Commentary: Qualitative comparison of choroidal vascularity measurement algorithms.

Optical coherence tomography (OCT) has made tremendous inroads into the daily routine of the vitreoretinal practice.[1] In contrast to the retinal evaluation, the evaluation of choroid is far more imprecise and difficult. The recent advances in the technology in the form of swept-source OCT has made it possible to image the choroid in addition to the retina in great detail.[2] The initial studies were on the overall choroidal thickness in various retinal and choroidal disorders. In this issue, Rasheed et al. have evaluated another parameter – “The choroidal vascularity index.”[3] Quantifying the choroidal vasculature was made possible by processing the OCT image using customized algorithms. The article deals with comparison of manual vs automatic delineation of the choroidal vasculature.

Intuitively, the manual technique is presumably more accurate as it involves the subjective judgment of the experienced observer. However, the down side of this technique is that it is time consuming, leads to fatigue-induced errors, and it is difficult to create volumetric data. Automated algorithms obviously score over manual technique for these considerations.

The authors compared the results of manual vs automated techniques for evaluating the choroidal vascularity index and found the automated technique to be reliable and accurate. The results appear to be promising and support the routine use of automated algorithms. In addition to being fast and repeatable, automated algorithms are operator independent.

This article is an important contribution to science. I would like to congratulate the authors on a well-planned and executed study.