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Muijzer MB, Heslinga FG, Couwenberg F, Noordmans HJ, Oahalou A, Pluim JPW, Veta M, Wisse RPL. Automatic evaluation of graft orientation during Descemet membrane endothelial keratoplasty using intraoperative OCT. BIOMEDICAL OPTICS EXPRESS 2022; 13:2683-2694. [PMID: 35774322 PMCID: PMC9203112 DOI: 10.1364/boe.446519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/31/2021] [Accepted: 02/24/2022] [Indexed: 05/27/2023]
Abstract
Correct Descemet Membrane Endothelial Keratoplasty (DMEK) graft orientation is imperative for success of DMEK surgery, but intraoperative evaluation can be challenging. We present a method for automatic evaluation of the graft orientation in intraoperative optical coherence tomography (iOCT), exploiting the natural rolling behavior of the graft. The method encompasses a deep learning model for graft segmentation, post-processing to obtain a smooth line representation, and curvature calculations to determine graft orientation. For an independent test set of 100 iOCT-frames, the automatic method correctly identified graft orientation in 78 frames and obtained an area under the receiver operating characteristic curve (AUC) of 0.84. When we replaced the automatic segmentation with the manual masks, the AUC increased to 0.92, corresponding to an accuracy of 86%. In comparison, two corneal specialists correctly identified graft orientation in 90% and 91% of the iOCT-frames.
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Affiliation(s)
- Marc B. Muijzer
- Utrecht Cornea Research Group, Ophthalmology Department, University Medical Center Utrecht, Heidelberglaan 100, 3584CX, Utrecht, The Netherlands
- Contributed equally
| | - Friso G. Heslinga
- Department of Biomedical Engineering, Eindhoven University of Technology, Postbus 513, 5600 MB, Eindhoven, The Netherlands
- Contributed equally
| | - Floor Couwenberg
- University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands
| | - Herke-Jan Noordmans
- Medical technical and Clinical physics department, University Medical Center Utrecht, Heidelberglaan 100, 3584CX, Utrecht, The Netherlands
| | | | - Josien P. W. Pluim
- Department of Biomedical Engineering, Eindhoven University of Technology, Postbus 513, 5600 MB, Eindhoven, The Netherlands
- Image Sciences Institute, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584CX, Utrecht, The Netherlands
| | - Mitko Veta
- Department of Biomedical Engineering, Eindhoven University of Technology, Postbus 513, 5600 MB, Eindhoven, The Netherlands
- Contributed equally
| | - Robert P. L. Wisse
- Utrecht Cornea Research Group, Ophthalmology Department, University Medical Center Utrecht, Heidelberglaan 100, 3584CX, Utrecht, The Netherlands
- Contributed equally
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