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Purpose To develop a deep learning-based framework to improve the image quality of optical coherence tomography (OCT) and evaluate its image enhancement effect with the traditional image averaging method from a clinical perspective. Methods 359 normal eyes and 456 eyes with various retinal conditions were included. A deep learning framework with high-resolution representation was developed to achieve image quality enhancement for OCT images. The quantitative comparisons, including expert subjective scores from ophthalmologists and three objective metrics of image quality (structural similarity index measure (SSIM), peak signal-to-noise ratio (PSNR) and contrast-to-noise ratio (CNR)), were performed between deep learning method and traditional image averaging. Results With the increase of frame count from 1 to 20, our deep learning method always obtained higher SSIM and PSNR values than the image averaging method while importing the same number of frames. When we selected 5 frames as inputs, the local objective assessment with CNR illustrated that the deep learning method had more obvious tissue contrast enhancement than averaging method. The subjective scores of image quality were all highest in our deep learning method, both for normal retinal structure and various retinal lesions. All the objective and subjective indicators had significant statistical differences ( P  &lt; 0.05). Conclusion Compared to traditional image averaging methods, our proposed deep learning enhancement framework can achieve a reasonable trade-off between image quality and scanning times, reducing the number of repeated scans.

Development and quantitative assessment of deep learning-based image enhancement for optical coherence tomography