Deep learning for interactive and automated inner retinal layer segmentation in OCT images of patients with retinitis pigmentosa using limited training data

Purpose: New therapeutic strategies such as optogenetics have created a need for accurate tracking of inner retina degeneration in Retinitis pigmentosa (RP) patients. We introduce two tailored deep learning models to segment the RNFL (retinal nerve fibre layer), GCIPL (ganglion cell inner plexiform layer), INL (inner nuclear layer), CFT (central foveal thickness) and RPE (retinal pigment epithelium) in RP: The first is based on a Segment Anything Model (SAM), the second on nnU-Net. To our knowledge, SAM has not yet been applied to retinal layers in OCT data. Methods: SD-OCT images of a retrospective cohort of 37 RP patients were included. Data for four training cycles were prepared semi-automatically in MATLAB, then assessed and corrected by three expert graders. 1,700 segmented B-Scans from two open datasets were used for pretraining. For post-processing, semantic retinal boundary detection was developed. The final models, OCT-SAM and nnU-Net, were trained on 228 annotated RP scans. Detected layer thicknesses were validated against manual segmentation at 90 random points in 30 OCT B-Scans. Finally, OCT-SAM was tested on three RP cases with retrospective, longitudinal OCT data. Results: nnU-Net achieved a precision, recall and F-1 score of 0.96 while OCT-SAM performance resulted in slightly lower values of 0.93, 0.8 and 0.85, respectively. OCT-SAM measurements had low bias and good agreement with manual annotations, confirming reliability. Conclusions: OCT-SAM enabled fast data annotation and tool integration, whereas nnU-Net provided the best segmentation performance. OCT-SAM demonstrated longitudinal reproducibility and detected RP-characteristic pathologies and degenerative changes. Future work will extend OCT-SAM to 3D OCT segmentation.