Segmentation-Based Measurement of Orbital Structures: Achievements in Eyeball Volume Estimation and Barriers in Optic Nerve Analysis

Background/Objective: Orbital diseases often require precise measurements of eyeball volume, optic nerve sheath diameter (ONSD), and apex-to-eyeball distance (AED) for accurate diagnosis and treatment planning. This study aims to automate and optimize these measurements using advanced deep learning segmentation techniques on orbital Computed Tomography (CT) scans. Methods: Orbital CT datasets from individuals of various age groups and genders were used, with annotated masks for the eyeball and optic nerve. A 2D attention U-Net architecture was employed for segmentation, enhanced with slice-level information embeddings to improve contextual understanding. After segmentation, the relevant metrics were calculated from the segmented structures and evaluated for clinical applicability. Results: The segmentation model demonstrated varying performance across orbital structures, achieving a Dice score of 0.8466 for the eyeball and 0.6387 for the optic nerve. Consequently, eyeball-related metrics, such as eyeball volume, exhibited high accuracy, with a root mean square error (RMSE) of 1.28–1.90 cm³ and a mean absolute percentage error (MAPE) of 12–21% across different genders and age groups. In contrast, the lower accuracy of optic nerve segmentation led to less reliable measurements of optic nerve sheath diameter (ONSD) and apex-to-eyeball distance (AED). Additionally, the study analyzed the automatically calculated measurements from various perspectives, revealing key insights and areas for improvement. Conclusions: Despite these challenges, the study highlights the potential of deep learning-based segmentation to automate the assessment of ocular structures, particularly in measuring eyeball volume, while leaving room for further improvement in optic nerve analysis.