Original StudyAN IMPROVED OPTICAL COHERENCE TOMOGRAPHY–DERIVED FUNDUS PROJECTION IMAGE FOR DRUSEN VISUALIZATIONChen, Qiang PhD*,†; Leng, Theodore MD, MS‡; Zheng, Luo Luo MS‡; Kutzscher, Lauren BS‡; De Sisternes, Luis PhD*; Rubin, Daniel L. MD, MS*Author Information *Department of Radiology and Medicine (Biomedical Informatics Research), Stanford University School of Medicine, Stanford, CA; †School of Computer Science and Engineering, Nanjing University of Science and Technology, Nanjing, China; and ‡Byers Eye Institute at Stanford, Stanford University School of Medicine, Palo Alto, CA. Reprint requests: Qiang Chen, PhD, School of Computer Science and Engineering, Nanjing University of Science and Technology, Xiao Lingwei 200#, Nanjing 210094, China; e-mail: [email protected] Supported by a grant from the Bio-X Interdisciplinary Initiatives Program of Stanford University; a grant from the National Cancer Institute, National Institutes of Health (Grant U01-CA-142555); and grants from Qing Lan Project. Retina: May 2014 - Volume 34 - Issue 5 - p 996-1005 doi: 10.1097/IAE.0000000000000018 Buy Metrics AbstractIn Brief Purpose: To develop and evaluate an improved method of generating en face fundus images from three-dimensional optical coherence tomography images which enhances the visualization of drusen. Methods: We describe a novel approach, the restricted summed-voxel projection (RSVP), to generate en face projection images of the retinal surface combined with an image processing method to enhance drusen visualization. The RSVP approach is an automated method that restricts the projection to the retinal pigment epithelium layer neighborhood. Additionally, drusen visualization is improved through an image processing technique that fills drusen with bright pixels. The choroid layer is also excluded when creating the RSVP to eliminate bright pixels beneath drusen that could be confused with drusen when geographic atrophy is present. The RSVP method was evaluated in 46 patients and 3-dimensional optical coherence tomography data sets were obtained from 8 patients, for which 2 readers independently identified drusen as the gold standard. The mean drusen overlap ratio was used as the metric to determine the accuracy of visualization of the RSVP method when compared with the conventional summed-voxel projection technique. Results: Comparative results demonstrate that the RSVP method was more effective than the conventional summed-voxel projection in displaying drusen and retinal vessels, and was more useful in detecting drusen. The mean drusen overlap ratios based on the conventional summed-voxel projection method and the RSVP method were 2.1% and 89.3%, respectively. Conclusion: The RSVP method was more effective for drusen visualization than the conventional summed-voxel projection method, and it may be useful for macular assessment in patients with nonexudative age-related macular degeneration. The authors describe a novel approach, the restricted summed-voxel projection, to generate en face projection images of the retinal surface from three-dimensional spectral-domain optical coherence tomography images. Comparative results demonstrate that the restricted summed-voxel projection method was more effective than conventional summed-voxel projection in displaying drusen and retinal vessels and was more accurate in detecting drusen. © 2014 by Ophthalmic Communications Society, Inc.