Automatic subretinal fluid segmentation of retinal SD-OCT images with neurosensory retinal detachment guided by Enface fundus imaging

Objective: Accurate segmentation of neurosensory retinal detachment (NRD) associated subretinal fluid in spectral domain optical coherence tomography (SDOCT) is vital for the assessment of central serous chorioretinopathy (CSC). A novel two-stage segmentation algorithm was proposed, guided by Enface fundus imaging. Methods: In the first stage, Enface fundus image was segmented using thickness map prior to detecting the fluidassociated abnormalities with diffuse boundaries. In the second stage, the locations of the abnormalities were used to restrict the spatial extent of the fluid region, and a fuzzy level set method with a spatial smoothness constraint was applied to subretinal fluid segmentation in the SD-OCT scans. Results: Experimental results from 31 retinal SDOCT volumes with CSC demonstrate that our method can achieve a true positive volume fraction (TPVF), false positive volume fraction (FPVF), and positive predicative value (PPV) of 94.3%, 0.97%, and 93.6%, respectively, for NRD regions. Our approach can also discriminate NRD-associated subretinal fluid from subretinal pigment epithelium fluid associated with pigment epithelial detachment with a TPVF, FPVF, and PPV of 93.8%, 0.40%, and 90.5%, respectively. Conclusion: We report a fully automatic method for the segmentation of subretinal fluid. Significance: Our method shows the potential to improve clinical therapy for CSC.