic Review},
   journal = {Translational Vision Science {\&} Technology},
    volume = {6},
    number = {10},
      year = {2017},
  abstract = {Purpose: To assess the quality of optical coherence tomography (OCT) grading algorithms for retinal
              biomarkers of age-related macular degeneration (AMD).
              
              Methods: Following a systematic review of the literature data on detection and quantification of AMD
              retinal biomarkers by available algorithms were extracted and descriptively synthesized. Algorithm
              quality was assessed using a modified version of the Quality Assessment of Diagnostic Accuracy
              Studies 2 checklist with a focus on accuracy against established reference standards and risk of
              bias.
              
              Results: Thirty five studies reporting computer-aided diagnosis (CAD) tools for qualitative analysis
              or algorithms for quantitative analysis were identified. Compared with manual assessment in
              reference standards correlation coefficients ranged from 0.54 to 0.97 for drusen, 0.80 to 0.98 for
              geographic atrophy (GA), and 0.30 to 0.98 for intra- or subretinal fluid and pigment epithelial
              detachment (PED) detection by automated algorithms. CAD tools achieved area under the curve (AUC)
              values of 0.94 to 0.99, sensitivity of 0.90 to 1.00, and specificity of 0.89 to 0.92.
              
              Conclusions: Automated analysis of AMD biomarkers on OCT is promising. However, most of the
              algorithm validation was performed in preselected patients, exhibiting the targeted biomarker only.
              In addition, type and quality of reported algorithm validation varied substantially.
              
              Translational Relevance: The development of algorithms for combined, simultaneous analysis of
              multiple AMD biomarkers including AMD staging and the agreement on standardized validation
              procedures would be of considerable translational value for the clinician and the clinical
              researcher.},
       doi = {10.1167/tvst.6.4.10}
}