Rapid Image Evaluation System for Corneal In Vivo Confocal Microscopy

Sindt, Christine W.; Laÿ, Bruno; Bouchard, Helene; Kern, Jami

doi:10.1097/ico.0b013e31825ab9e2

Cited by 17 publications

(18 citation statements)

References 26 publications

(26 reference statements)

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“…Automated measurement of cellular structures for IVCM images, particularly for subbasal nerves, is an active area of the investigation, and recent studies have shown promising results for using such programs for future research. [40][41][42][43] In conclusion, our study demonstrates that the average values obtained from three representative standard IVCM images for the subbasal nerve and DC densities are comparable to those from the wide-field mapped composite images. Therefore, these standard images can be used in clinical studies to accurately measure cellular structures in the subbasal layer.…”

Section: Discussionsupporting

confidence: 49%

Comparison of Standard Versus Wide-Field Composite Images of the Corneal Subbasal Layer by In Vivo Confocal Microscopy

Kheirkhah

Müller

Mikolajczak

et al. 2015

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To evaluate whether the densities of corneal subbasal nerves and epithelial immune dendritiform cells (DCs) are comparable between a set of three representative standard images of in vivo confocal microscopy (IVCM) and the wide-field mapped composite IVCM images.METHODS. This prospective, cross-sectional, and masked study included 110 eyes of 58 patients seen in a neurology clinic who underwent laser-scanning IVCM (Heidelberg Retina Tomograph 3) of the central cornea. Densities of subbasal corneal nerves and DCs were compared between the average of three representative standard images and the wide-field mapped composite images, which were reconstructed by automated mapping.RESULTS. There were no statistically significant differences between the average of three representative standard images (0.16 mm 2 each) and the wide-field composite images (1.29 6 0.64 mm 2 ) in terms of mean subbasal nerve density (17.10 6 6.10 vs. 17.17 6 5.60 mm/mm 2 , respectively, P ¼ 0.87) and mean subbasal DC density (53.2 6 67.8 vs. 49.0 6 54.3 cells/mm 2 , respectively, P ¼ 0.43). However, there were notable differences in subbasal nerve and DC densities between these two methods in eyes with very low nerve density or very high DC density.CONCLUSIONS. There are no significant differences in the mean subbasal nerve and DC densities between the average values of three representative standard IVCM images and wide-field mapped composite images. Therefore, these standard images can be used in clinical studies to accurately measure cellular structures in the subbasal layer.

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Section: Discussionsupporting

confidence: 49%

Comparison of Standard Versus Wide-Field Composite Images of the Corneal Subbasal Layer by In Vivo Confocal Microscopy

Kheirkhah

Müller

Mikolajczak

et al. 2015

Invest. Ophthalmol. Vis. Sci.

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“…Research groups have developed automated algorithms for analyzing the subbasal nerve plexus by IVCM, 96–100 but, to date, there is no commercially available software for automated analysis of IVCM images. Scarpa et al 101 first devised a method for automatically tracing corneal nerves of confocal microscopy images, showing that automatic nerve length estimations were very well correlated to manual quantification.…”

Section: Assessment Of the Subbasal Corneal Nerve Plexusmentioning

confidence: 99%

In Vivo Confocal Microscopy of Corneal Nerves in Health and Disease

2017

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In vivo confocal microscopy (IVCM) is becoming an indispensable tool for studying corneal physiology and disease. Enabling the dissection of corneal architecture at a cellular level, this technique offers fast and noninvasive in vivo imaging of the cornea with images comparable to that of ex vivo histochemical techniques. Corneal nerves bear substantial relevance to clinicians and scientists alike, given their pivotal roles in regulation of corneal sensation, maintenance of epithelial integrity, and proliferation and promotion of wound healing. Thus, IVCM offers a unique method to study corneal nerve alterations in a myriad of conditions, such as ocular and systemic diseases and following corneal surgery, without altering the tissue microenvironment. Of particular interest has been the correlation of corneal subbasal nerves to their function, which has been studied in normal eyes, contact lens wearers, and patients with keratoconus, infectious keratitis, corneal dystrophies, and neurotrophic keratopathy. Longitudinal studies have applied IVCM to investigate the effects of corneal surgery on nerves, demonstrating their regenerative capacity. IVCM is increasingly important in the diagnosis and management of systemic conditions such as peripheral diabetic neuropathy and, more recently, in ocular diseases. In this review, we outline the principles and applications of IVCM in the study of corneal nerves in various ocular and systemic diseases.

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“…Previous studies aimed at automatic fibre detection in CCM images include Scarpa et al [18] who described a method for tracing nerve fibres based on automatically initialised seed points, and Holmes et al [19]who identified fibres based on ridge points. Sindt et al [20] detected several types of objects visible in CCM images, including dendritic immune cells and wing cells in addition to nerve fibres. Dabbah et al [21] presented a method of fibre detection based on a multi-scale Gabor filter with responses trained using a neural network.…”

Section: Introductionmentioning

confidence: 99%

An Automatic Tool for Quantification of Nerve Fibers in Corneal Confocal Microscopy Images

Chen

Graham

Dabbah³

et al. 2017

IEEE Trans. Biomed. Eng.

136

116

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Objective We describe and evaluate an automated software tool for nerve fibre detection and quantification in corneal confocal microscopy (CCM) images, combining sensitive nerve-fibre detection with morphological descriptors. Method We have evaluated the tool for quantification of Diabetic Sensorimotor Polyneuropathy (DSPN) using both new and previously published morphological features. The evaluation used 888 images from 176 subjects (84 controls and 92 patients with Type 1 diabetes). The patient group was further subdivided into those with (n=63) and without (n=29) DSPN. Results We achieve improved nerve-fibre detection over previous results (91.7% sensitivity and specificity in identifying nerve-fibre pixels). Automatic quantification of nerve morphology shows a high correlation with previously reported, manually measured, features. ROC analysis of both manual and automatic measurement regimes resulted in similar results in distinguishing patients with DSPN from those without: AUC of about 0.77 and 72% sensitivity-specificity at the equal error rate point. Conclusion Automated quantification of corneal nerves in CCM images provides a sensitive tool for identification of DSPN. Its performance is equivalent to manual quantification, while improving speed and repeatability. Significance Corneal confocal microscopy is a novel in-vivo imaging modality that has the potential to be a non-invasive and objective image biomarker for peripheral neuropathy. Automatic quantification of nerve morphology is a major step forward in the early diagnosis and assessment of progression, and, in particular, for use in clinical trials to establish therapeutic benefit in diabetic and other peripheral neuropathies.

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Rapid Image Evaluation System for Corneal In Vivo Confocal Microscopy

Abstract: The software rapidly and accurately analyzed the in vivo confocal micrographs of the healthy central corneas, yielding quantitative results to describe the nerves, dendritic immune cells, and wing cells.

Cited by 17 publications

References 26 publications

Comparison of Standard Versus Wide-Field Composite Images of the Corneal Subbasal Layer by In Vivo Confocal Microscopy

Comparison of Standard Versus Wide-Field Composite Images of the Corneal Subbasal Layer by In Vivo Confocal Microscopy

In Vivo Confocal Microscopy of Corneal Nerves in Health and Disease

An Automatic Tool for Quantification of Nerve Fibers in Corneal Confocal Microscopy Images

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