Significance: Speckle has historically been considered a source of noise in coherent light imaging. However, a number of works in optical coherence tomography (OCT) imaging have shown that speckle patterns may contain relevant information regarding subresolution and structural properties of the tissues from which it is originated.

Aim: The objective of this work is to provide a comprehensive overview of the methods developed for retrieving speckle information in biomedical OCT applications.

Approach: PubMed and Scopus databases were used to perform a systematic review on studies published until December 9, 2021. From 146 screened studies, 40 were eligible for this review.

Results: The studies were clustered according to the nature of their analysis, namely static or dynamic, and all features were described and analyzed. The results show that features retrieved from speckle can be used successfully in different applications, such as classification and segmentation. However, the results also show that speckle analysis is highly application-dependant, and the best approach varies between applications.

Conclusions: Several of the reviewed analyses were only performed in a theoretical context or using phantoms, showing that signal-carrying speckle analysis in OCT imaging is still in its early stage, and further work is needed to validate its applicability and reproducibility in a clinical context.