SLOctolyzer: Fully Automatic Analysis Toolkit for Segmentation and Feature Extracting in Scanning Laser Ophthalmoscopy Images.

Purpose: The purpose of this study was to introduce SLOctolyzer: an open-source analysis toolkit for en face retinal vessels in infrared reflectance scanning laser ophthalmoscopy (SLO) images. Methods: SLOctolyzer includes two main modules: segmentation and measurement. The segmentation module uses deep learning methods to delineate retinal anatomy, and detects the fovea and optic disc, whereas the measurement module quantifies the complexity, density, tortuosity, and caliber of the segmented retinal vessels. We evaluated the segmentation module using unseen data and measured its reproducibility. Results: SLOctolyzer's segmentation module performed well against unseen internal test data (Dice for all-vessels = 0.91; arteries = 0.84; veins = 0.85; optic disc = 0.94; and fovea = 0.88). External validation against severe retinal pathology showed decreased performance (Dice for arteries = 0.72; veins = 0.75; and optic disc = 0.90). SLOctolyzer had good reproducibility (mean difference for fractal dimension = -0.001; density = -0.0003; caliber = -0.32 microns; and tortuosity density = 0.001). SLOctolyzer can process a 768 × 768 pixel macula-centered SLO image in under 20 seconds and a disc-centered SLO image in under 30 seconds using a laptop CPU. Conclusions: To our knowledge, SLOctolyzer is the first open-source tool to convert raw SLO images into reproducible and clinically meaningful retinal vascular parameters. It requires no specialist knowledge or proprietary software, and allows manual correction of segmentations and re-computing of vascular metrics. SLOctolyzer is freely available at https://github.com/jaburke166/SLOctolyzer. Translational Relevance: SLO images are captured simultaneous to optical coherence tomography (OCT), and we believe SLOctolyzer will be useful for extracting retinal vascular measurements from large OCT image sets and linking them to ocular or systemic diseases.