Retinal Vascular Fractal Dimension Measurement and Its Influence from Imaging Variation: Results of Two Segmentation Methods

Aim: To assess the influences of imaging variation (different photographic angle) on the measurement of retinal vascular fractal dimension (Df), using two segmentation methods. Materials and methods: Nonlinear orthogonal projection segmentation (International Retinal Imaging Software-Fractal, termed IRIS-Fractal) and curvature-based segmentation (Singapore Institute Vessel Assessment-Fractal, termed SIVA-Fractal) methods were used to measure Df and were assessed for their reproducibility in detecting retinal vessels of 30 stereoscopic pairs of optic disc color images. Each pair was taken from the same eye with slightly different angles of incidence. Each photograph of the pairs had subtle variations in brightness between areas temporal and nasal to the optic disc. Results: Intragrader reproducibility of Df measurement was similar (intraclass correlation 0.81 and 0.96, respectively) for IRIS-Fractal and SIVA-Fractal. Within-image pair Pearson’s correlation coefficients (r) of Df measurements were moderate for both methods (0.57 and 0.48, respectively). Conclusions: Both nonlinear orthogonal projection and curvature-based retinal vessel segmentation methods were found to be sensitive to variations in image brightness, resulting from iris shadowing associated with different angle of photographic incidence.