Japanese Journal of Ophthalmology

, Volume 62, Issue 2, pp 179–185 | Cite as

Semi-automated software to measure luminal and stromal areas of choroid in optical coherence tomographic images

  • Shozo Sonoda
  • Taiji SakamotoEmail author
  • Naoko Kakiuchi
  • Hideki Shiihara
  • Tomonori Sakoguchi
  • Masatoshi Tomita
  • Takehiro Yamashita
  • Eisuke Uchino
Clinical Investigation



To determine the capabilities of “EyeGround” software in measuring the choroidal cross sectional areas in optical coherence tomographic (OCT) images.

Study design

Cross sectional, prospective study.


The cross-sectional area of the subfoveal choroid within a 1500 µm diameter circle centered on the fovea was measured both with and without using the EyeGround software in the OCT images. The differences between the evaluation times and the results of the measurements were compared. The inter-rater, intra-rater, inter-method agreements were determined.


Fifty-one eyes of 51 healthy subjects were studied: 24 men and 27 women with an average age of 35.0 ± 8.8 years. The time for analyzing a single image was significantly shorter with the software at 3.2±1.1 min than without the software at 12.1±5.1 min (P <0.001). The inter-method correlation efficient for the measurements of the whole choroid was high [0.989, 95% CI (0.981-0.994)]. With the software, the inter-rater correlation efficient was significantly high [0.997, 95% CI (0.995-0.999)], and the intra-rater correlation efficient was also significantly high [0.999, 95% CI (0.999-1.0)].


The EyeGround software can measure the choroidal area in the OCT cross sectional images with good reproducibility and in a significantly shorter times. It can be a valuable tool for analyzing the choroid.


EDI-OCT Choroid Image Binarization EyeGround 



The authors thank Professor Emeritus Duco Hamasaki of the Bascom Palmer Eye Institute of the University of Miami for providing critical discussions and suggestions to our study and revision of the final manuscript. This study was done by a grant from the Research Committee on Chorioretinal Degeneration and Optic Atrophy, Ministry of Health, Labor, and Welfare, Tokyo, Japan; and by a Grant-in-Aid for Scientific Research from the Ministry of Education, Science, and Culture of the Japanese Government, Tokyo, Japan.

Conflicts of interest

S. Sonoda, None; T. Sakamoto, None; N. Kakiuchi, None; H. Shiihara, None; T. Sakoguchi, None; M. Tomita, None; T. Yamashita, None; E. Uchino, None.

Supplementary material

10384_2017_558_MOESM1_ESM.tif (676 kb)
Supplementary Fig. S1 Representative images of the protocol of EyeGround software. Detailed protocol is as described in Methods. (a). Screen image of step 4. (b) Screen image of step 6-1. (c) Screen image of step 6-2. (d) Screen image of step 6-3. (e) Screen image of step 7. (f) Screen image of step 8. (g) Screen image of step 9.OCT Images with EyeGround software screen. (TIFF 675 kb)


  1. 1.
    Castro-Correia J. Understanding the choroid. Int Ophthalmol. 1995;19:135–47.CrossRefPubMedGoogle Scholar
  2. 2.
    Lutty GA, Cao J, McLeod DS. Relationship of polymorphonuclear leukocytes to capillary dropout in the human diabetic choroid. Am J Pathol. 1997;151:707–14.PubMedPubMedCentralGoogle Scholar
  3. 3.
    Imamura Y, Fujiwara T, Margolis R, Spaide RF. Enhanced depth imaging optical coherence tomography of the choroid in central serous chorioretinopathy. Retina. 2009;29:1469–73.CrossRefPubMedGoogle Scholar
  4. 4.
    Laude A, Cackett PD, Vithana EN, Yeo IY, Wong D, Koh AH, et al. Polypoidal choroidal vasculopathy and neovascular age-related macular degeneration: same or different disease? Prog Retin Eye Res. 2010;29:19–29.CrossRefPubMedGoogle Scholar
  5. 5.
    Saito M, Kano M, Itagaki K, Ise S, Imaizumi K, Sekiryu T. Subfoveal choroidal thickness in polypoidal choroidal vasculopathy after switching to intravitreal aflibercept injection. Jpn J Ophthalmol. 2016;60:35–41.CrossRefPubMedGoogle Scholar
  6. 6.
    Yoshikawa M, Akagi T, Nakanishi H, Ikeda HO, Morooka S, Yamada H, et al. Longitudinal change in choroidal thickness after trabeculectomy in primary open-angle glaucoma patients. Jpn J Ophthalmol. 2017;61:105–12.CrossRefPubMedGoogle Scholar
  7. 7.
    Spaide RF, Koizumi H, Pozzoni MC. Enhanced depth imaging spectral-domain optical coherence tomography. Am J Ophthalmol. 2008;146:496–500.CrossRefPubMedGoogle Scholar
  8. 8.
    Yamazaki T, Koizumi H, Yamagishi T, Kinoshita S. Subfoveal choroidal thickness after ranibizumab therapy for neovascular age-related macular degeneration: 12-month results. Ophthalmology. 2012;119:1621–7.CrossRefPubMedGoogle Scholar
  9. 9.
    Sonoda S, Sakamoto T, Otsuka H, Yoshinaga N, Yamashita T, Ki-I Y, et al. Responsiveness of eyes with polypoidal choroidal vasculopathy with choroidal hyperpermeability to intravitreal ranibizumab. BMC Ophthalmol. 2013;13:43. Scholar
  10. 10.
    Rayess N, Rahimy E, Ying GS, Bagheri N, Ho AC, Regillo CD, et al. Baseline choroidal thickness as a predictor for response to anti-vascular endothelial growth factor therapy in diabetic macular edema. Am J Ophthalmol. 2015;159:85–91. Scholar
  11. 11.
    Branchini LA, Adhi M, Regatieri CV, Nandakumar N, Liu JJ, Laver N, et al. Analysis of choroidal morphologic features and vasculature in healthy eyes using spectral-domain optical coherence tomography. Ophthalmology. 2013;120:1901–8.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Sohrab M, Wu K, Fawzi AA. A pilot study of morphometric analysis of choroidal vasculature in vivo, using en face optical coherence tomography. PLoS One. 2012;7:e48631.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Sonoda S, Sakamoto T, Yamashita T, Shirasawa M, Uchino E, Terasaki H, et al. Choroidal structure in normal eyes and after photodynamic therapy determined by binarization of optical coherence tomographic images. Investig Ophthalmol Vis Sci. 2014;55:3893–9.CrossRefGoogle Scholar
  14. 14.
    Sonoda S, Sakamoto T, Yamashita T, Uchino E, Kawano H, Yoshihara N, et al. Luminal and stromal areas of choroid determined by binarization method of optical coherence tomographic images. Am J Ophthalmol. 2015;159(1123–31):e1. Scholar
  15. 15.
    Iwata A, Mitamura Y, Niki M, Semba K, Egawa M, Katome T, et al. Binarization of enhanced depth imaging optical coherence tomographic images of an eye with Wyburn–Mason syndrome: a case report. BMC Ophthalmol. 2015;15:19.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Egawa M, Mitamura Y, Semba K, Naito T, Sonoda S, Sakamoto T. Changes of choroidal structure after treatment of primary intraocular lymphoma. BMC Ophthalmol. 2015;15:136.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Kawano H, Sonoda S, Yamashita T, Maruko I, Iida T, Sakamoto T. Relative changes in luminal and stromal areas of choroid determined by binarization of EDI-OCT images in eyes with Vogt–Koyanagi–Harada disease after treatment. Graefes Arch Clin Exp Ophthalmol. 2016;254:421–6. Scholar
  18. 18.
    Kinoshita T, Mitamura Y, Shinomiya K, Egawa M, Iwata A, Fujihara A, et al. Diurnal variations in luminal and stromal areas of choroid in normal eyes. Br J Ophthalmol. 2016. Scholar
  19. 19.
    Sonoda S, Sakamoto S, Kuroiwa N, Arimura N, Kawano H, Yoshihara N, et al. Structural changes of inner and outer choroid in central serous chorioretinopathy determined by optical coherence tomography. PLoS One. 2016;11:e0157190. Scholar
  20. 20.
    Egawa M, Mitamura Y, Akaiwa K, Semba K, Kinoshita T, Uchino E, et al. Vogt–Koyanagi–Harada disease. Br J Ophthalmol. 2016;100:1646–50. Scholar
  21. 21.
    Izumi T, Koizumi H, Maruko I, Takahashi Y, Sonoda S, Sakamoto T, et al. Structural analyses of choroid after half-dose verteporfin photodynamic therapy for central serous chorioretinopathy. Br J Ophthalmol. 2016. Scholar
  22. 22.
    Kinoshita T, Mitamura Y, Mori T, Akaiwa K, Semba K, Egawa M, et al. Changes in choroidal structures in eyes with chronic central serous chorioretinopathy after half-dose photodynamic therapy. Changes in choroidal structures in eyes with chronic central serous chorioretinopathy after half-dose photodynamic therapy. PLoS One. 2016;11(9):e0163104. Scholar
  23. 23.
    Nishi T, Ueda T, Mizusawa Y, Shinomiya K, Semba K, Mitamura Y, et al. Choroidal structure in children with anisohypermetropic amblyopia determined by binarization of optical coherence tomographic images. PLoS One. 2016;11(10):e0164672. Scholar
  24. 24.
    Kawano H, Sonoda S, Saito S, Terasaki H, Sakamoto T. Choroidal structure altered by degeneration of retina in eyes with retinitis pigmentosa. Retina. 2017;37:2175–82. Scholar
  25. 25.
    Kinoshita T, Mori J, Okuda N, Imaizumi H, Iwasaki M, Shimizu M, et al. Effects of Exercise on the Structure and Circulation of Choroid in Normal Eyes. PLoS One. 2016;11:e0168336. Scholar
  26. 26.
    Daizumoto E, Mitamura Y, Sano H, Akaiwa K, Niki M, Yamanaka C, et al. Changes of choroidal structure after intravitreal aflibercept therapy for polypoidal choroidal vasculopathy. Br J Ophthalmol. 2017;101(1):56–61. Scholar
  27. 27.
    Yamashita T, Yamashita T, Shirasawa M, Arimura N, Terasaki H, Sakamoto T. Repeatability and reproducibility of subfoveal choroidal thickness in normal eyes of japanese using different SD-OCT devices. Investig Ophthalmol Vis Sci. 2012;53:1102–7.CrossRefGoogle Scholar
  28. 28.
    Matsuo Y, Sakamoto T, Yamashita T, Tomita M, Shirasawa M, Terasaki H. Comparisons of choroidal thickness of normal eyes obtained by two different spectral-domain OCT instruments and one swept-source OCT instrument. Investig Ophthalmol Vis Sci. 2013;54:7630–6.CrossRefGoogle Scholar

Copyright information

© Japanese Ophthalmological Society 2017

Authors and Affiliations

  • Shozo Sonoda
    • 1
  • Taiji Sakamoto
    • 1
    Email author
  • Naoko Kakiuchi
    • 1
  • Hideki Shiihara
    • 1
  • Tomonori Sakoguchi
    • 1
  • Masatoshi Tomita
    • 1
  • Takehiro Yamashita
    • 1
  • Eisuke Uchino
    • 1
  1. 1.Department of OphthalmologyKagoshima University Graduate School of Medical and Dental SciencesKagoshimaJapan

Personalised recommendations