A Framework for the Discovery of Retinal Biomarkers in Optical Coherence Tomography Angiography (OCTA)

Recent studies have demonstrated the potential of OCTA retinal imaging for the discovery of biomarkers of vascular disease of the eye and other organs. Furthermore, advances in deep learning have made it possible to train algorithms for the automated detection of such biomarkers. However, two key limitations of this approach are the need for large numbers of labeled images to train the algorithms, which are often not met by the typical single-centre prospective studies in the literature, and the lack of interpretability of the features learned during training. In the current study, we developed a network analysis framework to characterise retinal vasculature where geometric and topological information are exploited to increase the performance of classifiers trained on tens of OCTA images. We demonstrate our approach in two different diseases with a retinal vascular footprint: diabetic retinopathy (DR) and chronic kidney disease (CKD). Our approach enables the discovery of previously unreported retinal vascular morphological differences in DR and CKD, and demonstrate the potential of OCTA for automated disease assessment.