Convolutional Neural Network–Based Automated Quality Assessment of OCT and OCT Angiography Image Maps in Individuals With Neurodegenerative Disease

Purpose: To train and test convolutional neural networks (CNNs) to automate quality assessment of optical coherence tomography (OCT) and OCT angiography (OCTA) images in patients with neurodegenerative disease. Methods: Patients with neurodegenerative disease were enrolled in the Duke Eye Multi-modal Imaging in Neurodegenerative Disease Study. Image inputs were ganglion cell– inner plexiform layer (GC-IPL) thickness maps and fovea-centered 6-mm × 6-mm OCTA scans of the superficial capillary plexus (SCP). Two trained graders manually labeled all images for quality (good versus poor). Interrater reliability (IRR) of manual quality assessment was calculated for a subset of each image type. Images were split into train, validation, and test sets in a 70%/15%/15% split. An AlexNet-based CNN was trained using these labels and evaluated with area under the receiver operating characteristic (AUC) and summaries of the confusion matrix. Results: A total of 1465 GC-IPL thickness maps (1217 good and 248 poor quality) and 2689 OCTA scans of the SCP (1797 good and 892 poor quality) served as model inputs. The IRR of quality assessment agreement by two graders was 97% and 90% for the GC-IPL maps and OCTA scans, respectively. The AlexNet-based CNNs trained to assess quality of the GC-IPL images and OCTA scans achieved AUCs of 0.990 and 0.832, respectively. Conclusions: CNNs can be trained to accurately differentiate good-from poor-quality GC-IPL thickness maps and OCTA scans of the macular SCP. Translational Relevance: Since good-quality retinal images are critical for the accurate assessment of microvasculature and structure, incorporating an automated image quality sorter may obviate the need for manual image review.