Disclosed are methods and systems for measuring areas of nonperfusion in the retina using OCT imaging. The disclosed methods and systems allow for the automated segmentation and quantification of avascular areas of the retina utilizing information obtained from both structural OCT and OCT angiography (OCTA) data. The disclosed methods include filtering approaches which enhance vessel structure while suppressing noise, dynamic thresholding approaches to mitigate the detrimental effects of within-scan variability and low scan quality, and distance transform-based approaches to improve detection of ischemic regions. When combined with methods such as projection-resolved OCTA, the sensitivity to detect nonperfusion within different plexuses of the inner retina is demonstrated. In the clinical setting of diabetic retinopathy, the disclosed methods and systems show high sensitivity and specificity to detect the mild non-proliferative form of the disease with high reproducibility.
