AS et al (2018) A fully automated cell segmentation and morphometric parameter system for quantifying corneal endothelial cell morphology. Computer Methods and Programs in Biomedicine. 160: 11-23. Rights
Endothelial dysfunction and damage underlie cerebrovascular disease and ischemic stroke. We undertook corneal confocal microscopy (CCM) to quantify corneal endothelial cell and nerve morphology in 146 patients with an acute ischemic stroke and 18 age-matched healthy control participants. Corneal endothelial cell density was lower (P < 0.001) and endothelial cell area (P < 0.001) and perimeter (P < 0.001) were higher, whilst corneal nerve fibre density (P < 0.001), corneal nerve branch density (P < 0.001) and corneal nerve fibre length (P = 0.001) were lower in patients with acute ischemic stroke compared to controls. Corneal endothelial cell density, cell area and cell perimeter correlated with corneal nerve fiber density (P = 0.033, P = 0.014, P = 0.011) and length (P = 0.017, P = 0.013, P = 0.008), respectively. Multiple linear regression analysis showed a significant independent association between corneal endothelial cell density, area and perimeter with acute ischemic stroke and triglycerides. CCM is a rapid non-invasive ophthalmic imaging technique, which could be used to identify patients at risk of acute ischemic stroke.
A confocal microscope provides a sequence of images of the corneal layers and structures at different depths from which medical clinicians can extract clinical information on the state of health of the patient's cornea. Hybrid model based on snake and particle swarm optimisation (S-PSO) is proposed in this paper to analyse the confocal endothelium images. The proposed system is able to pre-process (quality enhancement, noise reduction), detect the cells, measure the cell density and identify abnormalities in the analysed data sets. Three normal corneal data sets acquired using confocal microscope, and two abnormal endothelium images associated with diseases have been investigated in the proposed system. Promising results are achieved and the performance of this system are compared with the performance of two morphological based approaches. The developed system can be deployed as clinical tool to underpin the expertise of ophthalmologists in analysing confocal corneal images.
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