Predicting Drusen Regression from OCT in Patients with Age-Related Macular Degeneration

Age-related macular degeneration (AMD) is a leading cause of blindness in developed countries. The presence of drusen is the hallmark of early/intermediate AMD, and their sudden regression is strongly associated with the onset of late AMD. In this work we propose a predictive model of drusen regression using optical coherence tomography (OCT) based features. First, a series of automated image analysis steps are applied to segment and characterize individual drusen and their development. Second, from a set of quantitative features, a random forest classi er is employed to predict the occurrence of individual drusen regression within the following 12 months. The predictive model is trained and evaluated on a longitudinal OCT dataset of 44 eyes from 26 patients using leave-one-patient-out cross-validation. The model achieved an area under the ROC curve of 0.81, with a sensitivity of 0.74 and a speci city of 0.73. The presence of hyperre ective foci and mean drusen signal intensity were found to be the two most important features for the prediction. This preliminary study shows that predicting drusen regression is feasible and is a promising step toward identi cation of imaging biomarkers of incoming regression.