Oberwahrenbrock Timm, Traber Ghislaine L, Lukas Sebastian, Gabilondo Iñigo, Nolan Rachel, Songster Christopher, Balk Lisanne, Petzold Axel, Paul Friedemann, Villoslada Pablo, Brandt Alexander U, Green Ari J, Schippling Sven
NeuroCure Clinical Research Center (T.O., F.P., A.U.B.), Charité-Universitätsmedizin Berlin, Germany; Department of Ophthalmology (G.L.T.), University Hospital Zurich, University of Zurich; Neuroimmunology and Multiple Sclerosis Research Section (S.L., S.S.), Department of Neurology, University Hospital Zurich, University of Zurich, Switzerland; Center of Neuroimmunology (I.G., P.V.), Institut d'Investigacions Biomediques August Pi Sunyer (IDIBAPS)-Hospital Clinic, Barcelona, Spain; Division of Neuroinflammation and Glial Biology (R.N., C.S., A.J.G.), Department of Neurology, University of California San Francisco; Neuro-ophthalmology Division (A.J.G.), Department of Ophthalmology, University of California, San Francisco; Multiple Sclerosis Center (L.B., A.P.), Departments of Neurology and Ophthalmology, Neuro-ophthalmology Expertise Centre, VUmc, Amsterdam and Moorfields Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery and UCL, United Kingdom; Clinical and Experimental Multiple Sclerosis Research Center (F.P.), Department of Neurology, Charité-Universitätsmedizin Berlin; Experimental and Clinical Research Center (F.P., A.U.B.), Charité-Universitätsmedizin Berlin and Max-Delbrück Center for Molecular Medicine, Germany; Department of Methods and Experimental Psychology (I.G.), Faculty of Psychology and Education, Universidad de Deusto, Bilbao, Spain.
Neurol Neuroimmunol Neuroinflamm. 2018 Mar 13;5(3):e449. doi: 10.1212/NXI.0000000000000449. eCollection 2018 May.
To evaluate the inter-rater reliability of semiautomated segmentation of spectral domain optical coherence tomography (OCT) macular volume scans.
Macular OCT volume scans of left eyes from 17 subjects (8 patients with MS and 9 healthy controls) were automatically segmented by Heidelberg Eye Explorer (v1.9.3.0) beta-software (Spectralis Viewing Module v6.0.0.7), followed by manual correction by 5 experienced operators from 5 different academic centers. The mean thicknesses within a 6-mm area around the fovea were computed for the retinal nerve fiber layer, ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer, outer plexiform layer (OPL), and outer nuclear layer (ONL). Intraclass correlation coefficients (ICCs) were calculated for mean layer thickness values. Spatial distribution of ICC values for the segmented volume scans was investigated using heat maps.
Agreement between raters was good (ICC > 0.84) for all retinal layers, particularly inner retinal layers showed excellent agreement across raters (ICC > 0.96). Spatial distribution of ICC showed highest values in the perimacular area, whereas the ICCs were poorer for the foveola and the more peripheral macular area. The automated segmentation of the OPL and ONL required the most correction and showed the least agreement, whereas differences were less prominent for the remaining layers.
Automated segmentation with manual correction of macular OCT scans is highly reliable when performed by experienced raters and can thus be applied in multicenter settings. Reliability can be improved by restricting analysis to the perimacular area and compound segmentation of GCL and IPL.
评估光谱域光学相干断层扫描（OCT）黄斑容积扫描半自动分割的评分者间信度。
17名受试者（8例多发性硬化症患者和9名健康对照）左眼的黄斑OCT容积扫描由海德堡眼探险家（v1.9.3.0）测试版软件（Spectralis查看模块v6.0.0.7）自动分割，随后由来自5个不同学术中心的5名经验丰富的操作人员进行手动校正。计算视网膜神经纤维层、神经节细胞层（GCL）、内丛状层（IPL）、内核层、外丛状层（OPL）和外核层（ONL）在中央凹周围6毫米区域内的平均厚度。计算各层平均厚度值组内相关系数（ICC）。使用热图研究分割容积扫描的ICC值的空间分布。
所有视网膜层评分者间的一致性良好（ICC>0.84），尤其是视网膜内层在评分者间显示出极好的一致性（ICC>0.96）。ICC的空间分布在黄斑周围区域显示出最高值，而中央小凹和更外周的黄斑区域的ICC值较差。OPL和ONL的自动分割需要最多的校正且一致性最低，而其余层的差异则不太明显。
由经验丰富的评分者进行手动校正的黄斑OCT扫描自动分割在多中心环境中高度可靠，因此可应用于多中心研究。通过将分析限制在黄斑周围区域以及对GCL和IPL进行复合分割，可以提高信度。
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