{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:13:48Z","timestamp":1786122828277,"version":"build-2736575974"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"Abstract<\/jats:title>\n \n Purpose:<\/jats:title>\n To compare choroidal vascular index (CVI) measurements obtained using manual ImageJ-based Niblack thresholding and protocol-standardized Otsu thresholding in patients with pachychoroid pigment epitheliopathy (PPE), employing a full-length choroidal region of interest (ROI) approach.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n This retrospective observational study included 30 eyes of 30 patients diagnosed with PPE. Enhanced depth imaging\u2013optical coherence tomography (EDI-OCT) scans were acquired using Heidelberg Spectralis. Both horizontal and vertical fovea-centered B-scans were analyzed. The ROI was manually delineated on the OCT device using the polygon selection tool to include the entire visible choroid from the retinal pigment epithelium\/Bruch\u2019s membrane complex to the choroidoscleral junction across the full scan width. CVI was calculated as the ratio of luminal area-to-total choroidal area. Manual ImageJ-based Niblack local thresholding was compared with protocol-standardized Otsu global thresholding using identical manually defined ROIs. Agreement was evaluated using paired\n t<\/jats:italic>\n -tests, Pearson correlation, intraclass correlation coefficient (ICC), and Bland\u2013Altman analysis.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n A total of 60 OCT B-scans were analyzed. Mean CVI values were 0.615 \u00b1 0.030 for ImageJ-Niblack and 0.626 \u00b1 0.052 for Otsu thresholding. The mean intermethod difference was +0.011 \u00b1 0.028, with no statistically significant difference between methods (\n P<\/jats:italic>\n = 0.085). A strong linear association was observed (\n r<\/jats:italic>\n = 0.90,\n P<\/jats:italic>\n < 0.001), and ICC (2,1) demonstrated good agreement (0.76). Bland\u2013Altman analysis showed a small mean bias (+0.012) with 95% limits of agreement from \u22120.049 to +0.073. Because no external reference standard or prespecified clinical equivalence margin was available, the findings support methodological consistency rather than interchangeability or accuracy equivalence.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Protocol-standardized Otsu thresholding yielded CVI measurements that were directionally consistent with manual ImageJ-based Niblack analysis in PPE when a full-length choroidal ROI strategy was applied. This approach may support standardized group-level research analyses, but it should not be interpreted as establishing accuracy equivalence or full clinical interchangeability.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/joco.joco_25_26","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T14:41:15Z","timestamp":1786027275000},"page":"55-60","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Choroidal Vascular Index Measurements in Pachychoroid Pigment Epitheliopathy using Manual ImageJ-Based Niblack and Protocol-Standardized Otsu Thresholding"],"prefix":"10.4103","volume":"38","author":[{"given":"Do\u011fukan","family":"C\u00f6merter","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Sultan Abd\u00fclhamid Han Training and Research Hospital, University of Health Sciences, Istanbul, 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