Flex center method versus center method for endothelial corneal evaluation in eye banking. A comparative analysis

Villalba, Rafael; Jiménez, Alfons; Fornés, G.; Eisman, M.; Villagrán, J. L. Gómez

doi:10.1007/s10561-014-9434-0

Cited by 8 publications

(1 citation statement)

References 14 publications

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“… 20 They suggested the Flex-Center Method is good for assessing corneas with high endothelial cell loss over time, such as transplanted corneas. Villalba et al, 21 used Flex-Center Method versus Center Method for endothelial corneal evaluation in eye banking. In the 67 corneas they studied, they found there were differences in NUM values between the Center and Flex-Center Methods.…”

Section: Discussionmentioning

confidence: 99%

Comparison of manual & automated analysis methods for corneal endothelial cell density measurements by specular microscopy

Huang

Maram

Tepelus

et al. 2018

Journal of Optometry

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PurposeTo determine the reliability of corneal endothelial cell density (ECD) obtained by automated specular microscopy versus that of validated manual methods and factors that predict such reliability.MethodsSharp central images from 94 control and 106 glaucomatous eyes were captured with Konan specular microscope NSP-9900. All images were analyzed by trained graders using Konan CellChek Software, employing the fully- and semi-automated methods as well as Center Method. Images with low cell count (input cells number <100) and/or guttata were compared with the Center and Flex-Center Methods. ECDs were compared and absolute error was used to assess variation. The effect on ECD of age, cell count, cell size, and cell size variation was evaluated.ResultsNo significant difference was observed between the Center and Flex-Center Methods in corneas with guttata (p = 0.48) or low ECD (p = 0.11). No difference (p = 0.32) was observed in ECD of normal controls <40 yrs old between the fully-automated method and manual Center Method. However, in older controls and glaucomatous eyes, ECD was overestimated by the fully-automated method (p = 0.034) and semi-automated method (p = 0.025) as compared to manual method.ConclusionOur findings show that automated analysis significantly overestimates ECD in the eyes with high polymegathism and/or large cell size, compared to the manual method. Therefore, we discourage reliance upon the fully-automated method alone to perform specular microscopy analysis, particularly if an accurate ECD value is imperative.

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Section: Discussionmentioning

confidence: 99%

Comparison of manual & automated analysis methods for corneal endothelial cell density measurements by specular microscopy

Huang

Maram

Tepelus

et al. 2018

Journal of Optometry

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An automatic approach for cell detection and segmentation of corneal endothelium in specular microscope

Karmakar

Nooshabadi

Eghrari

2021

Graefes Arch Clin Exp Ophthalmol

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Morphometry of organ cultured corneal endothelium using Voronoi segmentation

Brookes

2017

Cell Tissue Bank

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The endothelial viability of eye-banked corneas must be assessed before transplantation, yet phase-contrast images of the endothelium of corneas stored in an Organ Culture system have a huge variety of endothelial appearance at different focal planes, due to stromal swelling and an evaluation technique that swells the cells and their intercellular spaces to make them visible. This makes them difficult to assess using common edge-based segmentation methodologies that have mostly been developed in vivo using specular microscopy. Additionally, as the endothelial cell architecture has radically different form at apical and basal poles, segmentation of only the apical view cannot describe the cell as a whole. Using custom software, this study instead defines the cell borders using a calibrated Voronoi diagram, a region-based image segmentation technique that uses a point cloud of cell centroids as the only input required to measure the size (polymegathism) and shape (pleomorphism) of the endothelial cells. Measurements included the range and variation in the cell area and density, the number of cell sides, and several novel shape descriptors. A dataset of endothelial cell measurements was compiled from 2000 images of 678 corneas comprising 354,998 cells, and validated by comparison to previous studies from a variety of tissue sources, imaging modalities, and analysis techniques. While there were some differences in cell size variation and pleomorphic composition than seen in some other studies, much of the data was directly comparable, demonstrating fast and accurate endothelial cell morphometry at a large scale for a wide range of routine organ cultured corneas.

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Flex center method versus center method for endothelial corneal evaluation in eye banking. A comparative analysis

Cited by 8 publications

References 14 publications

Comparison of manual & automated analysis methods for corneal endothelial cell density measurements by specular microscopy

Comparison of manual & automated analysis methods for corneal endothelial cell density measurements by specular microscopy

An automatic approach for cell detection and segmentation of corneal endothelium in specular microscope

Morphometry of organ cultured corneal endothelium using Voronoi segmentation

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