Joint retinal layer and fluid segmentation in OCT scans of eyes with severe macular edema using unsupervised representation and auto-context.

Modern optical coherence tomography (OCT) devices used in ophthalmology acquire steadily increasing amounts of imaging data. Thus, reliable automated quantitative analysis of OCT images is considered to be of utmost importance. Current automated retinal OCT layer segmentation methods work reliably on healthy or mildly diseased retinas, but struggle with the complex interaction of the layers with fluid accumulations in macular edema. In this work, we present a fully automated 3D method which is able to segment all the retinal layers and fluid-filled regions simultaneously, exploiting their mutual interaction to improve the overall segmentation results. The machine learning based method combines unsupervised feature representation and heterogeneous spatial context with a graph-theoretic surface segmentation. The method was extensively evaluated on manual annotations of 20,000 OCT B-scans from 100 scans of patients and on a publicly available data set consisting of 110 annotated B-scans from 10 patients, all with severe macular edema, yielding an overall mean Dice coefficient of 0.76 and 0.78, respectively.