Efficient and high accuracy 3-D OCT angiography motion correction in pathology

We propose a novel method for non-rigid 3-D motion correction of orthogonally raster-scanned optical coherence tomography angiography volumes. This is the first approach that aligns predominantly axial structural features like retinal layers and transverse angiographic vascular features in a joint optimization. Combined with the use of orthogonal scans and favorization of kinematically more plausible displacements, the approach allows subpixel alignment and micrometer-scale distortion correction in all 3 dimensions. As no specific structures or layers are segmented, the approach is by design robust to pathologic changes. It is furthermore designed for highly parallel implementation and brief runtime, allowing its integration in clinical routine even for high density or wide-field scans. We evaluated the algorithm with metrics related to clinically relevant features in a large-scale quantitative evaluation based on 204 volumetric scans of 17 subjects including both a wide range of pathologies and healthy controls. Using this method, we achieve state-of-the-art axial performance and show significant advances in both transverse co-alignment and distortion correction, especially in the pathologic subgroup.