| Reproducibility of OCT Radiomics after Cataract Surgery: Effects of Media Opacity, Signal strength, and ROI selection |
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Na Hee Kim, Hyeong Min Kim, Hyewon Chung, Hyungwoo Lee |
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Department of Ophthalmology, Konkuk University College of Medicine, Konkuk University Medical Center, Seoul, Republic of Korea |
Correspondence:
Hyungwoo Lee, Tel: 82-2-2030-8198, Fax: 82-2-2030-5273,
Email: hwlee@kuh.ac.kr
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Received: 19 October 2025 • Revised: 30 December 2025 • Accepted: 10 February 2026 |
| Abstract |
Purpose
To determine how cataract-related image-quality improvement and region of interest (ROI) definition affect the reproducibility of optical coherence tomography (OCT) radiomics features.
Methods
This retrospective study included 50 eyes from 46 patients who underwent cataract surgery. Preoperative and postoperative OCT images were acquired using a standardized protocol. Radiomics features (n=93) were extracted from two ROI configurations: Retina ROI (Rr; retina only) and Full ROI (Rf; retina, choroid, vitreous). Pre- versus postoperative differences were tested with the Wilcoxon signed-rank test and Cohen’s d; repeatability was assessed with the intraclass correlation coefficient (ICC). Agreement between ROIs was evaluated with Wilcoxon statistics, Spearman correlation, the concordance correlation coefficient (CCC) and Bland–Altman plots. The influence of signal strength was analyzed with paired t-tests and Spearman correlation.
Results
Postoperative signal strength significantly improved from 28.24 ± 3.16 to 31.40 ± 3.06 dB (p < 0.001). Significant pre-/postoperative changes occurred in 49/93 features (52.7 %) within Rr and in 81/93 (87.1 %) within Rf. ICC showed good-to-excellent repeatability in 51.6 % of Rr features and 87.1 % of Rf features, yet 29.0 % of Rr features still demonstrated poor reliability. Across ROI methods, 94.6% of feature pairs differed significantly between Rr and Rf, and no feature achieved CCC > 0.85. Only two descriptors—FOS 10 Percentile and GLDM Gray Level Variance—showed no significant change with surgery and minimal dependence on signal strength.
Conclusions
Radiomics features in OCT respond variably to media opacity, signal-to-noise ratio, and ROI definition: most are susceptible to these factors, yet a small subset remains stable across them. Limiting analysis to an anatomically precise retina-bounded ROI and enrolling eyes with comparable cataract status and signal-strength scores may therefore improve reproducibility. Implementing these standardizations will help future OCT-radiomics studies identify the most reliable biomarkers for clinical use. |
| Key Words:
Radiomics; Optical coherence tomography; Cataract; Signal strength; Reproducibility |
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